tbuckley/cabot-search huggingface dataset:
Treatment of Exacerbations of Chronic Bronchitis with Ampicillin
Authors: G. A. J. Ayliffe, N. B. Pride
Journal: BMJ (1962)

TRANSIENT HEART-BLOCK MEDIBTmH 1641labile, the exercise tolerance may be severely limited.The pain is not always immediately relieved by rest, since this relief appears to depend on the return of the heart- block to the resting state.Similarly, the pain may occur at rest with the abrupt slowing of the heart rate due to the onset of heart-block.The history may be very suggestive of an impending cardiac infarction.When the change is from 1: 1 to 2: 1 block a cardiogram will not be helpful between attacks, and the fear that the symptoms are due to an impending cardiac infarction will prevent an exercise test being done.Some of these patients must be undergoing treatment with continuous anticoagulants and unnecessarily running the hazards of this therapy.A 2: 1 block might be missed when alternate P waves are buried in the T waves as in Case 2 (Fig. 2 c).The feeling of panic, probably a manifesta- tion of left ventricular failure (Fowler, 1962), also suggests a psychogenic basis for the symptoms.The symptoms in patients with a transient or changing heart-block vary from typical Stokes-Adams attacks on the one hand to the unrecognized chest pain and other symptoms described here.When chest pain occurs in a patient with heart-block it is assumed to be anginal and the pain and the block are attributed to ischaemic heart disease.Smith and Zoob (1961) have shown that many cases of heart-block in elderly persons are not due to ischaemia, the cause being unknown.One of the four cases described had clinical evidence of coronary artery disease and another had post-mortem proof.But it cannot be assumed that the heart-block in these patients was due to ischaemia.The chest pain was clearly
Attenuation of the rise in extracellular potassium concentration during myocardial ischaemia by d.l-sotalol and d-sotalol
Authors: M N Hicks, S M Cobbe
Journal: Cardiovascular Research (1990)

Study objective – The aim was to study the effects of d.l-sotalol, d-sotalol or atenolol on the rate of rise of extracellular potassium concentration ([K-]o) and the electrophysiological changes that occur during myocardial ischaemia. Design – The study was performed in isolated, arterially perfused interventricular septa from rabbit. Six septa were treated with d.l-sotalol 10−4mol·litre−1, six with d-sotalol 10−4 mol·litre−1, six with atenolol 10−5 mol·litre−1, and there were seven untreated controls. At these concentrations d.l and d-sotalol are equipotent in their class III effect, though d-sotalol has only 7% of the β blocking activity of the racemic form, and atenolol is equipotent in its β blocking activity to d.l-sotalol. [K-]o and electrophysiological variables were compared before and during a 30 min period of global zero flow ischaemia. Measurements and main results – Prior to ischaemia [K-]o, measured using potassium sensitive valinomycin electrodes, was similar in all the groups. [K-]o rose during ischaemia in all the groups, and at 30 min was 13.0 (SEM 0.7) mmol·litre−1 in the control group which was not different from 12.7(0.5) mol·litre−1 in the atenolol group. In the d.l and d-sotalol groups the increases were markedly attenuated, reaching 9.2(1.0) and 8.8(0.7) mmol·litre−1 respectively. During ischaemia the class III effect of d.l and d-sotalol was lost within 6 min though the fall in maximum upstroke velocity of the action potentials (dV/dtmax) and the extent of resting membrane potential (Em) depolarisation were less in comparison to the control and atenolol groups. Conclusions – The results indicate an attenuation by sotalol of the ischaemic rise in [K-]o, with preservation of dV/dtmax and Em, despite the loss of an effect on action potential duration. This potentially antiarrhythmic effect of sotalol in ischaemic myocardium is attributable to a direct membrane effect rather than p adrenoceptor antagonism.
Quantification of regional matrix nail production
Authors: D. DE BERKKR, B. MAWHINNEY, L. SVILAND
Journal: British Journal of Dermatology (1996)

The relative nail producing capacity of different regions within the nail matrix has not been quantified. In order to do this, the number of nail plate cells in the dorsoventral axis of 12 human great toenails was counted at five sites in the longitudinal axis, and compared with direct measurements of nail plate thickness at the same sites. The mean number of nail cells in the nail plate reached a maximum at the lunula, with no further increase along the length of the nail bed. At the mid-point between the proximal tip of the germinal matrix and lunula, mean cell numbers achieved 81% of the value at the lunula. Mean nail thickness was only 90% of its maximum at the lunula, with a further significant increase (P = 0.02) between the lunula and end of the nail bed. These observations suggest that the proximal nail matrix is the main source of nail within the matrix. This is consistent with clinical experience where distal matrix surgery has a low potential for scarring in comparison with proximal matrix surgery. The additional finding of increased nail thickness, but not cell numbers, along the nail bed make it likely that cells within the nail plate change shape as they move distally.
Neisseria subflava as a Cause of Meningitis and Septicemia in Children
Authors: Richard A. Lewin
Journal: JAMA (1966)

In five cases of meningitis or septicemia in children, the causative organism was Neisseria subflava. The organism is similar to N meningitidis. Only one previous case of meningitis caused by N subflava in a child has been found in the literature, but this organism may be more commonly pathogenic than has been thought. The clinical findings and course are not unlike those of septicemia and meningitis due to N meningitidis.
Literature and Medicine
Authors: Ronald A. Carson
Journal: JAMA (1989)

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
Regression and Progression of Early Femoral Atherosclerosis in Treated Hyperlipoproteinemic Patients
Authors: ROBERT BARNDT
Journal: Annals of Internal Medicine (1977)

Femoral angiograms were done to evaluate change in early atherosclerosis in 12 patients with type IV hyperlipoproteinemia and 13 with type II hyperlipoproteinemia. The patients' average age was 48 years; only one had claudication. Elevated blood lipids and blood pressure were treated with drugs and diet. Repeat angiograms after an interval of 13 months showed regression of atherosclerosis in nine patients, no change in three, and progression in 13. Comparison of preangiogram levels with average levels between angiograms showed significant reduction in serum cholesterol, triglyceride, and blood pressure in the group with lesion improvement but not in the group with lesion progression. Sporadic examples of human atherosclerosis regression are known, but most other studies in man indicate only atherosclerosis progression. Our different result appears due to our selection of patients and radiographic method. We have studied patients with earlier atherosclerosis than previous workers, using a radiographic procedure more sensitive to small changes in lesions.
Pharmacokinetics of the selective PDE4 inhibitor Roflumilast and its active metabolite Roflumilast N-oxide are not affected by concomitant budesonide, salbutamol, or erythromycin*1
Authors: B. Hauns, A. Huennemeyer, W. Siegmund, J. Waitzinger, R. Hermann, K. Zech, T.D. Bethke
Journal: Journal of Allergy and Clinical Immunology (2004)
The Best Hysterias: Author's Response to Ghaemi
Authors: David Healy
Journal: PLoS Medicine (2006)

I am a disease monger.I teach primary care doctors how to identify bipolar disorder.Worse yet, I take money from pharmaceutical companies for doing so.I use it to subsidize my practice so that I can treat patients with no insurance, or little money, who now account for over a third of my patients-in part because the pharmaceutical companies have drained so much money out of the health-care system.Ironic, isn't it?My Web site PsychEducation.org(http:⁄⁄www.psycheducation.org) is number one on Google for searches on "bipolar II."See if you think it looks like disease mongering.Hundreds of people have written thanking me for explaining bipolar II and the concept of a bipolar spectrum, indicating that this new perspective really helps them understand their long-standing symptoms.To my immediate recall, none have complained about being led astray by an overbroad interpretation of bipolarity.Notice that, just like Mr. Moynihan, one of the guest editors of your April 2006 series of articles on disease mongering [1], I could be mongering even now, as I too have a new book.At least I'm not trying to attract attendees to my conference.Tricky, isn't it.Has there been an oversimplifi cation in this analysis?(PsychEducation.org
Spending watchdog slates provision of doctors out of hours care in England
Authors: Lynn Eaton
Journal: BMJ (2007)

Doctors were the only winners from changes in 2004 to out of hours provision, states a report from the government's spending watchdog, the Public Accounts Committee.

As far as patients are concerned, they lost out—not only because of a reduction in the quality of the service, but because of the additional financial burden on them as taxpayers, says the report.

The findings, published on Wednesday, look at the changes in GP out of hours cover introduced in 2004. Before then, GPs provided the cover themselves, either by pooling together to operate as a cooperative when their surgeries were closed or by paying for a commercial deputising service. After 2004, they were able to opt out of this arrangement. Instead they paid £6000 a year to their local primary care trust (PCT), which took over responsibility for …
Chylous reflux in the lungs and pleurae
Authors: H. C. Maier
Journal: Thorax (1968)

Lymphangiectasis of varying extent may be present in some cases of chronic pulmonary disease. Often the dilated lymphatic channels are not identified because pulmonary fibrosis and emphysema together with secondary inflammatory changes obscure the lymph vessel pathology. When chylothorax is associated with such chronic pulmonary pathology, attention may be drawn to the lymphatic system. The presence of a chylothorax is usually attributed to obstruction or injury of the thoracic duct, whereas in some cases chylous reflux into the lungs and pleurae via abnormal lymph channels in the lungs and pleurae as well as in the mediastinum may cause the chylothorax. In rare instances a patient may actually expectorate chylous fluid which seeps into the bronchi from the abnormal peribronchial lymphatics. A detailed analysis of reported cases together with some personal experience has demonstrated that pathological changes in the pulmonary and pleural lymphatic vessels are more common than is usually appreciated. The normal remarkable regenerative potential which is usually evident after experimental interruption of the lymphatics apparently is lacking in some humans due to genetic and other factors. Thus pathological changes, difficult to simulate experimentally, may be encountered. Lymphangiectasis is often found not to be limited to a single organ if complete studies of the lymphatic system are made.
Small Bowel Endoscopy
Authors: M. Keuchel, F. Hagenmüller
Journal: Endoscopy (2005)

Video capsule endoscopy continues to be the major focus in papers dealing with diagnostic small-bowel endoscopy. Although capsule endoscopy is used for a variety of indications, its major field of application is still obscure bleeding from the small intestine, where it can be regarded as a first-line test. There is increasing evidence that capsule endoscopy for suspected Crohn’s disease may be diagnostic in individual cases after inconclusive conventional tests. Push enteroscopy is the clinical reality for biopsy and treatment in the proximal small bowel, whereas intraoperative enteroscopy is used for distal or diffuse small-intestinal disorders. Further reports on double-balloon enteroscopy suggest that this method may be able to replace at least intraoperative enteroscopy in many circumstances. The availability of specific antibody tests for celiac disease is leading to recurrent interest in endoscopy and histology, showing that villous atrophy and lymphocytic infiltrates are typical, but not specific, findings.
The Systemic Inflammatory Response Syndrome-Reply
Authors: M. Sigfrido Rangel-Frausto
Journal: JAMA (1995)

<h3>In Reply.</h3> —We agree with the argument that sepsis as defined by the American College of Chest Physicians—Society of Critical Care Medicine Consensus Conference<sup>1</sup>is a form of SIRS and not specifically an initial stage of the dynamic process of infection. However, it was our hypothesis that SIRS could define the population at risk for sepsis based on the suggestions of the members of the conference. In our study, SIRS was frequently the initial stage for the subgroup of patients who subsequently developed sepsis or a more serious SIRS. More importantly, the interval to sepsis was carefully measured and was progressively shorter as more clinical criteria for SIRS were met. Such data are useful clinically. As stated by Dr Balk, some patients in the study had SIRS, and empirical antimicrobial treatment was prescribed by their physicians for presumed but never documented infection. We elected to quantify this group because they
Glucose-Insulin-Potassium Therapy for Treatment of Acute Myocardial Infarction
Authors: Farzin Fath-Ordoubadi, Kevin J. Beatt
Journal: Circulation (1997)

Background Glucose-insulin-potassium (GIK) therapy has been advocated for the treatment of acute myocardial infarction. However, the results from the clinical trials have been inconclusive, largely because of the small number of patients recruited and discrepancies between protocols used in these studies. Method and Results A systematic MEDLINE search for all the randomized placebo-controlled studies of GIK therapy in acute myocardial infarction was made, and a meta-analysis of the mortality data was performed. Fifteen trials were identified, 5 were excluded because of poor randomization, and 1 was excluded because recruitment was limited to diabetic patients. The 9 remaining trials with a total of 1932 patients were included in the analysis. Hospital mortality was reduced from 21% (205 of 972 patients) in the placebo group to 16.1% (154 of 956) in the GIK group ( P =.004; odds ratio, 0.72; 95% confidence interval [CI], 0.57 to 0.90). The proportional mortality reduction was 28% (CI, 10% to 43%). The number of lives saved per 1000 patients treated was 49 (95% CI, 14 to 83). Conclusions The findings indicate that GIK therapy may have an important role in reducing the in-hospital mortality after acute myocardial infarction. The value of this therapy in the era of thrombolysis and acute revascularization by primary angioplasty can be fully resolved only by conducting a large randomized mortality study.
Combined Systemic and Topical Therapy with Metronidazole for Vaginal Trichomoniasis
Authors: Alvin F. Goldfarb
Journal: New England Journal of Medicine (1961)

Failure of local treatment of infestation with Trichomonas vaginalis in the female is largely attributable to inability of such therapy to eradicate extravaginal foci of infection. Symptomatic relief may persist for weeks or months, but when conditions are again favorable for their survival, trichomonads reinvade the vagina. A second factor often responsible for reinfection is that male consorts who harbor the infection are not effectively treated.Since vaginitis recurs in virgins and women who are not indulging in coitus, extravaginal foci of infection are probably the most important single cause of treatment failure. This implies the necessity for a systemically . . .
Inclusion-Body β-Thalassemia Trait
Authors: G. Stamatoyannopoulos, R. Woodson, Th. Papayannopoulou, D. Heywood, S. Kurachi
Journal: New England Journal of Medicine (1974)

In a family of Swiss-French descent several members in three generations had, on hemoglobin analysis, typical findings of heterozygous β-thalassemia. However, hemoglobin concentrations, red-cell morphology, iron kinetics, splenic size and clinical histories indicated that the disorder was more severe than in the usual β-thalassemia trait. The ratios of β-chain to α-chain synthesis in blood and bone marrow differed from those in β-thalassemia trait, and, most importantly, up to 70 per cent of the late normoblasts contained inclusions shown to consist of precipitated α chains. The data suggest existence of a form of thalassemia that produces a definite excess of α chains in the immature erythroid cells of simple heterozygotes. The abnormality is designated "inclusion-body β-thalassemia trait." The findings provide an apparent pathophysiologic and genetic explanation for the more severe anemia and red-cell abnormalities present in a small proportion of families with β-thalassemia trait. (N Engl J Med 290:939–943, 1974)
Maternal Efforts to Prevent Type 1 Diabetes in At-Risk Children
Authors: Amy E. Baughcum, Suzanne Bennett Johnson, Stacy K. Carmichael, Adam B. Lewin, Jin-Xiong She, Desmond A. Schatz
Journal: Diabetes Care (2005)

OBJECTIVE—The aim of this study was to assess maternal diabetes prevention efforts aimed at children identified as at risk through newborn genetic screening. RESEARCH DESIGN AND METHODS—A total of 192 mothers of children identified as at risk for type 1 diabetes through newborn genetic screening were administered a structured interview 3.6 ± 0.8 years after risk notification. The interview assessed possible diabetes prevention behaviors across six domains: health surveillance, diet, physical activity, illness prevention, medications, and stress reduction. A mother’s cognitive (diabetes risk perception and perceived control), affective (anxiety), and coping responses to the child’s at-risk status were assessed. RESULTS—A total of 67% of mothers reported one or more diabetes prevention behaviors. Monitoring behaviors (e.g., watching for signs of diabetes and checking blood glucose) were the most common, reported in 59%, followed by modifications in the child’s diet in 34% and physical activity in 14%. Potentially harmful prevention behaviors (e.g., limiting contact with other children, delaying immunizations, and giving medications including insulin) were rare. Mothers who engaged in diabetes prevention behaviors reported higher diabetes risk perception, greater anxiety, and more use of certain coping styles. Infants of these mothers were more likely to have a first-degree relative with diabetes. CONCLUSIONS—In the absence of known methods of preventing type 1 diabetes, most mothers of at-risk children report diabetes prevention behaviors. Such behaviors must be more carefully assessed to ensure accurate interpretation of data obtained from natural history studies and prevention trials.
Serum Lipids and Lipoproteins in Insulin-dependent Diabetic Subjects During High-Carbohydrate, High-Fiber Diet
Authors: Marja Riitta Taskinen, Esko A Nikkilä, Anneli Ollus
Journal: Diabetes Care (1983)

The response of blood glucose and serum lipids and lipoproteins to a high-carbohydrate, high-fiber, low-fat diet was assessed in 10 insulin-dependent diabetic subjects. The diet contained approximately 60% of calories as carbohydrate (CHO) and 20% as fat. The patients were followed for 2 wk in a metabolic ward and subsequently for 4 wk at home without changing insulin dosage. During this 6-wk period, the fasting blood glucose fell from 10.6 ± 1.1 to 8.9 ± 1.3 mmol/L (NS); HbA1 fell from 11.7 ± 0.5 to 11.0 ± 0.7% (P &amp;lt; 0.05). Serum total triglyceride and very-low-density lipoprotein levels remained unchanged. After 2 wk in the ward on a high-CHO diet, total cholesterol fell by 15% (P &amp;lt; 0.01), LDL cholesterol by 16% (P &amp;lt; 0.001), and HDL cholesterol by 10% (P &amp;lt; 0.05). The fall of HDL cholesterol was due to a decrease of HDL3 cholesterol only. After the 4-wk home period on a high-CHO diet, the observed lipoprotein changes were reversed. Heparin-releasable adipose tissue LPL activity was not influenced by a high-CHO diet. In conclusion, a high-carbohydrate, high-fiber, low-fat diet did not deteriorate the diabetic control, and it had no unfavorable effects on serum lipids or lipoproteins.
LONG-TERM CARDIOVASCULAR OUTCOMES IN A REAL-LIFE COHORT OF CONTEMPORARY MYOCARDIAL INFARCTION PATIENTS FREE OF EVENTS AT 1 YEAR: A SUBANALYSIS OF THE EPICOR STUDY
Authors: Francisco J. Noriega, Frans Van de Werf, Stuart Pocock, Nicolas Danchin, Lieven Annemans, Jesus Medina, Héctor Bueno
Journal: Journal of the American College of Cardiology (2015)
Physician-Based Group Insurance
Authors: Frank O. Evans
Journal: New England Journal of Medicine (1980)

IN our system of health care, individual doctors direct most medical expenditures, whereas administrators try to control costs through persuasion or regulation. This system predictably wastes money and time in conflicts between physicians and administrators. If those responsible for cost control do not interfere with the care of patients, physicians tend to overspend. On the other hand, the quality of medical care is threatened when administrators can modify the medical decisions of physicians.This paper is a proposal for controlling medical costs that does not depend on detailed regulatory control. In developing this plan, which I call "Physician-Based Group Insurance" . . .