tbuckley/cabot-search huggingface dataset:
Low level alcohol consumption and the fetus
Authors: Raja A S Mukherjee, S Hollins, Mohammed T Abou-Saleh, Jeremy Turk
Journal: BMJ (2005)

hospital clinicians working side by side with social scientists on simulated patient teaching, 10 and a feasibility study where students worked in a scenario based environment requiring them to communicate with a patient while conducting a procedure.Students perceived this to be a realistic and powerful learning experience. 11 Evidence from randomised controlled trials that interactive continuing medical education is effective in changing clinical performance positively 12 has stimulated the development of other models of integrated learning.These include the patient pathway tutorial, in which students have to perform a series of tasks that represent the temporal sequence of clinical and communication skills needed for management.For example, the tutorial for chronic obstructive pulmonary disease consists of stations in history taking, examination, discussion of differential diagnosis, writing the prescription, explaining treatment, reviewing the chest radiograph, sharing bad news, written clinical communication, and a discussion with colleagues and carers if appropriate.At the end of each task the learner is encouraged to reflect and then provided with feedback.Organising a cohesive faculty of teachers of communication skills as well as hospital clinicians in medical schools helps in developing a single integrated course for communication and clinical skills.Even in teaching something as skills based as resuscitation, encouragement to learn about effective communication with other team members may also help save lives.The scenario also gives students an opportunity to practise talking to patients and relatives, who report lasting impact from doctors' communication skills at a time of crisis.Learning side by side also implies that trainee professionals of different disciplines learn some team skills together so that interpersonal communication and role linkages become embedded.
Effect of intrajejunal acidity on lipid digestion and aqueous solubilisation of bile acids and lipids in health, using a new simple method of lipase inactivation.
Authors: P L Zentler-Munro, D R Fine, W J Fitzpatrick, T C Northfield
Journal: Gut (1984)

We have investigated whether acid-mediated bile acid precipitation, pancreatic enzyme inactivation, and fatty acid partitioning occur in health when intraluminal pH falls below 5. In order to assess lipolysis and aqueous solubilisation of lipid, we first developed a new technique for inactivating lipase in jejunal aspirate (acid inactivation), and showed it to be more effective and simpler than the established technique (heat inactivation). We then studied 14 healthy subjects, aspirating jejunal content for three hours after a liquid meal, and pooling according to pH. Eighteen per cent of the total aspirate was collected at pH less than 5 compared with 56% at pH greater than 6 (p less than 0.01). Forty eight per cent of the bile acids were precipitated at pH less than 5 compared with 18% at pH greater than 6 (p less than 0.01), leading to a reduction in aqueous phase bile acid concentration at low pH (2.1 mmol/l at pH less than 5 vs 5.8 mmol/l at pH greater than 6, p less than 0.01). Lipase activity was reduced at low pH (133 IU/l at pH less than 5 vs 182 IU/l at pH greater than 6, p less than 0.01), leading to reduced lipolysis at low pH (14% at pH less than 5 vs 32% at pH greater than 6, p less than 0.01). Aqueous phase lipid concentration was reduced at low pH (3.5 mmol/l at pH less than 5 vs 12.5 mmol/l at pH greater than 6, p less than 0.01). This reduction was less dependent on bile acid precipitation than on lipase inactivation and fatty acid partitioning. We conclude that intraluminal acidity influences aqueous solubilisation of bile acids and lipid in health.
Medication Nonadherence
Authors: Zachary A. Marcum, Mary Ann Sevick, Steven M. Handler
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
568. In Vitro SFHR-Mediated Modification of SMA Locus in Different Human Trophoblast Cells
Authors: Federica Sangiuolo, Antonio Filareto, Paola Spitalieri, Lucia Scaldaferri, Emanuela Bruscia, Ruggiero Mango, Citro Gennaro, Massimo De Felici, Giuseppe Novelli
Journal: Molecular Therapy (2005)

Spinal Muscular Atrophy (SMA) is a severe neuromuscular disease characterized by degeneration of alpha motor neurons in the spinal cord. The majority of patients affected by SMA have deletion of the Survival of Motor Neuron-1 (SMN1) gene but they retain a copy of SMN2 gene, that produces a defective SMN protein due to a C|[rarr]|T transition on exon 7.
Effects of Poisoning on Serum Enzyme Activities, Coagulation, and Fibrinolysis
Authors: N. Wright, A. R. Clarkson, S. S. Brown, V. Fuster
Journal: BMJ (1971)

Prolonged coma due to acute overdosage with hypnotic drugs is shown to be associated with a pronounced increase in the activity of serum creatine kinase and in the concentration of fibrin degradation products and with less pronounced abnormalities of other serum enzymes and of other indices of coagulation and fibrinolysis. Evidence is presented that skeletal muscle damage occurs and that this is related to the coagulation abnormality. These findings probably explain some of the non-specific features such as fever which commonly occur in recovery from severe poisoning.
Motor activity recorded in the unprepared colon of healthy humans.
Authors: M Lemann, B Flourie, L Picon, B Coffin, R Jian, J C Rambaud
Journal: Gut (1995)

A manometric method was developed to study the motor activity in the unprepared human colon, and the results in eight healthy subjects were compared with those obtained in the same subjects after bowel cleansing with a non-absorbable solution containing polyethylene glycol 4000 (PEG). A tube assembly (4.5 m long, 12 lumen) was introduced through the nose and passed through the gastrointestinal tract. Two manometric recordings were performed one month apart, one without any preparation and the other after bowel cleansing with PEG. There was no obvious qualitative difference between the recordings performed in the uncleansed and PEG cleansed colon. Moreover, in the unprepared colon motility indices were close to those measured in the cleansed colon. The number of high amplitude propagated contractions (mean (SEM)) was, however, higher in the cleansed colon (8.6 (2.8) v 5.4 (1.8)/subject/9 h in the unprepared colon; p < 0.04). It is concluded that in healthy subjects taking a regular diet, motor activity is not different between the uncleansed and cleansed colon with PEG, except for the high amplitude propagated contractions, which occur more frequently in the cleansed colon.
You Can Lead a Horse to Water...
Authors: Samuel Vaisrub
Journal: JAMA (1975)

Noncompliance rarely entered into consideration when a physician prescribed a therapeutic regimen or evaluated its effects. It was assumed that a patient concerned about his illness stuck to his diet, took his medication regularly, and generally did what "the doctor ordered." Otherwise, why would he have come to the doctor in the first place? The assumption may have been justified when the therapeutic transaction took place between a physician who cared and a patient who wanted to get better. But, is it still valid now when, as is often the case, an asymptomatic patient sees the doctor in the setting of some physician-instigated, community-initiated disease prevention project? Can we be confident that he will comply with the prescribed treatment? Recent experience with mass screening for hypertension and the treatment of the identified asymptomatic hypertensive individuals suggests that such confidence may often be misplaced. Sackett et al<sup>1</sup>conducted a randomized
Erythrocytosis and Hypothyroidism
Authors: JAMES M. FALKO
Journal: Annals of Internal Medicine (1976)

Letters1 April 1976Erythrocytosis and HypothyroidismJAMES M. FALKO, JAMES R. COHENJAMES M. FALKOSearch for more papers by this author, JAMES R. COHENSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-4-446 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe association of hypothyroidism and ventilatory abnormalities (1) is well known, as is the relation of hypoxia to erythrocytosis (2). No patients with hypothyroidism and absolute erythrocytosis, however, have been described, but we have recently seen a patient who presented with both. Erythrocytosis resolved after treatment with thyroid hormone alone. Pulmonary function studies were normal, and other secondary causes of polycythemia were excluded.A 24-year-old white man was admitted to Carswell USAF Regional Hospital because of fatigue, cold intolerance, and hoarseness of 1 month's duration. His past medical history revealed that he had had a subtotal thyroidectomy for hyperthyroidism 8...References1. ZWILLICH C, PIERSON D, and HOFELDT F: Ventilatory control in myxedema and hypothyroidism. N Engl J Med 292:662-665, 1975 CrossrefMedlineGoogle Scholar2. MURRAY J: Classification of polycythemic disorders. With comments on the diagnostic value of arterial blood oxygen analysis. Ann Intern Med 64:892-903, 1966 LinkGoogle Scholar3. SAGONE A and BALCERZAK S: Smoking as a cause of erythocytosis. Ann Intern Med 82:512-515, 1975 LinkGoogle Scholar4. MILLER W, DELIVORIA-PAPADOPOULOS M, and MILLER L: Oxygen releasing factor in hyperthyroidism. JAMA 211:1824-1826, 1970 CrossrefMedlineGoogle Scholar5. GROSZ H and FARMER B: Reduction-oxidation potential of blood determined by oxygen releasing factor in thyroid disorders. Nature (Lond) 222:875-876, 1969 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES M. FALKO; JAMES R. COHEN PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySilicon Carbide, SiC 1 April 1976Volume 84, Issue 4Page: 446-447KeywordsFatigueHyperthyroidismHypothyroidismHypoxiaPolycythemiaPulmonary functionThyroid hormonesThyroidectomy ePublished: 1 December 2008 Issue Published: 1 April 1976 PDF downloadLoading ...
RNA degradation in antiviral immunity and autoimmunity
Authors: Rachel E. Rigby, Jan Rehwinkel
Journal: Trends in Immunology (2015)

Post-transcriptional control determines the fate of cellular RNA molecules. Nonsense-mediated decay (NMD) provides quality control of mRNA, targeting faulty cellular transcripts for degradation by multiple nucleases including the RNA exosome. Recent findings have revealed a role for NMD in targeting viral RNA molecules, thereby restricting virus infection. Interestingly, NMD is also linked to immune responses at another level: mutations affecting the NMD or RNA exosome machineries cause chronic activation of defence programmes, resulting in autoimmune phenotypes. Here we place these observations in the context of other links between innate antiviral immunity and type I interferon mediated disease and examine two models: one in which expression or function of pathogen sensors is perturbed and one wherein host-derived RNA molecules with a propensity to activate such sensors accumulate.
Excessive Activation of mTOR in Postnatally Generated Granule Cells Is Sufficient to Cause Epilepsy
Authors: Raymund Y.K. Pun, Isaiah J. Rolle, Candi L. LaSarge, Bethany E. Hosford, Jules M. Rosen, Juli D. Uhl, Sarah N. Schmeltzer, Christian Faulkner, Stefanie L. Bronson, Brian L. Murphy, David A. Richards, Katherine D. Holland, Steve C. Danzer
Journal: Neuron (2012)
Treatment of Myeloma — Are We Making Progress?
Authors: Brian G.M. Durie
Journal: New England Journal of Medicine (2008)

In this issue of the Journal, San Miguel et al.1 describe the benefit of combining bortezomib with melphalan plus prednisone, as compared with melphalan plus prednisone alone, as initial therapy for patients with myeloma who are not candidates for hematopoietic stem-cell transplantation. The critical comparative statistics leave no doubt that combination therapy with bortezomib is superior to melphalan plus prednisone alone. But how does this clear-cut evidence inform treatment decisions? To effectively apply these findings to clinical practice in the appropriate setting, we need prospective comparisons with other available options, valid uniform standards for those comparisons, and greater consideration of . . .
Combined-Modality Treatment and Selective Organ Preservation in Invasive Bladder Cancer: Long-Term Results
Authors: Claus Rödel, Gerhard G. Grabenbauer, Reinhard Kühn, Thomas Papadopoulos, Jürgen Dunst, Martin Meyer, Karl M. Schrott, Rolf Sauer
Journal: Journal of Clinical Oncology (2002)

To evaluate our long-term experience with combined modality treatment and selective bladder preservation and to identify factors that may predict treatment response, risk of relapse, and survival.Between 1982 and 2000, 415 patients with bladder cancer (high-risk T1, n = 89; T2 to T4, n = 326) were treated with radiotherapy (RT; n = 126) or radiochemotherapy (RCT; n = 289) after transurethral resection (TUR) of the tumor. Six weeks after RT/RCT, response was evaluated by restaging-TUR. In case of complete response (CR), patients were observed at regular intervals. In case of persistent or recurrent invasive tumor, salvage-cystectomy was recommended. Median follow-up was 60 months (range, 6 to 199 months).CR was achieved in 72% of patients. Local control after CR without muscle-invasive relapse was maintained in 64% of patients at 10 years. Distant metastases were diagnosed in 98 patients with an actuarial rate of 35% at 10 years. Ten-year disease-specific survival was 42%, and more than 80% of survivors preserved their bladder. Early tumor stage and a complete TUR were the most important factors predicting CR and survival. RCT was more effective than RT alone in terms of CR and survival. Salvage cystectomy for local failure was associated with a 45% disease-specific survival rate at 10 years. Cystectomy because of a contracted bladder was restricted to 2% of patients.TUR with RCT is a reasonable option for patients seeking an alternative to radical cystectomy. Ideal candidates are those with early-stage and unifocal tumors, in whom a complete TUR is accomplished.
Reducing errors in medicine
Authors: D. M Berwick, L. L Leape
Journal: BMJ (1999)

“Ladies and gentlemen, welcome aboard Sterling Airline's Flight Number 743, bound for Edinburgh. This is your captain speaking. Our flight time will be two hours, and I am pleased to report both that you have a 97% chance of reaching your destination without being significantly injured during the flight and that our chances of making a serious error during the flight, whether you are injured or not, is only 6.7%. Please fasten your seatbelts, and enjoy the flight. The weather in Edinburgh is sunny.”

Would you stay aboard? We doubt it.

Luckily, the safety statistics in airline travel are far, far better than these figures. Between 1990 and 1994 United States airline fatalities were 0.27 per 1 000 000 aircraft departures, less than one third the rate in mid-century, despite vast increases in the complexity and volume of our aviation systems. One estimate is that a modern passenger would have to fly continuously for 20 000 years in order to reach a 50% chance of injury in an airplane accident.

In health care it is a totally different story. With the rising complexity and reach of modern medicine have come startling …
SIMPLIFIED METHODS OF BLOOD EXAMINATION. THEIR PRACTICAL APPLICABILITY TO GENERAL DIAGNOSIS.
Authors: ALFRED C. CROFTAN
Journal: JAMA (1899)

Laboratory aids to diagnosis, to be universally employed by the practicing physician, should be simple and rapid of execution, should require no costly or complicated paraphernalia, and should yield quicker and more positive results than purely clinical methods. No period in the history of medicine has been free from attempts to find diagnostic clues in the examination of the blood; it was tried to interpret the rapidity of coagulation, the<i>crusta phlogistica</i>of eighteenth century physicians, the appearance of the blood as it flowed from the incised vein. With the development of microscopic technic and an insight into the truths of cellular pathology, valuable data relating to the morphology of the corpuscular elements of the blood in health and disease were discovered. During the last decade, especially through the efforts of German and American investigators—at their head Ehrlich of Berlin and Neusser of Vienna—a mass of purely empiric data on
Sun-induced localized bullous pemphigoid
Authors: Chang Woo Lee, Young Suck Ro
Journal: British Journal of Dermatology (1992)

Journal Article Sun‐induced localized bullous pemphigoid Get access CHANG WOO LEE, CHANG WOO LEE Department of Dermatology, Hanyang University Hospital, Sungdong‐ku, Seoul 133‐792. South Korea Search for other works by this author on: Oxford Academic Google Scholar YOUNG SUCK RO YOUNG SUCK RO Department of Dermatology, Hanyang University Hospital, Sungdong‐ku, Seoul 133‐792. South Korea Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 126, Issue 1, 1 January 1992, Pages 91–92, https://doi.org/10.1111/j.1365-2133.1992.tb08414.x Published: 01 January 1992
Management guidelines for women with normal colposcopy after low grade cervical abnormalities: population study
Authors: G. R Teale
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objectives:</b> To develop an evidence based protocol for the follow up of women with low grade cervical abnormalities for whom treatment is not immediately indicated. <b>Design:</b> Population outcome study. <b>Setting:</b> Colposcopy clinic of an inner city teaching hospital. <b>Participants:</b> 566 women with low grade cytological abnormalities who were not treated at a first visit to the colposcopy clinic, followed up for a total of 881 years. <b>Main outcome measures:</b> Resolution of abnormalities, persistence of disease, and treated disease. <b>Results:</b> Abnormalities resolved in 306 (54.1%) women, whereas 138 (24.4%) had persistent disease and 122 (21.5%) were subsequently treated. Colposcopic opinion, smear test results, age, smoking history, and number of pregnancies were all significantly related to outcome. Logistic regression analysis produced a model that correctly identified 70% of women whose abnormalities resolved. Only 23 of 295 women (7.8%) with a normal cervix on colposcopy and a smear without dyskaryosis at a first visit were treated by the end of the observation period. <b>Conclusions:</b> Women referred with low grade cytological abnormalities who have a normal cervix on colposcopy and a negative or borderline repeat smear test result may be discharged from the colposcopy clinic. We propose a follow up protocol that could safely avoid unnecessary visits to a clinic.
Protein conjugate pneumococcal vaccines
Authors: V. Spoulou
Journal: BMJ (2002)

Given the substantial global burden of invasive pneumococcal disease, the introduction of protein conjugate pneumococcal vaccines may provide a useful option for protecting individuals at risk. Optimism stems from a large prospective study showing that a protein conjugate pneumococcal vaccine prevented 94% of invasive disease in young children.1 The clinical effectiveness of this vaccine now needs to be established among other children and adults at risk. These include people with increased exposure to Streptococcus pneumoniae , immunological defects due to HIV infection, bone marrow transplants, multiple myeloma, nephrotic syndrome, anatomical or functional asplenia, and older people with chronic conditions. The efficacy of the vaccine is unpredictable because the immune defects are different in each group.

The need for a strict, objective assessment of the vaccine is further enhanced by serious concerns raised recently when this vaccine was unexpectedly found to increase the rates of pneumonia in HIV infected individuals.2 The lack of knowledge of the basic mechanism underlying pneumococcal vaccine failures indicates that adequate evidence should …
Foreign Body in the Bronchial Tube
Authors: F. Page
Journal: BMJ (1863)

A. F., a child, aged .3years, was seized on November 12th, 1861, with violent and long continued cough, threat- ening death by suffocation.These symptoms were sup- posed to be caused by a piece of slate-pencil having slipped from the child's mouth through the rima of the glottis into the tralchea.Next day there was active pneumonia on both sides of the chest, from which the little patient recovered after an illness of three weeks.From this tinme up to December 6th, 1862, the child's health was bad, owing to repeated attacks of bronchitis, diarrhoea, and irritability of stomach.On the evening of December 6th, after a violent fit of coughing, the child became black in the face, was unable to breathe, and died imTnediately.A post mortem examination showed that both lungs were diseased.The left had formed adhesions all round the chest, and was carnified.In the left bronchial tube a piece of slate-pencil, an inch in length, was found: it
Clinical Pharmacology of Procainamide.
Authors: Hugh S. Weily
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Clinical Pharmacology of Procainamide.Hugh S. Weily, M.D., Edward Genton, M.D., F.A.C.P.Hugh S. Weily, M.D.Search for more papers by this author, Edward Genton, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-823_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough it is a frequently used antiarrhythmic agent, the routes and mechanisms of procainamide excretion and the effect of urine pH, urine flow rate, and disease states on its renal clearance, plasma half-time, and 6-hr renal excretion have not been defined. Procainamide was administered intravenously to 20 mongrel dogs and 15 humans in a 500-mg bolus or by constant infusion. The 6-hr excretion averaged 65% in normal humans and dogs. Patients with primary renal disease and renal impairment secondary to cardiac failure or hepatic disease had prolonged T½ (5.85 ± 0.39 hr) and decreased renal excretion (40.8 ± 1.8%) compared... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Denver, Colo. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 823-823KeywordsBlood plasmaClinical pharmacologyExcretionHeart failureRenal diseasesRenal failureUrine Issue Published: 1 May 1971 PDF DownloadLoading ...