tbuckley/cabot-search huggingface dataset:
Psychological factors in the irritable bowel syndrome.
Authors: F Creed, E Guthrie
Journal: Gut (1987)

This paper reviews recent psychological studies of patients with the irritable bowel syndrome (IBS) or 'functional abdominal pain'. Many studies have used unreliable or invalid methods of assessment and some have confused personality with treatable psychiatric illness. Reliable and valid measures have indicated that 40-50% of patients with recently diagnosed functional abdominal pain have demonstrable psychiatric illness; these patients have a worse prognosis than those who are psychologically normal. When psychiatric disorder is diagnosed in a patient with IBS there are three possibilities: (1) The patient may have developed abdominal and psychiatric symptoms simultaneously in which case treatment of the latter may relieve the bowel symptoms. (2) Psychiatric disorder may precipitate increased concern about bowel symptoms, and consequent attendance at the gastroenterology clinic, of those with chronic mild symptoms. In this case it is illness behaviour, rather than abdominal symptoms, that is caused by the anxiety/depression. (3) Those with chronic neurotic symptoms as part of their personality must be screened for organic disease if they have a fresh onset of bowel symptoms; but they are at high risk of becoming persistent clinic attenders. Further research is needed to clarify when psychological abnormalities play a role in the aetiology of IBS and when they are coincidental, but lead to illness behaviour. The role of psychological factors in the aetiology of the irritable bowel syndrome (IBS) is far from clear, but a review of the literature suggests that some consistent patterns are emerging in spite of methodological problems. There have been three major defects with studies that have linked IBS with neurotic symptomatology. First, the measurement of psychological factors has generally been imprecise. Second, most studies have considered IBS patients as a single group, without making allowance for differing symptom patterns. Third, conclusions have been drawn about hospital samples and extrapolated to all IBS subjects, without taking account of factors which affect consulting behaviour. Most studies have been concerned with psychological factors so these will be considered in most detail.
Prevention of suicide
Authors: S Davies, A Buckley, P Naik, A S Lee
Journal: BMJ (1994)

consultations per hour in the afternoon).By contrast, the potential consultation time for one of the doctors who held walk in surgeries was eight minutes per patient.3The nurses' fee for service work earned about one third of the salary costs borne by the practice.2Most of the tasks that the nurses carried out were simple, such as changing dressings, taking blood pressure, and testing urine; some of them could be delegated to staff who were not nurses, freeing resources for more difficult work such as giving advice on health.Mark R Williamson has argued that venepuncture should be delegated to receptionists.4In the study by Fallon et al 9-2% of tasks were venepuncture.Delegating this task would free substantial time.Fallon et al's study supports the argument for rethinking skill mix in primary care, offers the hypothesis that nurses are popular with patients because they have more time than doctors to spend with patients, and provides further data on the relative costs in relation to consultations under- taken.Policymakers cannot assume that changing skill mix will save money as the advent of practice nurses has shown.With a massive iceberg of unmet need in the population,5 changing the skill mix is a way of providing a broader and more appropriate range of services, of freeing highly trained staff for the most demanding tasks, and of enriching the work experience of those who accept the delegated work.
Maternal alpha-fetoprotein screening: two years' experience in a low-risk district.
Authors: S J Standing, M J Brindle, A P Macdonald, R W Lacey
Journal: BMJ (1981)

Over a two-year period, 3479 pregnant women in the Kings' Lynn Health District were screened for neural tube defects by estimation of maternal serum alpha-fetoprotein. Most pregnancies were scanned by sonar for fetal maturity. Eight women had fetuses with open neural tube defects; four with anencephaly were associated with very high alpha-fetoprotein values. Of the four with open neural tube defects without anencephaly, only one was detected by screening and confirmed after amniocentesis. One other had a raised serum alpha-fetoprotein but a normal amniotic fluid value. The other two affected fetuses were missed. This disappointing outcome was attributed to the poor predictive value of alpha-fetoprotein in detecting open neural tube defects (anencephaly apart) rather than to errors in its estimation or in assessment of fetal maturity by sonar scan. We question the validity of screening, particularly in areas of intermediate or low incidence.
Transplantable rat glucagonomas cause acute onset of severe anorexia and adipsia despite highly elevated NPY mRNA levels in the hypothalamic arcuate nucleus.
Authors: P B Jensen, N Blume, J D Mikkelsen, P J Larsen, H I Jensen, J J Holst, O D Madsen
Journal: Journal of Clinical Investigation (1998)

We have isolated a stable, transplantable, and small glucagonoma (MSL-G-AN) associated with abrupt onset of severe anorexia occurring 2-3 wk after subcutaneous transplantation. Before onset of anorexia, food consumption is comparable to untreated controls. Anorexia is followed by adipsia and weight loss, and progresses rapidly in severity, eventually resulting in reduction of food and water intake of 100 and 80%, respectively. During the anorectic phase, the rats eventually become hypoglycemic and hypothermic. The tumor-associated anorexia shows no sex difference, and is not affected by bilateral abdominal vagotomy, indicating a direct central effect. The adipose satiety factor leptin, known to suppress food intake by reducing hypothalamic neuropeptide Y (NPY) levels, was not found to be expressed by the tumor, and circulating leptin levels were reduced twofold in the anorectic phase. A highly significant increase in hypothalamic (arcuate nucleus) NPY mRNA levels was found in anorectic rats compared with control animals. Since elevated hypothalamic NPY is among the most potent stimulators of feeding and a characteristic of most animal models of hyperphagia, we conclude that the MSL-G-AN glucagonoma releases circulating factor(s) that overrides the hypothalamic NPY-ergic system, thereby eliminating the orexigenic effect of NPY. We hypothesize a possible central role of proglucagon-derived peptides in the observed anorexia.
Sequence of mechanical, electrocardiographic and clinical effects of repeated coronary artery occlusion in human beings: Echocardiographic observations during coronary angioplasty
Authors: Andrew M. Hauser, Vellappillil Gangadharan, Renato G. Ramos, Seymour Gordon, Gerald C. Timmis, Patricia Dudlets
Journal: Journal of the American College of Cardiology (1985)
Duty Hours for Resident Physicians — Tough Choices for Teaching Hospitals
Authors: Debra F Weinstein
Journal: New England Journal of Medicine (2002)

Those involved in graduate medical education have long struggled with competing priorities that surround the issue of residents' work hours: providing each trainee with an adequate amount of clinical experience; protecting time for teaching conferences and self-study; preserving sufficient continuity of patient care; and avoiding excessive fatigue. The recent decision by the Accreditation Council for Graduate Medical Education (ACGME) to implement new limits on residents' work hours has abruptly intensified that struggle. When fully implemented in July 2003, these “common duty hour standards”1 will, for the first time, apply a core set of requirements for work hours to all specialties. . . .
Complexity of Sham Acupuncture
Authors: Wei Huang, Nancy Kutner, Donald Bliwise
Journal: JAMA Internal Medicine (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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 Internal Medicine journal
How protective is the working time directive?: New Zealand is still dealing with the issues 20 years on…
Authors: Frank A Frizelle, Angus Watson
Journal: BMJ (2004)

Cholesterol values seem to divergeEditor-The targets for cholesterol management seem to be ever decreasing, but I cannot get my head around the fact that in the new guidelines from the British Hypertension Society box 8 suggests we should consider treatment if the 10 year risk of cardiovascular disease is > 20% and the total cholesterol level is > 3.5 mmol/l but the target to be attained, which is printed beside box 8, is higher, 4 mmol/l. 1 Can someone explain this anomaly to a simple general practitioner who will have to explain it to patients?
EEG has diagnostic partner in MEG
Authors: S. Siwolop
Journal: JAMA (1983)

To better understand how the brain's magnetic field might be used in medical diagnosis, scientists at the Massachusetts Institute of Technology (MIT), Cambridge, have produced simultaneous magnetoencephalogram (MEG) and electroencephalogram (EEG) maps of two human heads. A comparison of the two volunteers' brain mappings demonstrates the differences between the EEG, which records the electrical potential on the scalp, and the MEG, which records the magnetic field produced by the same electrical activity. The MEG seems to be most useful when it complements information provided by the EEG; by itself it does not pinpoint electrical activity much better than the EEG. According to physicist David Cohen, PhD, and electrical engineer B. Neil Cuffin, PhD, there are several major differences between the two types of signals (<i>Electroencephalogr Clin Neurophysiol</i>1983; 56:38-51). The first is that, although both the EEG and the MEG result from the same electrical activity in the brain, the
Elevation of Tumor Necrosis Factor-α and Increased Risk of Recurrent Coronary Events After Myocardial Infarction
Authors: Paul M. Ridker, Nader Rifai, Marc Pfeffer, Frank Sacks, Serge Lepage, Eugene Braunwald
Journal: Circulation (2000)

Background —Levels of tumor necrosis factor-α (TNF-α) increase with acute ischemia. However, whether elevations of TNF-α in the stable phase after myocardial ischemia (MI) are associated with increased risk of recurrent coronary events is unknown. Methods and Results —A nested case-control design was used to compare TNF-α levels obtained an average of 8.9 months after initial MI among 272 participants in the Cholesterol And Recurrent Events (CARE) trial who subsequently developed recurrent nonfatal MI or a fatal cardiovascular event (cases) and from an equal number of age- and sex-matched participants who remained free of these events during follow-up (controls). Overall, TNF-α levels were significantly higher among cases than controls (2.84 versus 2.57 pg/mL, P =0.02). The excess risk of recurrent coronary events after MI was predominantly seen among those with the highest levels of TNF-α, such that those with levels in excess of 4.17 pg/mL (the 95th percentile of the control distribution) had an ≈3-fold increase in risk (RR=2.7, 95% CI 1.4 to 5.2, P =0.004). Risk estimates were independent of other risk factors and were similar in subgroup analyses limited to cardiovascular death (RR=2.1) or to recurrent nonfatal MI (RR=3.2). Conclusions —Plasma concentrations of TNF-α are persistently elevated among post-MI patients at increased risk for recurrent coronary events. These data support the hypothesis that a persistent inflammatory instability is present among stable patients at increased vascular risk. Novel therapies designed to attenuate inflammation may thus represent a new direction in the treatment of MI.
A Peripatetic Hepatologist
Authors: Charles S. Davidson
Journal: New England Journal of Medicine (1960)

WORKING in the Thorndike Memorial Laboratory of the Boston City Hospital in relative isolation from the world of "hepatology," this correspondent was wont to consider that all (or almost all) liver disease was the same: cirrhosis of the alcoholic patient. My friends have tried to dissuade me from this narrow view, not entirely without success.1 , 2 Still, progress was slow until greatly accelerated by a recent trip touching the antipodes and a number of places in the Far and Near East.‡ It must be freely admitted that my education in matters of liver disease in the southern and eastern world is . . .
Help Conserve Gamma Globulin
Authors: James A. McComb
Journal: JAMA (1961)

<h3>To the Editor:—</h3> The 1961 edition of the "Red Book" of the American Academy of Pediatrics distinguishes between the adult and the child dose for the first time in its recommendations for the prevention of infectious hepatitis. The dose amounts to 2 1/2 times more per pound of body weight for adults than for children. These recommendations resemble those of Krugman et al. (<i>JAMA</i><b>174:</b>823-830 [Oct. 15] 1960) and do not take into account 10 years of satisfactory experience and published reports by many workers using the dose of 0.01 cc. per pound of body weight first advocated by Stokes et al. 10 years ago. In the Krugman trials this dose did not show the satisfactory results of previous published reports. The lot of globulin used by him at this dosage was not tested at any other dosage level. When he employed a higher dosage in his next trial,
Renal Cell Carcinoma Metastases 25 Years After Nephrectomy
Authors: R. R. Bradham
Journal: JAMA (1973)

To the Editor.—  The subject of this report is a patient who was found to have pulmonary metastases 25 years following a nephrectomy for renal cell carcinoma. This unusually long latent period stresses caution in accepting five-year survivals without known disease as cures. It also raises many questions regarding factors that might inhibit tumor growth for such periods.  Report of a Case.—  A 66-year-old man was admitted to the hospital on two occasions during the first six months of 1968 because of intermittent hemoptysis. At first, bronchoscopy revealed nothing unusual. An x-ray film of the chest revealed fibrous changes at the right lung base that had not changed in several years. There was also noted some fullness of the hilum of the right lung. During the second admission, there was an abnormal area in the bronchus of the lower lobe of the right lung (Fig 1). This was biopsied and
Synthesis of novel substituted N-aryl benzamides as hA3G stabilizers and their inhibitory activities against hepatitis C virus replication
Authors: Yanping Li, Zonggen Peng, Lanhu Hao, Zhouyi Wu, Yanping Zhu, Laixing Hu, Jiandong Jiang, Zhuorong Li
Journal: Acta Pharmaceutica Sinica B (2013)

A series of novel amino-substituted N-aryl benzamide analogs were synthesized and evaluated for their ability to inhibit hepatitis C virus (HCV) replication in acutely infected Huh7.5 cells. Most of the substituted N-aryl benzamide compounds showed convincing anti-HCV activities. Compounds 1f, 1g and 4c exhibited potent anti-replicative activity at low micromolar levels (IC50=1.0–2.0 μM) with selective indices (SI) greater than 40. Mechanistic analysis indicated that the active compounds increased intracellular hA3G protein levels and inhibited HCV replication in a dose-dependent manner. The results demonstrate that this series of substituted N-aryl benzamide compounds warrant further investigation as inhibitors of HCV replication.
Interleukin 21 as a target of intervention in autoimmune disease
Authors: R Ettinger, S Kuchen, P E Lipsky
Journal: Annals of the Rheumatic Diseases (2008)

Interleukin 21 (IL21) belongs to a family of cytokines that bind to a composite receptor consisting of a private receptor (IL21R) and the common cytokine receptor gamma chain (gamma(C)). The IL21R is widely distributed on lympho-haematopoietic cells and IL21 impacts a number of cell types, including CD8+ memory T cells, NK cells and subsets of CD4 memory T cells. One essential role of IL21 is the promotion of B-cell activation and differentiation or death during humoral immune responses. Increased IL21 production is characteristic of certain autoimmune diseases and is likely to contribute to autoantibody production as well as pathological features of autoimmune disease. The critical role of IL21 in promoting humoral immune responses makes it an important focus of potential therapeutic interventions in conditions characterised by overproduction of pathogenic autoantibodies.
Crystalline Inclusions in Multiple Myeloma
Authors: Stanley B. Levine
Journal: JAMA (1985)

The management of disordered immunoglobulin metabolism is generally difficult. Features of diagnosis and evaluation have slowly accumulated through years of observation. Crystalline inclusions may be seen in patients with a protracted course of myeloma, and their presence indicates that the patients may not require chemotherapy. A 59-year-old laundry worker had a prolonged course of myeloma from August 1976 to February 1984. Crystals were present in the bone marrow biopsy specimen. He was found to have an elevated level of monoclonal IgG of K type in his serum. Chemotherapy for myeloma was instituted in the last few months of his life, without improvement of status. His terminal serum urea nitrogen level was 58 mg/dL; creatinine, 3.8 mg/dL. Aspirate smears obtained in 1976, 1977, 1978, and 1982 showed similar morphological features. There were approximately 10% to 15% large cells with oval nuclei and prominent blue to slate-gray cytoplasm containing variably sized, poorly
A9.14 Regulatory T Cell Abnormalities in Patients with SLE Suggest an IL-2-Based Immunotherapy
Authors: C von Spee, N Wassermann, JY Humrich, G Riemekasten
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Phenotypic and quantitative abnormalities of regulatory T cells have been described in association with systemic lupus erythematosus (SLE). Further, an impaired production of IL-2, the essential cytokine for Treg homeostasis, has been described for T cells from SLE patients. Here, we aim to substantiate the link between IL-2 deficiency and Treg abnormalities in SLE and to provide the basis for an IL-2 based immunotherapy. <h3>Methods</h3> Phenotype, frequency and homeostatic status of Foxp3+CD127lo Treg and conventional Foxp3- T cell (Tcon) subsets were analysed by multi-colour flow-cytometry of PBMCs from SLE patients and healthy donors ex vivo and after in vitro low-dose IL-2 treatment. Disease activity was determined according to the SLE activity index (SLEDAI). Two-tailed Mann-Whitney U test or 2-way ANOVA test were used for statistical analysis between patient or treatment groups, Spearman's rank coefficient was used to calculate correlations with disease activity. <h3>Results</h3> The frequency of CD25+ cells among Treg was significantly reduced in SLE patients compared to HC. Analysis of Ki67 expression revealed that proliferation was significantly increased in Tcon from SLE patients, resulting in a reduced Treg to Tcon proliferation ratio in SLE patients. The proliferation ratio correlated positively with the frequency of CD25+ Treg and inversely with disease activity. Treatment of SLE PBMCs with low-dose IL-2 in vitro resulted in increased frequencies of CD25+ cells among Treg and increased CD25 expression levels on Treg. Treg, but not Tcon proliferation was significantly increased under low-dose IL-2 treatment compared to untreated controls. <h3>Discussion</h3> Similar to what has been observed in lupus-prone mice and IL-2<sup>-/-</sup> mice, Treg from SLE patients show the classical hallmarks of IL-2 deficiency with loss of CD25 expression and impaired homeostasis. Our in vitro results show that these Treg defects can be restored by low-dose IL-2 treatment, suggesting IL-2 as a novel therapeutic target for SLE.
40 SEROCLEARANCE OF HBVDNA PREDICTS SIGNIFICANTLY REDUCED RISK OF HEPATOCELLULAR CARCINOMA AMONG THOSE WITH HIGH VIRAL LOADS: A TIME-DEPENDENT ANALYSIS OF SERIALLY MEASURED BIOMARKERS
Authors: J. Liu, H.-I. Yang, M.-H. Lee, C.-L. Jen, S.-N. Lu, L.-Y. Wang, S.-L. You, U.H. Iloeje, C.K. Hsiao, C.-J. Chen
Journal: Journal of Hepatology (2013)
Beta2-adrenergic receptor polymorphisms predict heart failure progression in idiopathic dilated cardiomyopathy
Authors: Cinzia Forleo, Nicoletta Resta, Sandro Sorrentino, Pietro Guida, Andrea Manghisi, Viviana De Luca, Roberta Romito, Massimo Iacoviello, Francesco Massari, Brian Rizzon, Ginevra Guanti, Paolo Rizzon, Mariavittoria Pitzalis
Journal: Journal of the American College of Cardiology (2003)