tbuckley/cabot-search huggingface dataset:
Cystic disease of the liver and biliary tract.
Authors: A Forbes, I M Murray-Lyon
Journal: Gut (1991)

The widespread availability of ultrasound imaging has led to more frequent recognition of cystic disease affecting the liver and biliary tract. There is a wide range of possible causes. Cystic disease of infective origin is usually caused by an Echinococcal species, or as the sequel of a treated amoebic or pyogenic abscess. The clinical and radiological features are often then distinctive and will not be dwelt upon in this review, except in respect of their contribution to the differential diagnosis of non-infective disorders. The principal non-infective cysts can be conveniently divided between the simple cyst, the polycystic syndromes (usually with coexistent renal disease), Caroli9s syndrome, and choledochal cysts. The overlap between constituent members of these groups, and the association of cystic disease with hepatic fibrosis (especially with congenital hepatic fibrosis) has attracted considerable attention, and it has been suggested that they may all be considered to belong to a hepatobiliary fibrocystic continuum. In addition there are a variety of cystic neoplasms and a miscellany of unusual forms.
Interpretation of single progesterone measurement in diagnosis of anovulation and defective luteal phase: observations on analysis of the normal range.
Authors: N C Wathen, L Perry, R J Lilford, T Chard
Journal: BMJ (1984)

Single serum progesterone determinations were made in 79 apparently normal women with a regular menstrual cycle. A normal range (40 subjects) was derived from the concentrations in the follicular phase and used to define an "anovular" range for luteal phase values (nine out of 39 subjects). The remaining luteal phase values were used to construct an "ovular" range for the luteal phase and, within this range, to define a group of values (less than the 20th centile) which could be described as a "defective luteal phase." The cut off limits between ovular and anovular and between normal and defective luteal phases were respectively two and four times the follicular phase median. It is proposed that the numerical findings of this study may be used as a rule of thumb for defining normality and abnormality from a single serum progesterone determination.
ELECTROCARDIOGRAPHIC CHARACTERISTICS IN RELATION TO ECHOCARDIOGRAPHIC SEVERITY IN ASYMPTOMATIC PATIENTS WITH AORTIC STENOSIS: A SEAS SUBSTUDY
Authors: Anders M. Greve, Eva Gerdts, Kurt Boman, Christa Gohlke-Baerwolf, Anne B. Rossebø, Lars Køber, Ronnie Willenheimer, Kristian Wachtell
Journal: Journal of the American College of Cardiology (2011)
Runx1 exon 6–related alternative splicing isoforms differentially regulate hematopoiesis in mice
Authors: Yukiko Komeno, Ming Yan, Shinobu Matsuura, Kentson Lam, Miao-Chia Lo, Yi-Jou Huang, Daniel G. Tenen, James R. Downing, Dong-Er Zhang
Journal: Blood (2014)
Chymopapain: a case study in federal drug regulation
Authors: P. Sampson
Journal: JAMA (1978)

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
Medical education's authenticity problem
Authors: B. W. Powers, A. S. Navathe, S. H. Jain
Journal: BMJ (2014)

Why we do what we do, and who we are, are often just as important as what we do

Medical education is punctuated by gating mechanisms, and anyone involved knows the unsavoury and contrived behaviors that this often breeds. At each stage of their training, aspiring physicians are pressured to shape and reshape their activities, interests, and values to meet the expectations of selection committees, attending physicians, and preceptors.

The notion of authenticity provides a useful framework for examining the impact of these dynamics on the development of new physicians. The term, popularized by Harvard Business School professor Bill George, entails discovering, understanding, and being faithful to your core values and purpose. Instead of emulating the characteristics, traits, or practices of others, authentic individuals interrogate their life experiences to discover their values and purpose through a process of continuous self reflection.1

Current dynamics in medical education are often at odds with authenticity. Selection requirements for undergraduate and graduate medical training lead aspiring physicians to appropriate and proclaim interests that are often disingenuous. Junior doctors hoping for selection into competitive training programs are pressured to research and publish, despite the …
Infant Formula, Autoimmune Triggers, and Type 1 Diabetes
Authors: David M. Harlan, Mary M. Lee
Journal: New England Journal of Medicine (2010)

Families are devastated when a child receives a diagnosis of type 1 diabetes. Although tremendous strides in insulin-based treatments — made feasible by technical advances such as continuous glucose monitors, modern “designer” insulin formulations, and novel insulin-delivery devices — have contributed to remarkable improvements in the prognosis of the disease, the proper management of type 1 diabetes is expensive and time-consuming. In addition, not all families and patients marshal the diligence and skills required to control glycemia with sufficient rigor to prevent complications. Moreover, the benefits of tight control of diabetes must be balanced with the detrimental consequences of hypoglycemia, . . .
PANCREATIC TREATMENT OF CANCER, WITH REPORT OF A CURE.
Authors: RICHARD A. GOETH
Journal: JAMA (1907)

When the first reports of the treatment of cancer with trypsin appeared I was greatly interested, as I had a patient with a large, rapidly growing tumor on the side of the neck. The condition was inoperable. At first I used solutions of the trypsin powder, making sterile solutions of it and injecting them, but abandoned them as soon as I got the injectio trypsini, put up by Fairchild Brothers. I found that the directions for the treatment as published inThe Journal<sup>1</sup>by Dr. John Beard, the discoverer, cover every detail. Though the injections of trypsin were rather painful, I used injections of cocain in a few instances, but found that they did not diminish the pain materially. <h3>Case 1.</h3> —This patient was a man with a large vascular tumor, undoubtedly a sarcoma, on the side of the neck. Although the trypsin treatment is supposed to give good
Encounter with a doula: is the system failing new mothers?
Authors: A. Chakladar
Journal: BMJ (2009)

“Anyone know what a doula is?” I asked in the coffee room. I was met with a roomful of blank faces. Earlier, during the morning obstetric meeting, a midwife told me that her patient had a doula. “A what?” I asked. “You know,” she said, “a birthing partner.” I didn’t know; anyway, isn’t that the job of the partner or the baby’s grandmother?

The word doula derives from the ancient Greek for “woman of service.” Recently it has been used to describe experienced women who help mothers care for newborn infants; the role now extends to attending prenatal classes and the birth itself.

On this occasion an epidural had been inserted as per the birth plan, and I was called to assess the patient’s analgesia, as she complained of discomfort. I found a missed segment and planned an epidural bolus with repositioning. The doula had been present since admission, as had the husband. Both the mother and father were confident and articulate, so I couldn’t help but wonder why they needed to pay for support.

In my practice the mother is the principal focus, but I address the couple together, recognising their joint experience of bringing a new life into the world. I found myself disconcerted by the doula’s presence, as I was unfamiliar with …
The Treatment of Acute and of Chroniccatarrhal Laryngitis in Adults: With Some Remarks on the Use of the Laryngoscope
Authors: F. Semon
Journal: BMJ (1880)

I21and incorporated with the walls of the vessels.And, in one case, I even succeeded in showing vascularisation of the blood-clot through the medium of the plastic basis at the point of ligature.As to the organw isation of carbolised catgut ligature, I am sceptical.Mr. Lister says that any chemist will tell us that it will not dissolve.I reply that I will believe my own eyes rather than " any chemist", for I have seen it soft and jelly-like, even whilst retaining its form; and, in a stump, I have seen the femoral surrounded by catgut ligature on the fourth day after amputation, bleeding whenever compression was removed, showing the catgut had lost its constrictive power; and it was as easily wiped away with the finger as if it had been recent lymph, thin clot, or other semi- fluid matter.Two things seem to be admitted by Mr. Lister and his followers in the discussion: that other simpler methods than the spray system may be considered antiseptic, and also that the system is limited in its application; that, for instance, it could not be carried out, Mr. Lister says, in cases where sinuses had existed in the vicinity of the joints which were excised.How many cases demanding excision or amputation do we meet with where such complications do not exist?
Early Deaths and Treatment-Related Mortality in Children Undergoing Therapy for Acute Myeloid Leukemia: Analysis of the Multicenter Clinical Trials AML-BFM 93 and AML-BFM 98
Authors: Ursula Creutzig, Martin Zimmermann, Dirk Reinhardt, Michael Dworzak, Jan Stary, Thomas Lehrnbecher
Journal: Journal of Clinical Oncology (2004)

The rates of early death (ED) and treatment-related mortality (TRM) are unacceptably high in children undergoing intensive chemotherapy for acute myeloid leukemia (AML). Better strategies of supportive care might help to improve overall survival in these children.In a retrospective study, we analyzed incidence, clinical features, and risk factors for lethal complications of 901 children enrolled onto the multicenter trials Acute Myeloid Leukemia-Berlin-Frankfurt-Muenster (AML-BFM) 93 and AML-BFM 98.One hundred four patients (11.5%) enrolled onto the clinical trials AML-BFM 93 and AML-BFM 98 died shortly after diagnosis or as a result of treatment-related complications. Thirty-two patients (3.5%) died before (six patients) or during (26 patients) the first 14 days of treatment, mainly as a result of bleeding or leukostasis. Low performance status, hyperleukocytosis, and French-American-British type M5 were the main risk factors for a lethal event before day 15. After day 15, the predominant causes of death were complications caused by infections, particularly bacterial and fungal infections. The incidence of lethal infections was highest during induction therapy and decreased thereafter. When comparing both clinical trials, significantly fewer patients died within the first 6 weeks in AML-BFM 98 than in AML-BFM 93 (14 [3.5%] of 430 patients v 35 [7.4%] of 471 patients; P = .01).To reduce the high incidence of ED and TRM in children with AML, early diagnosis and adequate treatment of complications are needed. Children with AML should be treated in specialized pediatric cancer centers only. Prophylactic and therapeutic regimens for better treatment management of bleeding disorders and infectious complications have to be assessed in future trials to ultimately improve overall survival in children with AML.
Focal Spinal Abnormalities on Bone Scans in Ankylosing Spondylitis: A Clue to the Presence of Fracture or Pseudarthrosis
Authors: DONALD RESNICK, SUSAN WILLIAMSON, NAOMI ALAZRAKI
Journal: Clinical Nuclear Medicine (1981)

Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding.
Supplementation with vitamin E or vitamin C did not differ from placebo for major cardiovascular events and mortality
Authors: Paul G. Shekelle
Journal: Annals of Internal Medicine (2009)

Source Citation Sesso HD, Buring JE, Christen WG, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2008;300:2123-33. 18997197
Screening for BRCA1 Mutations in Patients with Triple Negative Breast Cancer and Basal Phenotype.
Authors: R. Somer, D. Farengo-Clark, A. Patel, R. Schwarting, G. Grana, E. Rodler
Journal: Cancer Research (2009)

Abstract Introduction: Most models estimating risk of carrying germline BRCA mutations are based on family history and age of cancer onset. Additional histologic criteria may be useful to identify patients at risk for harboring BRCA1 mutations. BRCA1 positive breast tumors are significantly more often estrogen receptor, progesterone receptor, and erbB-2 (HER2-neu) negative (“triple negative” (TN)) and are strongly associated with a basal phenotype confirmed by DNA microarray. Basal-like tumors express cytokeratins 5,6, and 14 or 17 by immunohistochemistry (IHC). It is unknown whether testing for BRCA1 mutations in TN basal-like breast cancer patients will identify additional carriers of mutations in this gene.Methods: A retrospective evaluation of patients with triple negative breast cancer seen at Cooper Cancer Center between 2004 and 2006 was performed after IRB approval. IHC was performed to identify the subset of basal-like breast cancers.Results: A total of 89 women were identified as diagnosed with TN breast cancer, while 53 had pathology available for review. 21 patients were identified as basal phenotype, whereas 32 were non-basal. Of the 21 patients who had basal-phenotype tumors, six underwent genetic testing and 3 were found to have a deleterious BRCA1 mutation. Of 32 non-basal patients, 9 patients underwent genetic testing and 2 were found to have a deleterious BRCA1 mutation. There was no difference between basal subtype and BRCA1 postivity [Fisher's Exact Test p=0.32]. Of note, 1of 5 (20%) patients with basal phenotype had no family history but tested positive for BRCA1 mutation and would have been missed by relying on conventional methods.Conclusion: Although there is a trend towards a higher percentage of TN breast cancer patients with basal subtype having BRCA 1 mutations (50 vs 22%), this was not found to be statistically significant (Fisher's exact p=0.32). However, this dataset is limited by a small sample size. Only 40% of TN breast cancer patients had a basal phenotype by IHC in this study, while other studies have shown 70- to 85% rate. Ongoing evaluation of patients with basal-like subtype and triple negative tumors should continue to investigate this relationship, especially in light of newer therapeutics that may impact this population. This data also suggests that patients with basal phenotype and triple negative disease should be considered for referral for genetic testing even in the absence of family history. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4075.
937-5 Basal Post-Systolic Shortening Predicts the Response of Hypo-Akinetic Myocardium to Low-Dose Dobutamlne in Chronic Coronary Artery Disease Patients
Authors: Giuseppe Barletta, Patrizia Lo Sapio, Roberto Piero Dabizzi, Fabio Fantini
Journal: Journal of the American College of Cardiology (1995)
EYE TROUBLES ATTRIBUTABLE TO NASOPHARYNGEAL AND AURAL DISTURBANCES.
Authors: JOSEPH A. WHITE
Journal: JAMA (1899)

The direct anatomic connection between the eye and nose makes it easy to understand how disease can spread from the latter to the former by way of the nasal duct. Moreover, the intimate nervous and vascular connection between the two organs also plays an important part in the propagation of disease from the nose to the eye. Both these modes of transmission have been recognized since the last century, and referred to by different authors, but Bresgen—1881—was the first to lay any special stress on the fact that conjunctival catarrh was often dependent on nasal catarrh. Since his article appeared, medical literature has had numerous contributions on this and other eye troubles of nasal origin, whether by direct or reflex communication. Appended to my article on "Neurosis of the Nose and Nasopharynx," in Burnett's "System of Diseases of the Ear, Throat and Nose," and to Dr. Gould's article in the
Extracorporeal photochemotherapy in a patient with Ki-1-positive anaplastic large-ceil lymphoma
Authors: J. SCHWARTZ, J. GONZALEZ, C.M. COTTRILL, J.G. MAGIDSON, A. KLAINER, E. BISACCIA
Journal: British Journal of Dermatology (1996)

A 57-year-old man with Ki-1 anaplastic large-cell lymphoma treated with extracorporeal photochemotherapy is described.
US tightens rules on vitamin claims
Authors: G McBride
Journal: BMJ (1994)

New labelling regulations introduced by the US Food and Drug Administration (FDA) will make it more difficult for the manufacturers of vitamins and other dietary supplements to make health claims on behalf of their products. Any claims printed on labels must now be supported by “significant scientific agreement among qualified experts.”

The FDA has also announced further measures, to be introduced in a year's time. These will require all preparations that may contain vitamins, minerals, herbs, fish oils, amino acids and proteins, organ extracts, …
Socialism and Capitalism
Authors: LESLIE COHEN
Journal: Annals of Internal Medicine (1977)

Letters and Corrections1 September 1977Socialism and CapitalismLESLIE COHEN, M.D.LESLIE COHEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-3-379_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I found Dr. Biörck's opinions ("How to Be a Clinician in a Socialist Country," Ann Intern Med 86:813-817, 1977) very interesting, thought provoking, and disturbing. I also found it curious that this journal chose to publish his strongly anti-Socialist "opinions" without the necessary balance of a companion article by a Swedish physician of the opposite viewpoint, for example, Dr. Rexed or one of his colleagues.If the editors wish to achieve a fair approach and enlarge the forum, I am sure there are many politically sophisticated and thoughtful American physicians who would be glad to comment on... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 11 Robeson St. Jamaica Plain, MA 02130 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1977Volume 87, Issue 3Page: 379-379 Issue Published: 1 September 1977 PDF downloadLoading ...
Influence of mineral dusts on metabolism of arachidonic acid by alveolar macrophage.
Authors: L M Demers, D C Kuhn
Journal: Environmental Health Perspectives (1994)

The alveolar macrophage (AM) responds to stimuli such as coal mine dust by releasing inflammatory mediators such as cytokines, growth factors, reactive oxygen species, and eicosanoids. Eicosanoids are synthesized by AM through the action of cyclooxygenase and lipoxygenase enzymes and serve to modulate the proinflammatory function of this cell as part of the lungs' host defense mechanism. Reactive oxygen species can be generated by AM as a by-product in the biosynthetic pathway of the prostaglandins. AM produces primarily prostaglandin E2, thromboxane A2, and leukotriene B4 as part of the cellular response to an inflammatory stimulus. There is evidence to suggest that eicosanoid production by AM is functionally linked to both surface interaction with mine dust particles like silica and by the phagocytosis of the dust particle itself. In this report, we examined the effects of an antioxidant, vitamin E, on dust-induced synthesis of PGE2 and TXB2 in vitro and in vivo by AM obtained by bronchoalveolar lavage from rats. We also looked at the effects of the surface of silica particles on AM eicosanoid biosynthesis under conditions of calcination, a process that removes exposed hydroxyl groups from the surface of silica particles, thus reducing the likelihood of soluble hydroxyl radical formation. Treatment of AM with vitamin E in vivo and in vitro reduced the augmentation in eicosanoid production usually observed when AM are exposed to mine dusts. These results suggest that vitamin E may effectively reduce the inflammatory and fibrotic response produced by inhalation of mineral dust through an antioxidant mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)
A COMPARISON OF RHYTHMIC AND NON-RHYTHMIC MUSIC IN CHRONIC SCHIZOPHRENIA
Authors: AARON GILLIS, C. F. LASCELLES, NORA CRONE
Journal: American Journal of Psychiatry (1958)

Two groups of chronic schizophrenic patients attended twice-weekly sessions of rhythmic and non-rhythmic music respectively for 6 months. Assessments were made by psychiatric interview and rating scale before and after this period. Appreciable improvement occurred in both groups. The female group showed a particularly good response to rhythmic music.
Coordination improves outcomes in malignant cord compression
Authors: P. Levack, L. Allan, L. Baker, T. McLeay, G. Houston, J. Dewar, S. Eljamel, R. Grant, A. Munro
Journal: BMJ (2009)

The guidance from the National Institute for Health and Clinical Excellence (NICE) on malignant cord compression argues that a committed, coordinated approach is needed.1 Following the Scottish audit (CRAG),2 all health boards in Scotland were advised to implement rapid referral systems and coordinate the process of early diagnosis. This Macmillan supported initiative has made good …