tbuckley/cabot-search huggingface dataset:
Risk Management and Litigation in Obstetrics and Gynaecology
Authors: Laurie Montgomery Irvine
Journal: Journal of the Royal Society of Medicine (2002)

Money paid out for clinical negligence now accounts for a sizeable part of National Health Service spending. The trend to litigation is increasing and the specialty of obstetrics and gynaecology suffers particularly because of high awards for brain damage in babies. Numerous books and courses offer advice on how to avoid such litigation, under the titles risk management and clinical governance. However, some clinicians feel that risk management is a drain on time and resources, without much benefit to the patient. This view, I believe, is partly due to a mistaken idea that risk management is synonymous with defensive medicine. Defensive medicine is a sloppy mode of practice whereby patients are overinvestigated so that the clinician escapes criticism if the outcome is unsatisfactory. (Most investigations yield some false-positives which then lead to further tests, which may be hazardous to the patient.) Risk management, by contrast, is about identifying the risks, deciding on practical strategies to minimize them and also deciding whether they are worth taking. Individuals and departments reach differing conclusions, hence the variations in management policies nationwide.
Multiple Use of Disposable Insulin Syringe-Needle Units
Authors: Robert H. Hodge
Journal: JAMA (1980)

Fourteen insulin-dependent diabetics were asked to use their insulin syringe-needle units three times in succession to determine the efficacy and safety of this practice. The mean duration of time each patient participated in the study was 20.4 weeks, and a total of 2,000 injections were taken. No signs of infections at the injection site were observed. Multiple use of disposable insulin syringe-needle units appears to be safe and cost beneficial.
Physical training increases ventricular fibrillation thresholds of isolated rat hearts during normoxia, hypoxia and regional ischemia.
Authors: T D Noakes, L Higginson, L H Opie
Journal: Circulation (1983)

The effect of exercise training on cardiovascular mortality is controversial. The purpose of this study was to determine the effect of a period of treadmill training on the ventricular fibrillation threshold of the isolated rat heart. Trained hearts had higher threshold values during standard, control perfusion conditions, and when exposed to hypoxia, hypoxia plus isoproterenol infusion, or when subjected to coronary artery ligation. Myocardial metabolic studies failed to define the mechanism for the effect of running training. However, in coronary ligated hearts, the content of the arrhythmogenic substance 3',5' cyclic adenosine monophosphate (cyclic AMP) was reduced in the ischemic zone of hearts from trained rats. Cyclic AMP levels were also lower in trained hearts during control perfusions. We conclude that running training increases the resistance of the heart to ventricular fibrillation by mechanisms that are largely unknown, although they may involve cyclic AMP.
Abstract P4-10-13: Therapeutic Delays, Mode of Diagnosis and Surgical Treatment of Operable Invasive Breast Cancer (BC) in Elderly Versus Non Elderly Patients in the Community
Authors: Y Tazi, J-R Garbay, N Berrada, J Chevalier, C Mazouni, M-C Mathieu, C Bourgier, J Domont, M Spielmann, D Dionysopoulos, S. Delaloge
Journal: Cancer Research (2010)

Abstract Background: National mammography screening program covers populations aged 50-74. We wondered whether breast cancer characteristics and treatment delays were influenced by age and screening method in a community-based breast unit. Patients and Methods: We analyzed complete data of prospectively recorded community operable breast cancer cases in a single regional cancer center between Jan 1st, 2005 and Oct 10th, 2007. Pts were eligible if they i. had a final diagnosis of invasive BC ii. were operated as first trt for BC, iii. had no history of other previous malignancy within the past 5 year period. Logistic regression analyses (SAS) were used to determine factors influencing delays between first description of the lesion and first appointment at breast unit. Results: 1044 pts met the inclusion criteria and had full data available. Age did not appear as a predictor of therapeutic delay, with both elderly and non-elderly pts having a median delay of 19 days between first screening/evidence of disease and 1st appointment at the breast unit. 59% of elderly and 65% of non-elderly pts had respectively had their breast cancer diagnosed through mammographic screening. As expected, mammographic screening as mode of discovery of the cancer was highest, among the 688 pts aged 50-74 (73%). Tumors characteristics and surgical treatment did not differ according to age categories elderly/non elderly as described in Table 1. Conservation rates were high in both populations. Conclusion: Despite absence of national mammographic screening program in elderly populations, patterns of screening and care appear efficient in a community-based setting, with absence of therapeutic delays, similar tumor staging and similar accesss to conservative surgery as compared to younger populations. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-13.
A CASE OF TUBERCULAR ADENITIS WITH GENERAL ALOPECIA AND PRURITUS.Read before the Section of Dermatology and Syphilography, at the Forty-third Annual Meeting of the American Medical Association, held at Detroit, June, 1892.
Authors: JAMES H. DUNN
Journal: JAMA (1893)

The following case of tuberculosis of the lymph nodes presents some phases in its clinical history which were to me quite novel, particularly the general alopecia and pruritus which during the first year of the disease were the patient's chief plague. Early in April, 1890, Dan. McA., Irish American, farmer, aged 21, fell under my observation and gave the following history: His father, mother, several brothers and sisters are all living and healthy. Of more distant relatives he knew but little, yet denied any rumor or knowledge of a tuberculous family record. He had been a very healthy and athletic young man, five feet nine inches in height, weight 185 pounds, light hair and complexion with bright blue eyes. For several years he had each autumn been engaged in "feeding" threshing machine. While employed in this very dusty work during the fall of 1888he began to cough without expectoration, noticed
17-Beta-Estradiol increases cardiac remodeling and mortality in mice with myocardial infarction
Authors: Martin van Eickels, Richard D Patten, Mark J Aronovitz, Alawi Alsheikh-Ali, Kim Gostyla, Flore Celestin, Christian Grohe, Michael E Mendelsohn, Richard H Karas
Journal: Journal of the American College of Cardiology (2003)
Self-Poisoning With Aspirin and Five Other Drugs
Authors: Walter J. Decker
Journal: JAMA (1970)

<h3>To the Editor.—</h3> The case report of Ferguson and Boutros,<sup>1</sup>"Death Following Self-Poisoning With Aspirin," raises a number of unanswered questions. The possibility of toxic effects from the five other drugs their patient took, namely propoxyphene hydrochloride, chlordiazepoxide, secobarbital sodium, amobarbital sodium, and chloral hydrate, was not considered in their comments. Any one of these drugs appears more likely to have caused the bulk of the symptoms reported than aspirin. The choice of the serum assays requested is usually disturbing—when the salicylate level was higher at eight hours than at admission did they not repeat the barbiturate determination or request analyses for propoxyphene, chloral hydrate, and chlordiazepoxide? Why bromides, since there was no apparent reason to suspect bromism? At autopsy was nothing unusual present in the gastrointestinal tract? We suspect that a bolus of unabsorbed drugs would be found. A brief review of case reports makes it readily apparent
Occupational disease trends in black South African gold miners. An autopsy-based study.
Authors: J Murray, D Kielkowski, P Reid
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The change in prevalence in silicosis and pulmonary tuberculosis in black South African gold miners dying from unnatural causes from 1975 to 1991 was studied. Data were analyzed for 16,454 black gold miners. Information on age at death, duration of service, year of autopsy examination, and the prevalence of silicosis and tuberculosis was collected. Analyses were done to assess secular trends in the prevalence of tuberculosis and silicosis, and to determine predictors of the diseases at death. The prevalence of tuberculosis increased from 0.9% in 1975 to 3.9% in 1991. The prevalence of silicosis increased from 9.3% to 12.8%. The prevalence of both diseases increased with age and duration of service. Silicosis was the most significant predictor of tuberculosis (odds ratio [OR] = 1.78, confidence limits [CL] = 1.27 to 2.30). A significant trend for tuberculosis, for year of autopsy, remained after adjustment for the other variables in the model, such as age and duration of service (p = 0.0046). In view of current labor stabilization in the South African mines, one can expect further increases in the prevalence of tuberculosis and silicosis. Lowering of dust levels in the mines is urgently required to prevent the increase of disease burden.
1994 Physicians' GenRx for Hard Disk: The Official Drug Reference of FDA Prescribing Information and Therapeutic Equivalents
Authors: Daniel Levinson
Journal: JAMA (1994)

Physicians' GenRx is a comprehensive official drug reference text supported by the US Food and Drug Administration. Physicians' GenRx for Hard Disk is an electronic version of Physicians' GenRx , and the virtues of the latter are the strengths of the former. It is similar to the widely used Physicians' Desk Reference (PDR) , but unlike the PDR , which is essentially a reprint collection of pharmaceutical package inserts, Physicians' GenRx is an unbiased compilation of prescribing information. In addition to the usual categories of clinical pharmacology, indications, contraindications, warnings, dosage and administration, and so forth, Physicians' GenRx contains valuable cost-comparison data and bibliographic citations. The Physicians' GenRx print edition, a hefty, 2700-page, 10-pound text, is straightforward to use and provides detailed prescribing information in a quick, easy-to-scan format.  GenRx for Hard Disk contains the same information as the print edition. The question is, which is easier to use? GenRx for Hard Disk
The Healing of Persons
Authors: Barbara Hull
Journal: JAMA (1965)

ABSTRACT The Healing of Persons is far from being just another book dealing with the treatment of the whole person. The original version of 1940 was not translated into English until 1965. The author readily acknowledges that some of his ideas have changed during this time; yet he chose not to revise the book radically lest its original spontaneity should suffer.His main thesis is that the unique individuality of the patient, with his past fears, interests, guilts, etc. play an immeasurable part in the inception, course, and prognosis of illnesses. The doctor must have recourse to all available technical helps in diagnosis and treatment, including psychotherapy, but he is not doing his full job unless he also tries to help the patient solve his life problems.The challenge is never-ending, demanding from the doctor a maturity which must be approached through self-understanding and continual spiritual growth. The healing of persons
Can Prescription Drug Monitoring Programs Help Limit Opioid Abuse?
Authors: Hallam M. Gugelmann, Jeanmarie Perrone
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 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
Abstract 1744: αB-crystallin as a novel marker of lymph node metastasis in breast cancer
Authors: Haesung Kim, Younok Lee, Hee Joon Kang, Lee-Su Kim
Journal: Cancer Research (2010)

Abstract αB-crystallin, the member of small heat shock protein, is known as an anti-apoptotic protein and is associated with aggressive tumor behavior. In addition, recent study revealed that αB-crystallin was overexpressed in a metastatic variant of the GI101A human breast carcinoma cell line. The purpose of this study was to investigate whether expression of αB-crystallin was associated with lymph node metastasis. And also we evaluated the relationship of expression of αB-crystallin and other established prognostic factors. Eighty two patients who underwent breast cancer surgery and chemotherapy at Hallym Sacred Heart hospital were enrolled. Expression of αB-crystallin was determined by immunohistochemical staining using monoclonal antibody (SPA-222, Stressgen Biotech.) and graded as negative=0, weakly positive=1, moderately positive=2 and highly positive=3. Estrogen receptor, progesterone receptor, cERB-2, lymphatic tumor emboli, histologic grades and other tumor markers were compared with αB-crystallin expression. Expression of αB-crystallin in breast cancer tissues was associated with lymph node metastasis (p=0.01), lymphatic tumor emboli (p&amp;lt;0.01), high nuclear grade (p=0.02) and triple negative status (p=0.02). Five of 6 visceral metastasis cases showed highly expression of αB-crystallin. Results of this study revealed a strong relationship between αB-crystallin and lymph node metastasis of breast cancer. And also the expression of αB-crystallin significantly correlated with other breast tumor markers. We thought that αB-crystallin could be a novel marker of lymph node metastasis of breast cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1744.
Postextrasystolic potentiation worsens fast filling of the hypertrophied left ventricle in aortic stenosis and hypertrophic cardiomyopathy.
Authors: W J Paulus, S U Sys, P Nellens, G R Heyndrickx, E Andries
Journal: Circulation (1988)

Impaired left ventricular (LV) filling in aortic stenosis (AS) and in hypertrophic cardiomyopathy (HCM) is caused by slow LV pressure decay, which could be explained by depressed inactivation of hypertrophied myocardium. Postextrasystolic potentiation (PESP), which increases activator calcium, could lead to further deterioration of LV relaxation. The influence of PESP on LV filling dynamics was, therefore, investigated in normal controls and in patients with LV hypertrophy caused by AS or by HCM. LV hemodynamics and LV hemodynamic relaxation indexes were determined during normal sinus rhythm (NSR) and after PESP. LV pressures were recorded by micromanometer tip catheters (controls, n = 10; AS, n = 17; HCM, n = 11). Simultaneous mitral flow Doppler echocardiograms were obtained in patients with LV hypertrophy (AS, n = 8, HCM, n = 5). Despite significant increases of LV dP/dtmax after PESP in all three study groups, PESP affected LV hemodynamic relaxation indexes differently. The time constant of LV pressure decay (TPB) derived from exponential curve fits with nonzero asymptote pressure remained unaltered after PESP in normal controls, rose from 62 +/- 17 to 74 +/- 21 msec (p less than 0.02) in patients with AS, and rose from 74 +/- 18 to 84 +/- 19 msec (p less than 0.02) in patients with HCM. Early diastolic LV pressure decay was measured by phi (phase of the first harmonic of a Fourier transform applied to the diastolic LV pressure waves) and by t (time interval from LV dP/dtmin to LV minimum diastolic pressure). After PESP, phi remained unaltered in normal controls but decreased in AS from 42.8 +/- 19.1 degrees to 24.0 +/- 28.8 degrees (p less than 0.001) and in HCM from 39.7 +/- 15.4 degrees to 26.9 +/- 15.7 degrees (p less than 0.001). Similarly, t was unchanged after PESP in normal controls but prolonged in AS from 146 +/- 48 to 205 +/- 86 msec (p less than 0.001) and in HCM from 168 +/- 40 to 208 +/- 53 msec (p less than 0.02).(ABSTRACT TRUNCATED AT 400 WORDS)
THE UTILITY OF ROUTINE INTRA-VASCULAR ULTRASOUND DURING PERCUTANEOUS CORONARY INTERVENTION OF SAPHENOUS VEIN GRAFTS.
Authors: Asmir I. Syed, Gabriel Maluenda, Itsik Ben-Dor, Manuel A. Gonzalez, Michael A. Gaglia, Cedric Delhaye, Loic Belle, Kohei Wakabayashi, Nicholas Hanna, Sara D. Collins, Rebecca Torguson, Zhenyi Xue, Nelson Bernardo, William O. Suddath, Kenneth M. Kent, Lowell F. Satler, Augusto D. Pichard, Joseph Lindsay, Ron Waksman
Journal: Journal of the American College of Cardiology (2010)
Interobserver Agreement and Intraobserver Reproducibility of the Subjective Determination of Glaucomatous Visual Field Progression
Authors: Angelo P. Tanna, Jagadeesh R. Bandi, Donald L. Budenz, William J. Feuer, Robert M. Feldman, Leon W. Herndon, Douglas J. Rhee, Julia Whiteside-de Vos
Journal: Ophthalmology (2010)
No-smoking laws in the United States. An analysis of state and city actions to limit smoking in public places and workplaces
Authors: N. A. Rigotti
Journal: JAMA (1991)

<h3>Objective.</h3> —To assess the prevalence, content, and growth of state and city laws restricting smoking in public places and workplaces in the United States and to identify factors associated with their passage. <h3>Design.</h3> —A mailed survey of city clerks in US cities with a population of 25000 or greater (N =980) and review of existing data sources confirmed the status of smoking restrictions in 902 (92%) of the cities in the sample. State laws were identified by contacting each state's Legislative Reference Bureau (100% response). Content of laws was coded using previously developed categories. <h3>Main Outcome Measures.</h3> —Prevalence, comprehensiveness, and cumulative incidence of no-smoking laws in states and in cities with a population of 25000 or greater. <h3>Results.</h3> —By July 1989, 44 states and 500 (51%) of the cities in our sample had adopted some smoking restriction, but content varied widely. While 42% of cities limited smoking in government buildings, 27% in public places, 24% in restaurants, and 18% in private workplaces, only 17% of cities and 20% of states had comprehensive laws restricting smoking in all four of these sites. The number of city no-smoking laws increased tenfold from 1980 to 1989. City no-smoking laws were independently associated with population size, geography, state tobacco production, and adult smoking prevalence. Laws were more common in larger cities, Western cities, and states with fewer adult smokers. Laws were less common in tobacco-producing states and in the South. <h3>Conclusions.</h3> —No-smoking laws are more widespread than previously appreciated, especially at the local level, reflecting a rapid pace of city government action in the 1980s. Nonetheless, comprehensive laws, which are most likely to provide meaningful protection from environmental tobacco smoke exposure, remain uncommon and represent a major gap in smoking control policy. Laws are most needed in smaller and non-Western cities and in states that produce tobacco and have a higher proportion of smokers. (<i>JAMA</i>. 1991;266:3162-3167)
Trimethoprim in the Treatment of Urinary Infections in Hospital
Authors: R. N. Gruneberg, R. Kolbe
Journal: BMJ (1969)

Success in the cure of urinary infections of hospital patients was compared for five-day courses of sulphamethoxazole alone, sulphamethoxazole plus one-tenth its weight of trimethoprim, and sulphamethoxazole plus one-fifth its weight of trimethoprim (Septrin). The cure rates were 65%, 84%, and 92% respectively. Fifty-four per cent. of 111 patients had urinary tract abnormalities. Forty-three per cent. of the causative organisms were sulphonamide-resistant in vitro. There were no major side-effects, though two patients had pruritus or a rash. The degree of potentiation of sulphamethoxazole activity by one-fifth the weight of trimethoprim was so great that its cure rate of infections due to sulphonamide-resistant organisms exceeded that of sulphamethoxazole alone used in infections due to sulphonamide-sensitive organisms. The degree of synergism between trimethoprim and sulphamethoxazole demonstrated in vitro against urinary organisms was directly related to the cure rate of the combination.
1193 A DESCRIPTION OF VIROLOGIC ESCAPE IN HCV GENOTYPE 1-INFECTED PATIENTS TREATED WITH DACLATASVIR (BMS-790052) IN COMBINATION WITH RIBAVIRIN AND PEGINTERFERON ALFA-2A OR PEGINTERFERON ALFA-2B
Authors: F. McPhee, D. Hernandez, F. Yu, J. Ueland, K. Chayama, J. Toyota, N. Izumi, O. Yokosuka, N. Kawada, Y. Osaki, E. Hughes, H. Watanabe, H. Ishikawa, H. Kumada
Journal: Journal of Hepatology (2012)
Letter by Leurent et al Regarding Article, “Prevalence and Clinical Significance of Papillary Muscle Infarction Detected by Late Gadolinium-Enhanced Magnetic Resonance Imaging in Patients With ST-Segment Elevation Myocardial Infarction”
Authors: Guillaume Leurent, Marcel Laurent, Erwan Donal
Journal: Circulation (2011)

To the Editor:We first would like to thank Tanimoto et al 1 for their study regarding cardiac magnetic resonance and ischemic mitral regurgitation (IMR).They sought to explore the relationship between papillary muscle infarction (detected by postgadolinium cardiac magnetic resonance) and IMR.IMR is still a subject of debate: Its qualification is challenging, and its treatment remains not much evaluated.We believe it would be interesting to argue in regard to Tanimoto et al's conclusions.Because IMR is known to be related to left ventricular remodeling and to loading conditions, it probably should be explored by exercise stress echocardiography.We all know that IMR severity, even its reality, might be extremely load dependent.Exercise stress echocardiography has been demonstrated for IMR diagnosis and prognostic evaluation. 2 During an exercise, changes in loading conditions might reveal any significant IMR. 3 An ongoing European multicentric study has sought to confirm the clinical value of IMR and its surgical treatment. 4hus, according to the 2008 European guidelines on the management on valvular heart diseases, 5 it would have been extremely informative to assess the Tanimoto et al patients by exercise echo and cardiac magnetic resonance (with the papillary muscle characteristics, including their localization).We then still do not really know whether papillary muscle vascularization has any kind of impact on the genesis of the IMR.