tbuckley/cabot-search huggingface dataset:
GPs' leader writes to review body on out of hours stalemate BMA council supports consultants' sanctions Request deferred for referendum on GMSC membership BMA will consider investigating racism in the NHS More work will be done on telephone helpline GPs can appeal over dispensing decision NHS Executive issues guidance on NHS occupational health service GPs comment on drug budget proposals
Authors: L. Beecham
Journal: BMJ (1995)

# GPs' leader writes to review body on out of hours stalemate {#article-title-2}

At its November meeting the General Medical Services Committee rejected the Department of Health's derisory offer of a fixed payment of £2000 per principal for out of hours work and a new night visit fee of £9 and instructed the chairman to seek a meeting with the secretary of state (26 November 1994, p 1392).

At the December meeting the chairman, Dr Ian Bogle, reported that the negotiators had met Mrs Bottomley and that he had written to the chairman of the doctors' and dentists' review body to bring it up to date on the lack of progress on settling a payment for out of hours work.

The negotiators had left the minister in no doubt about how strongly general practitioners felt about the increased aggravation of out of hours work, and about the paucity of the November offer. They told her that the whole contract was underpriced and that the out of hours part was underfunded and needed to be separately identified and priced. They urged her to support the profession's cases to the review body.

Dr Bogle told the GMSC that he understood the strength of feeling on the subject but he suggested that there should be no precipitate action until the review body had reported, probably at the end of January. The GMSC's resignation from the NHS task force would meet during January and an options document would be prepared. Dr Bogle said that he hoped that the change to paragraph 13 of the terms of service, which would allow doctors to decide whether and where to visit a patient out of hours, would be approved in January.

In his letter to the review body chairman Dr Bogle pointed out that the out of hours issue had brought the profession's disenchantment with the current level of pay …
Production of angiotensin converting enzyme by rheumatoid synovial membrane.
Authors: D Veale, G Yanni, B Bresnihan, O FitzGerald
Journal: Annals of the Rheumatic Diseases (1992)

Vascular proliferation and mononuclear cell infiltration are prominent changes observed in synovium from actively inflamed joints of patients with rheumatoid arthritis. Angiotensin converting enzyme (ACE) is a halide activated peptidase produced mainly by endothelial cells and by activated monocytes. It has been proposed that levels of ACE activity in synovial fluid might reflect changes in membrane vascularity, the degree of monocyte infiltration, or the thickness of the lining layer. In this study, ACE activity in serum and synovial fluid samples from 18 patients with inflammatory arthritis was measured and compared with levels in 12 control subjects with non-inflammatory arthritis. Although serum levels were similar in the two groups, ACE activity in synovial fluid was significantly increased in the group with inflammatory arthritis compared with controls (mean (SE) 37 (5) v 19 (3)). Staining of synovial membranes from patients with rheumatoid arthritis with a monoclonal antibody to ACE localised ACE to the endothelium and to mononuclear cells of macrophage origin. ACE activity was then measured in supernatants of synovial membrane from patients with rheumatoid arthritis after one and seven days of culture. A significant increase in ACE activity was observed after seven days of culture (mean (SE) day 1, 17 (5) v day 7, 25 (3)). Levels of ACE activity, however, did not correlate with the lining layer thickness, with the number of macrophages per square millimetre, nor with the number of blood vessels per square millimetre of synovial tissue. No correlation was observed either between levels of ACE in the supernatant of synovial membrane and levels of interleukin 1 or interleukin 6. In conclusion, ACE is produced by the synovial membrane of patients with rheumatoid arthritis and is localised to monocytes and endothelial cells. Levels of activity do not directly reflect membrane vascularity, monocyte or macrophage number, or the thickness of the lining layer.
Government removes data sharing clause from coroners' bill
Authors: Z. Kmietowicz
Journal: BMJ (2009)

Jack Straw, the UK justice secretary, is to abandon plans that could have allowed patients’ medical records to be used by third parties without patients’ consent.

A spokeswoman for the Ministry of Justice said that the government still believed strongly in data sharing but had accepted the concerns of many critics that clause 152 of the Coroners and Justice Bill was not the way forward.

Although the aims of the clause, which would allow data to be shared among government departments so that it was easy to identify, for example, children who were entitled …
Cryptococcal Interstitial Pneumonia
Authors: Bruce D. Fisher, Donald Armstrong
Journal: New England Journal of Medicine (1977)

The emergence of acute interstitial pneumonia in immunocompromised patients is a serious, often life-threatening event.1 A treatable cause of this syndrome is the yeast Cryptococcus neoformans. Although definitive diagnosis of invasive pulmonary infection by this organism rests on its demonstration in lung tissue,2 thrombocytopenia in heavily immunosuppressed patients may preclude biopsy procedures. Immunologic demonstration of cryptococcal polysaccharide capsular antigen in serum, by latex agglutination, is simple, rapid and conclusive proof of cryptococcosis, when the test is positive3 and when concurrent control assays for rheumatoid factors are done.4 In addition, in studies of serum and cerebrospinal fluid of 30 patients . . .
Stunned vs Hibernating Myocardium
Authors: Charles J. Gbur
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The recent review by Dr Bolooki<sup>1</sup>on surgical management of complications of acute myocardial infarction should serve as a standard for treatment of these critically ill patients. However, the statement pertaining to postinfarction cardiogenic shock that "acute revascularization should result in immediate improvement in the function of the ischemic areas and of the 'stunned' myocardium" is somewhat misleading. "Myocardial stunning" refers to transient postischemic contractile abnormalities seen after reperfusion has been restored.<sup>2</sup>This phenomenon has been shown to last for up to several days. In contrast, "hibernating myocardium" refers to dysfunction of viable tissue as a result of prolonged, chronic hypoperfusion, which is completely reversible on restoring adequate blood flow.<sup>2,3</sup>The jeopardized myocardium that Dr Bolooki discusses fits neither of these definitions. This most likely represents salvage of myocytes that have not been irreversibly damaged by the acute ischemic insult. These two terms are
Delay of HIV-1 rebound after cessation of antiretroviral therapy through passive transfer of human neutralizing antibodies
Authors: Alexandra Trkola, Herbert Kuster, Peter Rusert, Beda Joos, Marek Fischer, Christine Leemann, Amapola Manrique, Michael Huber, Manuela Rehr, Annette Oxenius, Rainer Weber, Gabriela Stiegler, Brigitta Vcelar, Hermann Katinger, Leonardo Aceto, Huldrych F Günthard
Journal: Nature Medicine (2005)
BABE WITH ONE LUNG.
Authors: RALPH HANSON
Journal: JAMA (1901)

Mrs. W. G. M. was delivered after a normal labor of a seven-pound female child on October 27, 1900, at about the thirty-sixth week of gestation. It breathed immediately, but not satisfactorily, the respirations being shallow and at too long intervals. There was no cry; the color was pale. The pulse in the cord was strong so the child was removed from the mother, and all usual efforts made to establish normal respiration, but without success. The respirations became less frequent and more shallow and ceased entirely in about fifteen minutes. The heart continued beating for several minutes longer. In working with the child the heart-beat was discovered to be on the right side and was easily felt, and the impulse was visible to both myself and the nurse. I thought I had a case of transposition of the viscera, and asked for permission to hold a postmortem examination, which
Percutaneous Balloon Versus Surgical Closed and Open Mitral Commissurotomy
Authors: Mohamed Ben Farhat, Mokdad Ayari, Faouzi Maatouk, Fethi Betbout, Habib Gamra, Mourad Jarrar, Mabrouk Tiss, Sonia Hammami, Rafik Thaalbi, Faouzi Addad
Journal: Circulation (1998)

Background —Percutaneous balloon mitral commissurotomy (BMC) has been proposed as an alternative to surgical closed mitral commissurotomy (CMC) and open mitral commissurotomy (OMC) for the management of rheumatic mitral valve stenosis (MS). Methods and Results —We conducted a prospective, randomized trial comparing the results of the 3 procedures in 90 patients (30 patients in each group) with severe pliable MS. Cardiac catheterization was performed in all patients before and at 6 months after each procedure. All patients had clinical and echocardiographic evaluation initially and throughout the 7-year follow-up period. Gorlin mitral valve area (MVA) increased much more after BMC (from 0.9±0.16 to 2.2±0.4 cm 2 ) and OMC (from 0.9±0.2 to 2.2±0.4 cm 2 ) than after CMC (from 0.9±0.2 to 1.6±0.4 cm 2 ). Residual MS (MVA &lt;1.5 cm 2 ) was 0% after BMC or OMC and 27% after CMC. There was no early or late mortality or thromboembolism among the three groups. At 7-year follow-up, echocardiographic MVA was similar and greater after BMC and OMC (1.8±0.4 cm 2 ) than after CMC (1.3±0.3 cm 2 ; P &lt;.001). Restenosis (MVA &lt;1.5 cm 2 ) rate was 6.6% after BMC or OMC versus 37% after CMC. Residual atrial septal defect was present in 2 patients and severe grade 3 mitral regurgitation was present in 1 patient in the BMC group. Eighty-seven percent of patients after BMC and 90% of patients after OMC were in New York Heart Association functional class I versus 33% ( P &lt;.0001) after CMC. Freedom from reintervention was 90% after BMC, 93% after OMC, and 50% after CMC. Conclusions —In contrast to surgical CMC, BMC and OMC produce excellent and comparable early hemodynamic improvement and are associated with a lower rate of residual stenosis and restenosis and need for reintervention. However, the good results, lower cost, and elimination of drawbacks of thoracotomy and cardiopulmonary bypass indicate that BMC should be the treatment of choice for patients with tight pliable rheumatic MS.
Increased advanced oxidation protein products in Behcet's disease: a new activity marker?
Authors: C. Yazici, K. Kose, M. CaliS, M. DemIr, M. Kirnap, F. AteS
Journal: British Journal of Dermatology (2004)

Background Behçet's disease (BD) is a chronic inflammatory disease with unknown pathogenesis. As various functions of neutrophils in peripheral blood, such as chemotaxis, phagocytosis and generation of reactive oxygen species (ROS) increase in BD, ROS-mediated oxidative stress related to neutrophil activation may have an important role in the pathogenesis of BD. Objectives To investigate the importance of neutrophil activation as the main source of oxidative stress through protein oxidation in the pathogenesis of BD, and also to investigate whether one of the products of protein oxidation, advanced oxidation protein products (AOPP), may be used as an activity marker for BD. Methods Patients with BD (n = 49), at active and inactive stages, with or without evidence of uveitis, and healthy volunteers (n = 40) were entered into the study. A full blood count, peripheral blood smears, routine biochemical analyses, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measurements were performed in all patients preceding the study. Plasma myeloperoxidase (MPO) activity, representing neutrophil activation, and biomarkers of oxidative stress reflecting protein oxidation, such as levels of AOPP and thiol, were measured spectrophotometrically. Statistical comparisons were made using Mann–Whitney U-tests, Student's t-tests, anova/post-anova tests and correlation analyses. Results In all patients, the results of full blood count, peripheral blood smears and routine biochemical analyses were in the normal range, but mean values of CRP and ESR were higher than laboratory reference values. Plasma MPO activity and AOPP levels were found to be higher and thiol values lower in the total patient group and individual subgroups than in controls. Patients with active BD had significantly higher MPO and AOPP levels and lower thiol levels than patients with inactive BD. There was no difference between uveitis-positive and uveitis-negative subgroups in MPO and thiol levels, but AOPP levels were lower in the latter group. Patients with active BD ± uveitis were shown to have increased MPO and AOPP but decreased thiol levels in comparison with the inactive BD, uveitis-negative subgroup. There were strong positive correlations between ESR and CRP, ESR and MPO, ESR and thiol, ESR and AOPP, CRP and MPO, CRP and AOPP, MPO and AOPP, and thiol and AOPP levels in patients with BD. Conclusions Based on this first study, in which MPO-mediated AOPP formation has been demonstrated, it may be suggested that activated neutrophils may play an important role in the pathogenesis of BD and that chlorinated oxidants of neutrophil origin may lead to oxidative stress, notably protein oxidation. Therefore, AOPP may be a useful marker for monitoring the progress and the severity of the disease activity.
Bradycardia after the use of atracurium.
Authors: M L Carter
Journal: BMJ (1983)

Four cases of severe bradycardia developed during surgery in patients given the neuromuscular blocking agent atracurium as part of the anaesthesia. In all cases sinus rhythm was restored by giving intravenous atropine. It is recommended that in all operations in which vagal stimulation is expected patients should be given atropine as part of the premedication or induction sequence and should undergo full electrocardiographic monitoring during surgery.
Divergent roles of endothelial nitric oxide synthase in cardiac hypertrophy and chamber dilatation?
Authors: A SHAH
Journal: Cardiovascular Research (2005)

See also article by Ruetten et al.  [11]  (pages 444–453) in this issue. 

Nitric oxide (NO) influences many aspects of cardiac function including excitation–contraction coupling, myofilament function, oxygen consumption, substrate metabolism, and cell growth and survival [1,2]. All three NO synthase (NOS) isoforms, namely eNOS, nNOS, and iNOS, can be expressed in the heart. An important paradigm with respect to the cardiomyocyte has been the demonstration that eNOS and nNOS are both expressed in this cell type but have distinct effects on contractile function as a result of their specific subcellular localization and distinct interactions with and/or proximity to other signaling molecules and targets such as SR calcium release channels, caveolin, cGMP-specific phosphodiesterases, and others [3,4]. In addition to this complexity at the cardiomyocyte level, individual NOS isoforms may be expressed in several different cell types within the heart. For example, eNOS is expressed at a much higher level in cardiac endothelial and endocardial cells than in cardiomyocytes, and NO released from endothelial cells is capable of exerting paracrine effects on adjacent cardiomyocytes [1].

Although the effects of NO on contractile function initially received more attention than its other actions, it is evident that NO may also influence cardiac hypertrophy and remodeling. NO …
Advisory on Need for Caution With Use of Vacuum-Assisted Delivery Devices
Authors: Stuart L. Nightingale
Journal: JAMA (1998)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Eternal Battle of Sex vs Gender
Authors: Doris E. Fletcher
Journal: JAMA (1991)

<h3>To the Editor.</h3> —I consider<i>JAMA</i>to be a standard setter for accepted grammar and usage. Therefore, I was disturbed to see your use of the word<i>gender</i>for<i>sex</i>(definition of<i>Matching</i>in "Instructions for Preparing Structured Abstracts").<sup>1</sup>This incorrect usage is becoming widespread, as if<i>sex</i>were a dirty word. Perpetuating such usage implies sanction.<i>Gender</i>is a grammatical term referring to words, which in some languages are masculine, feminine, or neuter.<i>Sex</i>refers to the biological characteristic of being male or female. The<i>New York Times</i>' publication W<i>inners &amp; Sinners</i>succinctly reminds writers and editors that "words have gender. People, bless their hearts, have sex."
Impedance and transmission properties of the pulmonary arterial system
Authors: S. R. Reuben, J. P. Swadling, B. J. Gersh, G. d. J. Lee
Journal: Cardiovascular Research (1971)

Journal Article Impedance and transmission properties of the pulmonary arterial system Get access S. R. Reuben, S. R. Reuben From the Cardiac Department and the Nuffield Department of Anaesthetics, the Radcliffe Infirmary, Oxford Search for other works by this author on: Oxford Academic PubMed Google Scholar J. P. Swadling, J. P. Swadling From the Cardiac Department and the Nuffield Department of Anaesthetics, the Radcliffe Infirmary, Oxford Search for other works by this author on: Oxford Academic PubMed Google Scholar B. J. Gersh, B. J. Gersh 2 From the Cardiac Department and the Nuffield Department of Anaesthetics, the Radcliffe Infirmary, Oxford 2B.J.G. is in receipt of a Rhodes Scholarship. Search for other works by this author on: Oxford Academic PubMed Google Scholar G. de J. Lee G. de J. Lee From the Cardiac Department and the Nuffield Department of Anaesthetics, the Radcliffe Infirmary, Oxford Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 5, Issue 1, January 1971, Pages 1–9, https://doi.org/10.1093/cvr/5.1.1 Published: 01 January 1971 Article history Accepted: 03 June 1970 Published: 01 January 1971
Hydrogen peroxide stimulates rat colonic prostaglandin production and alters electrolyte transport.
Authors: S S Karayalcin, C W Sturbaum, J T Wachsman, J H Cha, D W Powell
Journal: Journal of Clinical Investigation (1990)

The changes in short circuit current (electrogenic Cl- secretion) of rat colon brought about by xanthine/xanthine oxidase in the Ussing chamber were inhibited by catalase and diethyldithiocarbamate, but not by superoxide dismutase. These results, the reproduction of the response with glucose/glucose oxidase and with exogenous H2O2, and the lack of effect of preincubation with deferoxamine or thiourea implicate H2O2, and not O2- or OH., as the important reactive oxygen metabolite altering intestinal electrolyte transport. 1 mM H2O2 stimulated colonic PGE2 and PGI2 production 8- and 15-fold, respectively, inhibited neutral NaCl absorption, and stimulated biphasic electrogenic Cl secretion with little effect on enterocyte lactic dehydrogenase release, epithelial conductance, or histology. Cl- secretion was reduced by cyclooxygenase inhibition. Also, the Cl- secretion, but not the increase in prostaglandin production, was reduced by enteric nervous system blockade with tetrodotoxin, hexamethonium, or atropine. Thus, H2O2 appears to alter electrolyte transport by releasing prostaglandins that activate the enteric nervous system. The change in short circuit current in response to Iloprost, but not PGE2, was blocked by tetrodotoxin. Therefore, PGI2 may be the mediator of the H2O2 response. H2O2 produced in nontoxic concentrations in the inflamed gut could have significant physiologic effects on intestinal water and electrolyte transport.
Nasal Foreign Bodies and Bromidrosis
Authors: Walter W. Tunnessen
Journal: JAMA (1979)

To the Editor.—  I was pleased to read the short report by Katz et al,  Presentation of Nasal Foreign Bodies in Children, which appeared inThe Journal. The authors reported three cases of generalized body odor secondary to these foreign bodies, which occurred in their office practice in a one-year period. As they point out, this presentation may lead to considerable delay in diagnosis and expense in workup if it is not recognized.  Unfortunately, as noted by the authors, this association has received little notoriety. Golding 1 reported a similar case in 1965 under the title of An Unusual Cause of Bromidrosis. Bromidrosis refers to fetid or foul-smelling perspiration. Another case was reported in Clini-Pearls in 1978. 2   Although Katz et al have not described a new association, their report is still timely, interesting, and important for all physicians caring for children.
CXCL12 (SDF-1α) suppresses ongoing experimental autoimmune encephalomyelitis by selecting antigen-specific regulatory T cells
Authors: Moran Meiron, Yaniv Zohar, Rachel Anunu, Gizi Wildbaum, Nathan Karin
Journal: The Journal of Experimental Medicine (2008)

Experimental autoimmune encephalomyelitis (EAE) is a T cell–mediated autoimmune disease of the central nervous system induced by antigen-specific effector Th17 and Th1 cells. We show that a key chemokine, CXCL12 (stromal cell–derived factor 1α), redirects the polarization of effector Th1 cells into CD4+CD25−Foxp3−interleukin (IL) 10high antigen-specific regulatory T cells in a CXCR4-dependent manner, and by doing so acts as a regulatory mediator restraining the autoimmune inflammatory process. In an attempt to explore the therapeutic implication of these findings, we have generated a CXCL12-immunoglobulin (Ig) fusion protein that, when administered during ongoing EAE, rapidly suppresses the disease in wild-type but not IL-10–deficient mice. Anti–IL-10 neutralizing antibodies could reverse this suppression. The beneficial effect included selection of antigen-specific T cells that were CD4+CD25−Foxp3−IL-10high, which could adoptively transfer disease resistance, and suppression of Th17 selection. However, in vitro functional analysis of these cells suggested that, even though CXCL12-Ig–induced tolerance is IL-10 dependent, IL-10–independent mechanisms may also contribute to their regulatory function. Collectively, our results not only demonstrate, for the first time, that a chemokine functions as a regulatory mediator, but also suggest a novel way for treating multiple sclerosis and possibly other inflammatory autoimmune diseases.
Victor Stanley Brookes
Authors: R. Viney
Journal: BMJ (2009)

Victor Stanley Brookes was born in Dudley in late November 1920. Victor and his younger brother were orphaned at a young age and were raised by a local apothecary, giving him his first taste of medicine. He attended Dudley Grammar School from 1932 to 1938, where he won the prestigious Ironmasters prize, as well as prizes in physics, chemistry, biology, and English. He won the Dudley Guest Hospital Scholarship to study medicine at Birmingham University Medical School. While attaining his MB ChB with first class honours in 1943 he secured the Queen’s scholarship twice, the Ingleby scholarship, …