tbuckley/cabot-search huggingface dataset:
A piece of my mind. The captain
Authors: S. J. Kra
Journal: JAMA (1993)

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
The relationship between air pollution from heavy traffic and allergic sensitization, bronchial hyperresponsiveness, and respiratory symptoms in Dutch schoolchildren.
Authors: Nicole A H Janssen, Bert Brunekreef, Patricia van Vliet, Francee Aarts, Kees Meliefste, Hendrik Harssema, Paul Fischer
Journal: Environmental Health Perspectives (2003)

Studies have suggested that children living close to busy roads may have impaired respiratory health. This study was designed to test the hypothesis that exposure to exhaust from heavy traffic in particular is related to childhood respiratory health. Children attending 24 schools located within 400 m from busy motorways were investigated. The motorways carried between 5,190 and 22,326 trucks per weekday and between 30,399 and 155,656 cars per day. Locations were chosen so that the correlation between truck and car traffic counts was low. Air pollution measurements were performed at the schools for 1 year. Respiratory symptoms were collected by parent-completed questionnaire. Sensitization to common allergens was measured by serum immunoglobulin E and skin prick tests. Bronchial hyperresponsiveness (BHR) was measured with a hypertonic saline challenge. Respiratory symptoms were increased near motorways with high truck but not high car traffic counts. They were also related to air pollutants that increased near motorways with high truck traffic counts. Lung function and BHR were not related to pollution. Sensitization to pollen increased in relation to truck but not car traffic counts. The relation between symptoms and measures of exposure to (truck) traffic-related air pollution were almost entirely restricted to children with BHR and/or sensitization to common allergens, indicating that these are a sensitive subgroup among all children for these effects.
Adrenomyeloneuropathy Presenting as Addison's Disease in Childhood
Authors: Abdollah Sadeghi-Nejad, Boris Senior
Journal: New England Journal of Medicine (1990)

Adrenoleukodystrophy, a sex-linked peroxisomal disorder that results in the impaired oxidation of long-chain saturated fatty acids and causes neurologic impairment, is a rare cause of Addison's disease in children. Adrenomyeloneuropathy is the name given to a biochemically identical but milder and more slowly progressive variant of adrenoleukodystrophy that affects young adults, in whom adrenal insufficiency may long precede nervous system dysfunction. The transmission of adrenomyeloneuropathy, like that of most cases of adrenoleukodystrophy, is sex-linked. Because of a preponderance of male patients among a group of patients with the onset of adrenal failure in childhood, we questioned whether this condition might be the initial manifestation of adrenomyeloneuropathy. We therefore measured the plasma concentrations of very-long-chain saturated fatty acids in eight patients with adrenal insufficiency; of these, five had elevated plasma hexacosanoic acid concentrations (range, 2.42 to 6.43 mumol per liter; mean normal level [+/- SD], 0.83 +/- 0.45), confirming the presence of adrenomyeloneuropathy. Magnetic resonance imaging showed clear evidence of brain involvement in all five patients. Reexploration of the family histories revealed additional missed cases. We conclude that the possibility of adrenomyeloneuropathy should be considered in any boy with Addison's disease.
Advancing Research Data Infrastructure for Patient-Centered Outcomes Research
Authors: Amol S. Navathe, Carolyn Clancy, Sherry Glied
Journal: JAMA (2011)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Principal Component Analysis of the T Wave and Prediction of Cardiovascular Mortality in American Indians
Authors: Peter M. Okin, Richard B. Devereux, Richard R. Fabsitz, Elisa T. Lee, James M. Galloway, Barbara V. Howard
Journal: Circulation (2002)

Background — Increased QT interval dispersion (QTd) is a proposed ECG marker of vulnerability to ventricular arrhythmias and of cardiovascular (CV) mortality. However, principal component analysis (PCA) of the T-wave vector loop may more accurately represent repolarization abnormalities than QTd. Methods and Results — Predictive values of QTd and PCA were assessed in 1839 American Indian participants in the first Strong Heart Study examination. T-wave loop morphology was quantified by the ratio of the second to first eigenvalues of the T-wave vector by PCA (PCA ratio); QTd was quantified as the difference between maximum and minimum QT intervals. After 3.7±0.9 years mean follow-up, there were 55 CV deaths. In univariate analyses, an increased PCA ratio predicted CV mortality in women (χ 2 =7.8, P =0.0053) and men (χ 2 =9.5, P =0.0021). In contrast, increased QTd was a significant predictor of CV mortality in women (χ 2 =30.6, P &lt;0.0001) but not in men (χ 2 =2.0, P =NS). In multivariate Cox analyses controlling for risk factors and rate-corrected QT interval, the PCA ratio remained a significant predictor of CV mortality in women (χ 2 =4.0 P =0.043) and men (χ 2 =6.4, P =0.011); QTd was a significant predictor in women only (χ 2 =11.0, P =0.0009). PCA ratios &gt;90th percentile (32% in women and 24.6% in men) identified women with a 3.68-fold increased risk of CV mortality (95% CI, 1.54 to 8.83) and men with a 2.77-fold increased risk (95% CI, 1.18 to 6.49). Conclusions — Abnormalities of repolarization measured by PCA of the T-wave loop predict CV death in men and women, supporting use of PCA for quantifying repolarization abnormalities.
Reversal of Intrahepatic Cholestasis of Pregnancy in Women after High Dose S-Adenosyl-L-Methionine Administration†
Authors: Mario Frezza, Gabriele Pozzato, Lucio Chiesa, Giorgio Stramentinoli, Carlo Di Padova
Journal: Hepatology (1984)

Previous investigations have indicated that S-adenosyl-L-methionine (SAMe) leads to reversal of estrogen-induced bile flow impairment in rats. This randomized, single-blind clinical trial was performed to determine whether SAMe reverses intrahepatic cholestasis of pregnancy (ICP) which occurs in hypersensitive women associated with increased estrogen levels in late pregnancy. Eighteen women with ICP were randomly divided into three groups of six and treated for 20 days as follows: Group I received 200 mg per day of i.v. SAMe; Group II received 800 mg per day of i.v. SAMe; Group III served as control. At the beginning of the study, clinical and biochemical parameters were similar among groups. After 10 and 20 days of treatment with the higher dose of SAMe, the mean values of serum transaminases, conjugated bilirubin and total bile acids fell significantly in respect to initial levels; opposite results were found in the other two treatment groups. The final values of these selected parameters were lower in the group of subjects treated with 800 mg per day SAMe than in the other two groups of women. Pruritus graded on a 0 to 4+ scale significantly was reduced only in patients treated with the higher dose of SAMe. These results indicate a trend toward remission of ICP in women treated with 800 mg per day SAMe and suggest that SAMe administration may be a new therapeutic modality for ICP.
THE CONSIDERATION OF LATE HEREDITARY SYPHILIS.
Authors: R. R. CAMPBELL
Journal: JAMA (1904)

On several occasions young girls from 5 to 18 years of age have been shown at meetings of the Chicago Dermatological Society, who presented undoubted lesions of tertiary syphilis, without a history of extragenital infection or previous eruptions of syphilis, and in whom none of the triad symptoms of hereditary syphilis was present. In the discussion of these cases it was apparent that a difference of opinion existed as to whether these were cases of extragenital infection or cases of long periods of latency in hereditary syphilis. The question which arose was: Can hereditary syphilis manifest itself for the first time some years after birth by the presence of such late lesions as occur in the acquired form, and with a total absence of triad symptoms? That long periods of latency is one of the chief charasteristics of acquired syphilis there can be no doubt
Diuretics in Hypertension
Authors: Emanuel Goldberger
Journal: JAMA (1961)

To the Editor:—  I should like to comment briefly on the very interesting paper by Dr. Ray W. Gifford, Jr. (Use of Diuretics in Hypertension, JAMA  177 :70 [July 8] 1961) with respect to the use of potassium supplements in patients receiving chlorothiazide derivatives.  The major electrolyte disturbance resulting from the chlorothiazides is the development of a metabolic alkalosis due to the loss of potassium ions and of hydrochloric acid (hypochloremic metabolic alkalosis). This has been demonstrated numerous times and I have also pointed this out previously (Goldberger, E.: Primer of Water, Electrolyte and Acid-Base Syndromes , Philadephia: Lea & Febiger, 1959). Therefore, the drug of choice to counteract this is potassium chloride, and not a solution of potassium triplex, which contains the acetate, bicarbonate, and citrate salts of potassium.  When the chlorothiazide derivatives are used in the treatment of hypertension, the loss of chlorideions may not be as serious
Lipid solubility modulates pH potentiation of local anesthetic block of Vmax reactivation in guinea pig myocardium.
Authors: A Broughton, A O Grant, C F Starmer, J K Klinger, B S Stambler, H C Strauss
Journal: Circulation Research (1984)

Current theories envision recovery from local anesthetic block of sodium channels via slow hydrophilic and fast hydrophobic paths. Extracellular pH reduction which increases cationic/neutral anesthetic form should especially prolong recovery kinetics of highly lipid soluble compounds that could readily exit via the hydrophobic pathway at normal extracellular pH. To test this hypothesis, we compared the effects of three related compounds with similar pKa on the time course of Vmax reactivation in guinea pig papillary muscle at pHo 7.4 and 6.95. The compounds were lidocaine and its two desethylation products, monoethylglycinexylidide and glycinexylidide. Judged from the octanol:water partition coefficient, lidocaine was the most lipid soluble (log partition coefficient 2.39 +/- 0.10), followed by monoethylglycinexylidide (log partition coefficient 1.32 +/- 0.09) and glycinexylidide was the least lipid soluble (log partition coefficient 0.41 +/- 0.09). At 30 microM and pHo 7.4, the potency order for Vmax depression at zero diastolic interval was lidocaine (53 +/- 6%), monoethylglycinexylidide (17 +/- 3%), and then glycinexylidide (7.8 +/- 1.9%). The decay of Vmax block appeared monoexponential, and the time constant of recovery was dose independent. Most important is the fact that there were significant differences in the tau r increase with extracellular pH reduction (P less than 0.05; Scheffé contrasts). The increase was greatest with lidocaine [73 +/- 28% (mean +/- SD)], less with monoethylglycinexylidide (42 +/- 15%), and least with glycinexylidide (13 +/- 17%). The simplest interpretation of the differences in extracellular pH-dependence of recovery kinetics was that recovery from block due to the neutral form of these ionizable local anesthetics depended on lipid solubility, whereas recovery from block due to the protonated form depended on molecular weight.
TCT-139 Effect of thrombus burden and its residue on no-reflow phenomenon after manual thrombectomy in patients with ST-elevation myocardial infarction
Authors: Julio García-Tejada, Jurado-Roman Alfonso, Carolina Granda, Agustin Albarran, M. Teresa Velazquez, Felipe Henandez, Belen Rubio, Sandra Mayordomo, Juan C. Tascon
Journal: Journal of the American College of Cardiology (2014)
Characterization of Focal Atrial Tachycardia Using High-Density Mapping
Authors: Prashanthan Sanders, Mélèze Hocini, Pierre Jaïs, Li-Fern Hsu, Yoshihide Takahashi, Martin Rotter, Christophe Scavée, Jean-Luc Pasquié, Fréderic Sacher, Thomas Rostock, Chrishan J. Nalliah, Jacques Clémenty, Michel Haïssaguerre
Journal: Journal of the American College of Cardiology (2005)
Halted HIV Vaccine Trial Assessed
Authors: Anita Slomski
Journal: JAMA (2013)

Interim findings of a phase 2b double-blind efficacy trial of an HIV vaccine candidate in an at-risk US population revealed that there was no indication that the vaccine was protective (Hammer SM et al. N Engl J Med. doi:10.1056/NEJMoa1310566 [published online October 7, 2013]).
PWE-008 A Novel Sampling Device For Collecting Mucocellular Material From The Rectum
Authors: J Booth, J Lacy-Colson, M Norwood, C Murray
Journal: Gut (2014)

<h3>Introduction</h3> Earlier detection of colorectal and other gastrointestinal malignancies is an urgent objective. Currently much effort is directed at the development of <i><i>in vitro</i></i> diagnostic tests that evaluate informative protein or DNA biomarkers in stool or blood samples. Stool samples are inconvenient to collect, require special handling facilities, and suffer from contamination that may interfere with molecular assays. Blood samples, while more convenient, may not be as informative early in the disease process. Several studies have shown that significant numbers of exfoliated cells and their products are retained in a muco-cellular layer overlying the colonic mucosa but distinct from the stool itself, and that this material flows toward the rectum, where it can be captured for analysis. <h3>Methods</h3> Origin Sciences has developed a novel sampling device, which incorporates an inflatable nitrile membrane. Following insertion into the unprepared rectum via a standard proctoscope, the membrane is inflated to make contact with the rectal mucosa for 10 seconds. The membrane is then deflated and retracted into the device prior to removal from the patient. Upon retraction the material sampled from the rectal mucosa is retained on the inverted membrane, which acts as a receptacle for the addition of buffer to preserve the material for subsequent analysis. <h3>Results</h3> The sampler has been tested in over 2000 patients and healthy volunteers, and has shown excellent patient acceptability. Tests and <i><i>in vitro</i></i> experiments with monolayers of cultured human cells indicate that the membrane captures intact cells, which are easily washed off the membrane for further investigation. Mucous-associated soluble material captured by the device is rich in protein and nucleic acids. Levels of soluble protein present in the buffer varied between 90 and 3000 µg/mL, with a mean of 710 µg/mL. As part of a programme to identify novel cancer biomarkers, Origin Sciences has detected informative auto-antibody isotypes IgA, IgG and IgM by ELISA. The same preparation is also rich in nucleic acids; DNA has been found in amounts ranging from 0.5 to 21.9 ug/mL. This DNA is suitable for amplification and sequencing, since we have been able to detect a number of genes by quantitative PCR. <h3>Conclusion</h3> The sampling device represents a novel and minimally invasive means of capturing biomarker-rich material from the unprepared rectum. Since there is minimal contamination by stool, the material collected is readily analysable, in principle lending itself to point-of-care tests for a wide range of indications, including infectious and inflammatory diseases of the GI tract in addition to malignancy. The device can be used as a robust means of collecting material for later analysis by a wide range of technologies. <h3>Disclosure of Interest</h3> None Declared.
On Bedside Teaching
Authors: Thomas F. Mulrooney
Journal: Annals of Internal Medicine (1997)

Letters15 July 1997On Bedside TeachingThomas F. Mulrooney, MDThomas F. Mulrooney, MDMinnesota Lung Center; Minneapolis, MN 55407Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-2-199707150-00045 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article “On Bedside Teaching” [1] appeared at exactly the right time for me. I am teaching a course on physical diagnosis to a group of medical students at the University of Minnesota from March until May 1997. This represents a return to teaching for me after an absence of more than 20 years.As I recall, my own education included a great deal of hands-on teaching at the bedside. I was a little astonished and distressed to learn that this practice has become relatively uncommon. I hope that I can emulate the method and skills outlined ...References1. LaCombe MA. On bedside teaching. Ann Intern Med. 1997; 126:217-20. Google Scholar Author, Article, and Disclosure InformationAffiliations: Minnesota Lung Center; Minneapolis, MN 55407 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1997Volume 127, Issue 2Page: 173KeywordsHeart diseasesLungs Issue Published: 15 July 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Shortfall of family doctors means US faces "absolute crisis" by 2020
Authors: J. H. Tanne
Journal: BMJ (2009)

A predicted shortfall of 40 000 family doctors in the United States by 2020 has sparked fears that there will be too few doctors to cope with increased demand, including that arising from Barack Obama’s proposals for healthcare reform.

The country faces “an absolute crisis” in the provision of primary care doctors, said Ted Epperly, president of the 93 000 member American Academy of Family Physicians, which raised the alarm.

Students about to start medical school will be entering practice in 2020, but only one in 10 medical students currently enters primary care residencies; the rest all opt for specialties, Dr Epperly said. “We’re poised to do healthcare reform, but we …
Visualization of Aβ42(43) and Aβ40 in senile plaques with end-specific Aβ monoclonals: Evidence that an initially deposited species is Aβ42(43)
Authors: Takeshi Iwatsubo, Asano Odaka, Nobuhiro Suzuki, Hidehiro Mizusawa, Nobuyuki Nukina, Yasuo Ihara
Journal: Neuron (1994)
JAZF1 regulates visfatin expression in adipocytes via PPARα and PPARβ/δ signaling
Authors: Guang-feng Ming, Xi Li, Ji-ye Yin, Yu-hang Ai, Dao-miao Xu, Xin-hua Ma, Zhi-yong Liu, Hui-xia Liu, Hong-hao Zhou, Zhao-qian Liu
Journal: Metabolism (2014)
Body Temperature Regulation During Anesthesia in Infants and Children
Authors: C. R. Stephen
Journal: JAMA (1960)

In modern, air-conditioned operating rooms, maintained at temperatures between 68 and 72° F. (20 and 22.2° C.), the anesthetized pediatric patient, being virtually poikilothermic and possessing a relatively large surface area, is likely to lose heat. In a series of 600 infants and children between the ages of 1 day and 12 years, the rectal temperature at the end of operation was variable; but under the age of 6 months, a significant reduction in body temperature was common. To prevent complications associated with either hypothermia or hyperthermia, it is important to recognize trends as they develop: this end is accomplished best by constant monitoring of the body temperature. A heating-cooling apparatus is described which automatically regulates the body temperature of the patient to within 0.5° C. of that which is preset by the physician.
Marginal survival benefit in the treatment of early hepatocellular carcinoma
Authors: Yutaka Midorikawa, Tadatoshi Takayama, Kazuaki Shimada, Hisashi Nakayama, Tokio Higaki, Masamichi Moriguchi, Satoshi Nara, Shingo Tsuji, Masatoshi Tanaka
Journal: Journal of Hepatology (2012)
The Natural History of the Inherited Methylmalonic Acidemias
Authors: Suzanne M. Matsui, Maurice J. Mahoney, Leon E. Rosenberg
Journal: New England Journal of Medicine (1983)

Six biochemical and genetic forms of methylmalonic acidemia have been defined previously: two (mut° and mut -) resulting from defects in the mutase apoenzyme, and four (cbl A, cbl B, cbl C, and cbl D) resulting from deficient adenosylcobalamin synthesis. We retrospectively surveyed the clinical presentation, response to cobalamin supplementation, and long-term outcome in the four most prevalent mutant classes by collecting detailed information on 45 patients (15 mut°, 5 mut -, 14 cbl A, and 11 cbl B). Most patients presented acutely with a common set of clinical and laboratory findings; however, there were significant differences between mutant classes: mut° patients presented earlier in infancy than did cbl A and cbl B patients; in response to cobalamin supplements, marked decreases in the concentration of methylmalonic acid in blood or urine were reported in most cbl A patients and in nearly half the cbl B patients, but not in mut° or mut - patients; and finally, most cbl A, cbl B, and mut - patients were still living, whereas most mut - patients died during the first few months of life. Our data indicate that genotypic classification of the methylmalonic acidemias has prognostic and therapeutic use as well as diagnostic value. (N Engl J Med. 1983; 308:857–61.)