tbuckley/cabot-search huggingface dataset:
Cesarean Delivery on Maternal Request
Authors: Marco D. Huesch, Jason N. Doctor
Journal: JAMA (2013)

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
A Simple Audio-Calibrated Stethoscope
Authors: Norman S. Blackman
Journal: JAMA (1964)

ONE OF THE characteristics which often helps to distinguish organic from innocent heart murmurs is the loudness (intensity) of the murmur. It is therefore of great clinical importance to determine the intensity of a murmur with accuracy. In 1933, Freeman and Levine<sup>1</sup>devised a scheme by which the intensity of murmurs could be subjectively graded. A grade 1 murmur was considered to be the faintest murmur that could be distinctly heard, generally after a few seconds of concentrated auscultation. A grade 2 murmur was considered a slight murmur that was immediately apparent. A grade 5 murmur was the loudest murmur that was still inaudible when the stethoscope was removed from the chest, and a grade 6 murmur was described as an extremely loud murmur which could even be heard when the stethoscope was just removed from the chest wall. Grade 3 and grade 4 murmurs were "intermediate murmurs." Obviously,
US to test system for collecting patients' reports of healthcare safety events
Authors: B. Roehr
Journal: BMJ (2012)

A prototype system of direct consumer reporting of patient safety events will be evaluated next summer, according to plans by the US Agency for Healthcare Research and Quality (AHRQ).

Most existing reporting systems do not include or solicit reports from patients and their families. AHRQ believes that “the unique perspective of healthcare consumers could reveal important information that is not reported by healthcare providers,” it says in the Federal Register .1

“Patient …
Optimal Palliation of Malignant Bile Duct Obstruction: Experience with Endoscopic 12 French Prostheses
Authors: J. H. Siegel, W. Pullano, B. Kodsi, A. Cooperman, W. Ramsey
Journal: Endoscopy (1988)

Large-caliber prostheses, 11.5-12 French, were placed in 167 patients (183 attempts, 91 % success) presenting with obstructive jaundice. Thirty-three patients had additional prostheses placed to selectively decompress intrahepatic ducts obstructed by cholangiocarcinoma. In this prospective unrandomized series, there were 43 lesions of the common hepatic duct, 123 of the common bile duct (96 pancreas. 27 cholangiocarcinoma) and 17 ampullary. Transient fever responding to parenteral antibiotics occurred in 11 patients who did not receive prophylaxis, whereas only 2 patients who received antibiotics prior to the procedure developed fever subsequently. Four patients bled subsequent to sphincterotomy, 1 requiring a 2-unit transfusion. Pancreatitis occurred in only 1 patient. The mean hospital stay was only 3 days, range 1-10 days, with most patients being discharged within 48 hours. No procedural deaths occurred. The patency rate of this new, larger 12 Fr. prosthesis is significantly longer than that for the 10 Fr. stent, 190 days for 12 Fr., 150 days for 10 Fr. Given the advantages of the larger prosthesis, i. e., increased patency and function and decreased rehospitalization rate, the authors recommend this method of palliation for obstructive jaundice.
My Dear Colleague: Are You Considering Suicide?
Authors: Douglas A. Sargent
Journal: JAMA (1986)

To the Editor.—  Dr Victoroff's 1 moving appeal to a suicidal physician is timely and deeply appreciated. In December, the Council on Scientific Affairs accepted the preliminary report of the American Medical Association/American Pyschiatric Association Physician Mortality Project, which will go to the House of Delegates in June. Many points raised by Dr Victoroff reflect our initial sketch of the suicide-prone physician developed from our pilot study of physician suicide. 2 Except for the error about the rate of reported physician suicides (which is actually 30/100,000, exactly the same as that for persons of similar age and socioeconomic circumstances), Dr Victoroff's figures, too, ring true. It is a heartfelt appeal and was well worth reading.  However, I have a few quibbles. Dr Victoroff's appeal is to reason, and suicide is almost always an emotional, irrational act. The family, friends, and colleagues of the potential victim, who notice the aberrations Dr
Encounters With Qi: Exploring Chinese Medicine
Authors: Steven H. Fox
Journal: JAMA (1987)

In the fall and winter of 1979-1980, David Eisenberg and I were fellow inmates at a medium-security institution on the outskirts of Peking—the language school, which served as a halfway house for foreign students awaiting release into Chinese academia at large. Among those privileged "prisoners of peace" in that initial cautious period, we were the first admitted from the United States to study medicine in China. Eisenberg was at that time between the third and fourth years of medical school. In the spring semester, he moved to the Beijing Institute of Traditional Chinese Medicine. His book explores traditional Chinese medicine in much the way he did, through a succession of enthralling encounters with tutors explaining yin and yang, diagnosticians examining tongues and pulses, practitioners prescribing herbs and acupuncture, and, eventually, masters of<i>qi gong</i>performing feats of parapsychological derringdo. Anecdotes from events in and out of the classroom portray the
Abstract P5-01-11: ‘Same-day diagnosis’ of women suspected of breast cancer: success rate and impact on diagnostic quality and patients' anxiety levels
Authors: MW Barentsz, H Wessels, PJ van Diest, RM Pijnappel, CC van der Pol, AJ Witkamp, MA van den Bosch, HM Verkooijen
Journal: Cancer Research (2012)

Abstract Introduction: Uncertainty about a breast cancer diagnosis is a stressful event. As such, many initiatives have been undertaken to reduce the time of uncertainty by providing ‘same-day diagnosis’ for patients suspected of breast cancer. However, only few studies have evaluated the feasibility of ‘same-day diagnosis’ diagnosis, while the impact of ‘same-day diagnosis’ on diagnostic accuracy and patient anxiety has hardly been studied at all. This study aims to evaluates feasibility, diagnostic accuracy and impact on patients' anxiety of ‘same-day diagnosis’ of patients suspected of breast cancer. Materials and Methods: In November 2011, the ‘same-day diagnosis’ system was implemented in our hospital. This system consists of completing the following items on the day of the first visit: 1. Clinical examination, imaging (mammography, ultrasound), and (if necessary) FNA or core needle biopsy2. High speed processing of biopsy specimens using Leica Peloris tissue processor3. Multidisciplinary evaluation of clinical, imaging and histological findings4. Communication of the final diagnosis and treatment plan to the patient All patients presenting for ‘same-day diagnosis’ are entered prospectively in a database. Feasibility of ‘same-day diagnosis’ is evaluated, and reasons for failure are scrutinized. Diagnostic quality of ‘same-day diagnosis’ is evaluated by linking all patients to PALGA (Dutch National Pathology Database) six months following the day of diagnosis, in order to identify false negative results (i.e. missed cancers) and false positive results (i.e. ‘cancers’ turned out to be benign during further work-up). Impact of ‘same-day diagnosis’ on patient anxiety is measured by the 4-item State Trait Anxiety Inventory, which is filled out by patients on several occasions on the day of diagnosis as well as during the first seven days following diagnosis. Results: Between November 2011 and May 2012, 266 women were eligible for ‘same-day diagnosis’. Fifty-eight patients (22%) were diagnosed with breast cancer. Overall, 80% of the patients received a final diagnosis within one day. For patients with cancer, this proportion was somewhat lower, i.e. 71%. Accuracy of ‘same-day diagnosis’ and impact on patients' anxiety are currently under study. Conclusion: ‘Same-day diagnosis’ is feasible for the far majority of patients suspected of breast cancer. Evaluation of implementation of ‘same-day diagnosis’ on diagnostic quality and impact on patient anxiety is crucial. Updated results will be presented in December 2012. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-01-11.
Asthma and climatic conditions: experience from Bermuda.
Authors: J G Ayres, G E Packe
Journal: BMJ (1986)

The 19 controls had non-malignant lung disease and, like the lung-cancer group, virtually all-were smokers (one exception); they were aged 47-82 (mean 66-2) and 12 were men.No patient was receivg steroids in any form or any other medica- tion which might be expected to affect plasma sex hormone binding globulin concentratons.The table shows the results with both methods of measuring sex hormone binding globulin.Clearly there was no evidence at all for increased concentrations of sex hormone binding globulin in patients with lung cancer; indeed, the mean values in the patients with cancer were lower, albeit not significantly so.This was not due to our control group having higher values than the controls from the authors' study: our values for men both with and without cancer were closely similar to the values in their control group.Mean (SEM) sex hormone bing globulin concentra- tionsin patients wvithig cancer and contrl mesed bd fwo mehods Patints with Controls lung cncer Iminwwradimes,y assay Men 47-1(7-5) 32-8(3-3) Women 51-3(7-5) 40 7(5-6)Bir capacty nehod Men 51-8(7-6) 41-2(5-1) Women 69 8(9-0) 56-4(8O0)
The Essential Role of the Anterior Pituitary in the Pathogenesis of Cushing's Disease.
Authors: N. P. Christy
Journal: Annals of Internal Medicine (1962)

s1 April 1962The Essential Role of the Anterior Pituitary in the Pathogenesis of Cushing's Disease.N. P. Christy, M.D., W. D. Drucker, M.D.N. P. Christy, M.D.Search for more papers by this author, W. D. Drucker, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-673_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAdrenocorticotropic activity is not demonstrable in normal human plasma by current methods, but maximal stimulation of pituitary ACTH release (adrenalectomy, Addison's disease) results in measurable levels. When similar assay methods are applied to the plasma of patients with Cushing's disease (bilateral adrenal cortical hyperplasia), they fail to demonstrate adrenocorticotropic activity until complete adrenalectomy is performed. In order to implicate an adrenocorticotropin in the pathogenesis of this disorder, demonstration of increased activity in the plasma of the untreated patient is essential. In 1957, Jailer and colleagues showed an abnormal adrenocorticotropin in patients with the untreated disease, but its nature and origin... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: N. P. Christy, M.D.; W. D. Drucker, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 673-673KeywordsAdrenalectomyAdrenocorticotropic hormoneBlood plasmaPathogenesis ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...
Extracts from the Eulogy upon Pinel
Authors: M. Pariset
Journal: American Journal of Psychiatry (1846)

The picture drawn of Lord Dudley's education has its counterpart in every day's experience.The folly of his teacher is that of the present system of education.The over wrought and over stimulated intellect, is literally nourished with.the blood of life.The brain is inordinately excited at the expense of every other part of the system, and life or permanent ill health is too often the penalty paid for 1)1k violation of nature's laws.
Effect of Pronethalol in Angina Pectoris
Authors: G. A. O. Alleyne, C. J. Dickinson, A. C. Dornhorst, R. M. Fulton, K. G. Green, I. D. Hill, P. Hurst, D. R. Laurence, T. Pilkington, B. N. C. Prichard, B. Robinson, M. L. Rosenheim
Journal: BMJ (1963)

The problem of assessing the numerous new drugs offered to clinicians is continuously increasing.It is not always possible, even if desirable, to mount a substantial and definitive therapeutic trial for each new drug in a single department.In these circumstances close observation of a few patients in several centres may provide data adequate to justify more general distribution of a new drug, with minimal diversion of workers from their other tasks.The animal pharmacology of a new adrenergic beta-receptor blocking agent.pronethalol, has been reported by Black and Stephenson (1962), and some aspects of the human pharmacology by Dornhorst and Robinson (1962).It was thought that pronethalol might prove to be beneficial in angina because its restraining effect on tachycardia should reduce the cardiac work, and thus decrease requirements of myocardial oxygen at any given level of exercise.
Predicting Breast Tumor Response to Neoadjuvant Chemotherapy with Diffuse Optical Spectroscopic Tomography prior to Treatment
Authors: Shudong Jiang, Brian W. Pogue, Peter A. Kaufman, Jiang Gui, Michael Jermyn, Tracy E. Frazee, Steven P. Poplack, Roberta DiFlorio-Alexander, Wendy A. Wells, Keith D. Paulsen
Journal: Clinical Cancer Research (2014)

Abstract Purpose: To determine whether pretreatment biomarkers obtained from diffuse optical spectroscopic tomographic (DOST) imaging predicts breast tumor response to neoadjuvant chemotherapy (NAC), which would have value to potentially eliminate delays in prescribing definitive local regional therapy that may occur from a standard complete 6- to 8-month course of NAC. Experimental Design: Nineteen patients undergoing NAC were imaged with DOST before, during, and after treatment. The DOST images of total hemoglobin concentration (HbT), tissue oxygen saturation (StO2), and water (H2O) fraction at different time points have been used for testing the abilities of differentiating patients having pathologic complete response (pCR) versus pathologic incomplete response (pIR). Results: Significant differences (P &amp;lt; 0.001, AUC = 1.0) were found between pCR patients versus pIR in outcome, based on the percentage change in tumor HbT within the first cycle of treatment. In addition, pretreatment tumor HbT (pretreatment HbT) relative to the contralateral breast was statistically significant (P = 0.01, AUC = 0.92) in differentiating pCR from pIR. Conclusions: This is the first clinical evidence that DOST HbT may differentiate the two groups with predictive significance based on data acquired before NAC even begins. The study also demonstrates the potential of accelerating the validation of optimal NAC regimens through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure. Clin Cancer Res; 20(23); 6006–15. ©2014 AACR.
Specific transgene expression in HIV-infected cells using protease-cleavable transcription regulator
Authors: Daisuke Asai, Masanori Kuramoto, Yoko Shoji, Jeong-Hun Kang, Kota Bae Kodama, Kenji Kawamura, Takeshi Mori, Hiroshi Miyoshi, Takuro Niidome, Hideki Nakashima, Yoshiki Katayama
Journal: Journal of Controlled Release (2009)
Contraction, relaxation, and economy of force generation in isolated human diaphragm muscle.
Authors: C Coirault, B Riou, M Bard, I Suard, Y Lecarpentier
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Contraction, relaxation, and energetics of normal human diaphragm strips (n = 10) were investigated over the whole load continuum in both twitch and tetanus modes. For a given level of isotonic total force and over a large part of the contraction phase, instantaneous velocity was shown to be a unique function of instantaneous length, regardless of time and initial length. In afterloaded tetanic contractions and over a wide range of loads, the peak lengthening velocity (VL) linearly decreased when maximum extent of muscle shortening (delta L) decreased. Stimulation mode modulated the VL versus delta L relationship, the slope of this linear regression being greater in tetanus than in twitch. Conversely, over a wide range of load, an increase in load linearly accelerated the peak rate of force decay, regardless of the stimulation mode. The energetics of human diaphragm muscle was evaluated in terms of both mechanical activity and economy of force generation. Maximum mechanical work (Wmax) differed significantly according to the stimulation mode, and the relative force at which Wmax occurred was higher in tetanus than in twitch (p < 0.05). The G curvature of the P-V hyperbola and maximum mechanical efficiency were significantly higher in tetanus than in twitch. This strongly suggests that the economy of force generation is higher in tetanus contractions than in twitch.
A Hemorrhagic Syndrome in Waldenström's Macroglobulinemia Secondary to Immunoadsorption of Factor VIII
Authors: Jerome I. Brody, Mary E. Haidar, Ronald E. Rossman
Journal: New England Journal of Medicine (1979)

THE purpose of this report is to describe a patient with Waldenstrom's macroglobulinemia and a hemorrhagic disorder secondary to immunoadsorption of factor VIII by peripheral blood lymphocytes and by lymphocytes in a markedly enlarged spleen. Factor VIII became normal after splenectomy. Case Report A 32-year-old man was admitted to the Hospital of the Medical College of Pennsylvania because of previous hemorrhoidal bleeding, spontaneous hematuria, hemorrhage after a tooth extraction, axillary lymphadenopathy, splenomegaly and mild anemia. Inpatient findings were retinal-vein segmentation, hepatomegaly, splenomegaly, with the tip of the spleen extending to the umbilicus, a hemoglobin of 8.9 g per deciliter, hematocrit . . .
Quantitative trait locus mapping of human blood pressure to a genetic region at or near the lipoprotein lipase gene locus on chromosome 8p22.
Authors: D A Wu, X Bu, C H Warden, D D Shen, C Y Jeng, W H Sheu, M M Fuh, T Katsuya, V J Dzau, G M Reaven, A J Lusis, J I Rotter, Y D Chen
Journal: Journal of Clinical Investigation (1996)

Resistance to insulin-mediated glucose disposal is a common finding in patients with non-insulin-dependent diabetes mellitus (NIDDM), as well as in nondiabetic individuals with hypertension. In an effort to identify the generic loci responsible for variations in blood pressure in individuals at increased risk of insulin resistance, we studied the distribution of blood pressure in 48 Taiwanese families with NIDDM and conducted quantitative sib-pair linkage analysis with candidate loci for insulin resistance, lipid metabolism, and blood pressure control. We found no evidence for linkage of the angiotensin converting enzyme locus on chromosome 17, nor the angiotensinogen and renin loci on chromosome 1, with either systolic or diastolic blood pressures. In contrast, we obtained significant evidence for linkage or systolic blood pressure, but not diastolic blood pressure, to a genetic region at or near the lipoprotein lipase (LPL) locus on the short arm of chromosome 8 (P = 0.002, n = 125 sib-pairs, for the haplotype generated from two simple sequence repeat markers within the LPL gene). Further strengthening this linkage observation, two flanking marker loci for LPL locus, D8S261 (9 cM telomeric to LPL locus) and D8S282 (3 cM centromeric to LPL locus), also showed evidence for linkage with systolic blood pressure (P = 0.02 and 0.0002 for D8S261 and D8S282, respectively). Two additional centromeric markers (D8S133, 5 cM from LPL locus, and NEFL, 11 cM from LPL locus) yielded significant P values of 0.01 and 0.001, respectively. Allelic variation around the LPL gene locus accounted for as much as 52-73% of the total interindividual variation in systolic blood pressure levels in this data set. Thus, we have identified a genetic locus at or near the LPL gene locus which contributes to the variation of systolic blood pressure levels in nondiabetic family members at high risk for insulin resistance and NIDDM.
CHILDREN’S HEALTH: Sex-Specific Cognitive Effects of Lead
Authors: Julia R. Barrett
Journal: Environmental Health Perspectives (2009)

In the United States, only coal-and oil-fired power plants must report.**Each country's PRTR differs in the types of activities required to report under this sector.Water supply, sewage treatment** (200) 6 % Transportation equipment mfg.(285) 3 % Oil and gas extraction (production)*** (137) 15 % Chemicals mfg.(451) 3 % Paper products mfg.(115) 2 % Primary metals mfg.(246) 6 % Petroleum products mfg.(40) 3 % Services/support activities: mining, quarrying, oil/gas extraction*** (50) 58 % Fabricated metals mfg.(282) 2 % Waste management and remediation services* (127) 2 % Electrical equipment mfg.(76) 10 % Plastics and rubber mfg.(57) 5 % Generation and distribution of electricity* (49) 10 % Mining and quarrying (except oil and gas)** (33) 69 % Transportation equipment mfg.(206) 3 % Chemicals mfg.(324) 3 % *Only hazardous waste/solvent recovery facilities must report.**Only coal-and oil-fired power plants must report.***Each country's PRTR differs
What to tell the employer.
Authors: J M Goldman
Journal: BMJ (1977)

biopsies are necessary if such a claim is to be made.The changes in subepidermal IgA deposition reported in the paper would thus provide a useful additional basis for the assessment of a patient's progress.However, one would need to know that the pattem of IgA deposition did not show spontaneous variation before changes occurring over a period of six months could be confidently accepted as evidence of improvement.In consequence we are not yet convinced that the changes represent "a more objective and sensitive index of improvement in the skin than the ability to reduce dapsone," though the need for such an index is undisputed.