tbuckley/cabot-search huggingface dataset:
Vulval erosive lichen planus: a qualitative investigation of U.K. clinician views and principles of management
Authors: R.C. Simpson, K.S. Thomas, R. Murphy
Journal: British Journal of Dermatology (2013)

Funding sources: R.S.'s post as Dermatology Clinical Research Fellow is supported by National Institute for Health Research Flexibility and Sustainability Funding. Conflicts of interest: none declared. Madam, Erosive lichen planus of the vulva (ELPV) is an uncommon, chronic condition causing painful vulval erosions and subsequent scarring. It is often resistant to treatment1 2 and causes considerable impact on quality of life. There is no randomized controlled trial evidence to guide treatment,3 and there are no internationally agreed diagnostic criteria. In a recent study we performed a retrospective review of 173 patient notes from 10 specialist U.K. centres and found considerable variation in the diagnosis, therapeutic management and outcome measures used in clinical practice.2 In an attempt to clarify uncertainties identified by the case note review we subsequently engaged with physicians from a range of clinical environments. Using a structured interview process with a predefined pro forma, we aimed to ascertain (i) how physicians make the diagnosis of ELPV; (ii) how physicians measure severity and response to treatments; (iii) which first‐ and second‐line treatments are commonly used for ELPV; and (iv) which factors trigger a physician to escalate therapy.
Role of the Family Physician in Preparing a Patient for Surgery
Authors: Thomas E. Rardin
Journal: JAMA (1960)

Since he knows a patient well and, in turn, is well known by this patient, the family doctor's role as a member of the attending hospital team is one of major significance to the patient and his family. From the moment he detects a problem requiring surgery, through preliminary studies, admission to the hospital, selection of a surgeon, definitive studies, surgery, and postoperative care, the family doctor has definite responsibilities. He supplies information and observations peculiar to this one person and acts as his patient's personal consultant to all other attending men. He communicates the many facets of scientific information developed in the definitive management of the case to both patient and family in meaningful language. He must bring understanding to both patient and family in a highly personalized manner in a setting that often is too impersonal.
The Politics of Medical Encounters: How Patients and Doctors Deal With Social Problems
Authors: Jeffrey Michael Clair
Journal: JAMA (1991)

The title of this book is encouraging. It captures a concern about patient care acknowledged decades ago that persists into the present—the nature of physician-patient encounters. "by technically helping patients adjust in some way, physicians actually may be reinforcing 'the big social problems that keep people distressed and unhappy.'" Quality patient care focuses attention on a host of empathetic and egalitarian<i>social psychological</i>variables beyond normal medical models based on the symptomology and etiology of the patient's illness. Physician/biologist Howard Waitzkin alerts us to the prevalence of social problems within clinical settings and encounters. Waitzkin's intellectual diversity makes him uniquely capable of inspiring integrative efforts to knit together, empirically and conceptually, the seemingly disparate parts of the medical encounter. Waitzkin demonstrates that when patients approach a physician for help, they<i>re-present</i>a social context along with their physical problem(s). When social issues arise in the intimacy of the patient-doctor relationship,
Platelet activating factor: release from colonic mucosa in patients with ulcerative colitis and its effect on colonic secretion.
Authors: T D Wardle, L Hall, L A Turnberg
Journal: Gut (1996)

In the present study an attempt to evaluate the efficacy of echography as a diagnostic tool has been made. A total of 52 patients (chronic pancreatitis (42); pancreatic cysts (three); and carcinoma of the pancreas (seven)) were studied and the results compared with those from other diagnostic techniques. In 65.7% of chronic pancreatitis patients, and in all cases of carcinoma of the pancreas, echography provided evidence of pancreatic abnormality but in no case could an unambiguous diagnosis of the disease be made. However, in all cases of pancreatic cyst, echography gave precise and unequivocal diagnostic information. There was good agreement between the echographic picture and surgical findings. Cholangiography and duodenography indicated duodenal and choledochal compression in a high proportion of cases in which echography revealed enlargement of the head of the pancreas. It is concluded that echography is a simple, safe, and valuable addition to the techniques available for studying the pancreas.
Seroprevalence of antibodies to pandemic (H1N1) 2009 influenza virus among health care workers in two general hospitals after first outbreak in Kobe, Japan
Authors: Takao Toyokawa, Tomimasa Sunagawa, Yuichiro Yahata, Takaaki Ohyama, Tomoko Kodama, Hiroshi Satoh, Kumi Ueno-Yamamoto, Satoru Arai, Kazuko Araki, Fumito Odaira, Yuuki Tsuchihashi, Hideaki Takahashi, Keiko Tanaka-Taya, Nobuhiko Okabe
Journal: Journal of Infection (2011)
Medical Kits for In-flight Medical Emergencies—Reply
Authors: Melissa L. P. Mattison
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
Aortic Valve Replacement in Patients 80 Years of Age and Older
Authors: George Asimakopoulos, Maria-Benedicta Edwards, Kenneth M. Taylor
Journal: Circulation (1997)

Background Aging of the population and advances in preoperative and postoperative care are reflected in an increasing number of patients ≥80 years of age undergoing aortic valve replacement (AVR) in the United Kingdom. The present study presents data on postoperative 30-day mortality, actuarial survival, and cause of death based on a large collective patient population. Methods and Results Data were extracted from the UK Heart Valve Registry. From January 1986 to December 1995, 1100 patients ≥80 years of age underwent AVR and were reported to the registry. Six hundred eleven patients (55.5%) were women. The mean follow-up time was 38.9 months. The 30-day mortality was 6.6%. Of the 73 early deaths, 42 were due to cardiac reasons. The actuarial survival was 89%, 79.3%, 68.7%, and 45.8% at 1, 3, 5, and 8 years, respectively. After the first 30 postoperative days, 144 of the 205 deaths were due to noncardiac reasons. Malignancy, stroke, and pneumonia were the most common causes of late death. Bioprosthetic valves were implanted in 969 patients (88%) and mechanical valves in 131 (12%) patients. There was no difference in early mortality and actuarial survival between the two groups ( P &gt;.05). Conclusions The above results suggest that under the selection criteria for AVR currently applied in the United Kingdom, patients ≥80 years of age show a satisfactory early postoperative outcome and moderate medium-term survival benefit.
Estimating Incidence of HIV Infection in Uganda
Authors: Jim Todd
Journal: JAMA (2009)

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
Sickle cell disease in the United States: Looking back and forward at 100 years of progress in management and survival
Authors: Hari Prabhakar, Carlton Haywood, Robert Molokie
Journal: American Journal of Hematology (2010)

The past 100 years since James Herrick's first description of sickle cell disease in the United States have been characterized by the gradual development of management strategies. We review the progress in sickle cell disease management in the United States over the past 100 years, with emphasis on the diverse forces surrounding advances in disease management. Mortality and survival data are presented chronologically, with an attempt to highlight improvements in survival associated with specific advancements for pediatric and adult care. Finally, the future course for sickle cell disease management is explored, given the continued work in advancing the field.
Factors Prognostic of Unprovoked Seizures after Febrile Convulsions
Authors: John F. Annegers, W. Allen Hauser, Sally B. Shirts, Leonard T. Kurland
Journal: New England Journal of Medicine (1987)

We evaluated the risk of unprovoked seizures after febrile convulsions and the factors prognostic of them in a cohort of 687 children who had an initial febrile seizure while residing in Rochester, Minnesota. Overall, children with febrile convulsions had a fivefold excess of unprovoked seizures, and the risk until the age of 25 was 7 percent. The risk ranged from 2.4 percent among children with simple febrile convulsions to 6 to 8 percent among children with a single complex feature — i.e., focal or prolonged seizures or repeated episodes of febrile convulsions with the same illness. For children with any two of the complex features, the risk was 17 to 22 percent, and for those with all three features, 49 percent. The occurrence of subsequent partial unprovoked seizures was strongly associated with all three of the complex features, whereas the occurrence of subsequent unprovoked seizures of generalized onset was associated with the number of febrile convulsions and a family history of unprovoked seizures. These results are consistent with the view that the increased risk of generalized-onset unprovoked seizures reflects a predisposition to both simple febrile convulsions and generalized-onset unprovoked seizures. The association between complex febrile convulsions and partial seizures, on the other hand, may reflect either a causal association or the presence of preexisting brain disease that is responsible for both the complex febrile seizures and later partial seizures. (N Engl J Med 1987; 316:493–8.)
Cross-resistance between "Daraprim" and Proguanil
Authors: G. I. Robertson, D. G. Davey, N. H. Fairley
Journal: BMJ (1952)

<h3>Background and aims</h3> Microbiota alterations are linked with colorectal cancer (CRC) and notably higher abundance of putative oral bacteria on colonic tumours. However, it is not known if colonic mucosa-associated taxa are indeed orally derived, if such cases are a distinct subset of patients or if the oral microbiome is generally suitable for screening for CRC. <h3>Methods</h3> We profiled the microbiota in oral swabs, colonic mucosae and stool from individuals with CRC (99 subjects), colorectal polyps (32) or controls (103). <h3>Results</h3> Several oral taxa were differentially abundant in CRC compared with controls, for example, <i>Streptococcus</i> and <i>Prevotella</i>s pp. A classification model of oral swab microbiota distinguished individuals with CRC or polyps from controls (sensitivity: 53% (CRC)/67% (polyps); specificity: 96%). Combining the data from faecal microbiota and oral swab microbiota increased the sensitivity of this model to 76% (CRC)/88% (polyps). We detected similar bacterial networks in colonic microbiota and oral microbiota datasets comprising putative oral biofilm forming bacteria. While these taxa were more abundant in CRC, core networks between pathogenic, CRC-associated oral bacteria such as <i>Peptostreptococcus</i>, <i>Parvimonas</i> and <i>Fusobacterium</i> were also detected in healthy controls. High abundance of Lachnospiraceae was negatively associated with the colonisation of colonic tissue with oral-like bacterial networks suggesting a protective role for certain microbiota types against CRC, possibly by conferring colonisation resistance to CRC-associated oral taxa and possibly mediated through habitual diet. <h3>Conclusion</h3> The heterogeneity of CRC may relate to microbiota types that either predispose or provide resistance to the disease, and profiling the oral microbiome may offer an alternative screen for detecting CRC.
Cerebral arterial insufficiency and oral contraceptives.
Authors: E. R. Bickerstaff, J. M. Holmes
Journal: BMJ (1967)

Sodium salicylate and acetylsalicylic acid are drugs used as anti-inflammatory agents. Salicylate prevents nuclear factor-κB activation and can cause apoptosis. However, salicylate, a substrate of CYP2E1, is also an antioxidant and can scavenge reactive oxygen species. Experiments were carried out to evaluate whether salicylate can modulate CYP2E1-dependent toxicity. Addition of a polyunsaturated fatty acid such as arachidonic acid (AA) to HepG2 cells resulted in loss of cell viability, especially in cells expressing CYP2E1 (E47 cells). Toxicity was enhanced by the addition of 1 to 10 mM salicylate to the E47 cells but not to control HepG2 cells or HepG2 cells expressing CYP3A4. Salicylate alone was not toxic, and the enhanced toxicity by AA in the presence of salicylate was prevented by diallyl sulfide, a CYP2E1 inhibitor, and by the antioxidant (±)6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid. Salicylate potentiated AA-induced lipid peroxidation in the E47 cells, a reaction blocked by diallyl sulfide. CYP2E1 levels were elevated by salicylate at concentrations (&lt;5 mM), which did not increase CYP2E1 mRNA levels. This increase was associated with a decrease of CYP2E1 turnover by salicylate in the presence of cycloheximide. Salicylate also potentiated AA toxicity in hepatocytes isolated from pyrazole treated rats with high levels of CYP2E1 and from saline controls. In view of the potential role of CYP2E1 in contributing to alcohol-induced oxidative stress and liver injury, the potentiation of CYP2E1-dependent toxicity and the elevation of CYP2E1 levels by salicylate may be of clinical significance and merit caution in the use of salicylate and salicylate precursors such as acetylsalicylic acid with certain other drugs.
A Rapid Bedside Test for Intestinal Perforation
Authors: John McCraw
Journal: JAMA (1965)

SPONTANEOUS and traumatic perforations of the gastrointestinal tract, in spite of widespread use of antibiotics, are still associated with high morbidity and considerable mortality. The crux of adequate management frequently centers on early diagnosis. Unfortunately, the onset of peritonitis from perforation may be insidious and may escape early detection. Such generally reliable signs as free air under the diaphragm and paralytic ileus may be absent or equivocal. The purpose of this report is to describe acid precipitation of diatrizoate in urine as an additional diagnostic measure which has shown promise both in the laboratory and in limited clinical application. <h3>Methods and Results</h3> The use of orally administered water-soluble iodinated contrast media, particularly meglumine diatrizoate (Gastrografin) and sodium diatrizoate (Hypaque sodium) has become widely accepted in gastrointestinal radiography. Meglumine diatrizoate and sodium diatrizoate, used interchangeably in this study, are essentially unabsorbed by the gut lining (0.4% to 1.20% of the ingested
Venous collapse and the respiratory variability in systemic venous return
Authors: J. N Amoore, W. P Santamore
Journal: Cardiovascular Research (1994)

Venous collapse limits systemic venous return, but its effects on beat to beat respiratory venous return variations are less well known. The aim of this study was to investigate the effects of venous collapse on respiratory variations in venous return.A model of venous collapse which included both an increase in haemodynamic resistance to flow and an increase in vessel compliance was incorporated in a previously described cardiovascular model. Respiration was simulated by 5 mm Hg swings of intrathoracic pressure (PTH) at different mean pressures such that the abdominal vena cava and jugular vein were either fully collapsed (mean PTH -11 mm Hg), in the transition zone between collapse and distension (mean PTH -6 mm Hg), or fully distended (mean PTH 9 mm Hg). The mean and standard deviations over each respiratory cycle of the venous return volume (flow integral over heart cycle) and the abdominal vena caval volume were recorded.Different venous return volume variabilities in the three operating zones of the vena cava were identified: (1) reduced variability in the collapsed zone associated with the increased haemodynamic resistance [venous return 93(SD 6) ml, abdominal vena caval volume 30(3) ml. absolute right atrial pressure -6.3(1.1) mm Hg]; (2) increased variability in the transition zone [venous return 86(24) ml, abdominal vena caval volume 81(15) ml, right atrial pressure -2.2(0.8) mm Hg]; (3) low variability in the distended zone [venous return 42(11) ml, abdominal vena caval volume 120(2) ml, right atrial pressure 10.1(1.1) mm Hg]. The greater the change in compliance with collapse the greater the increase in flow variability in the transition zone; with no change in compliance there was no increased flow variability in the transition zone.The results suggest that venous collapse increases the respiratory variations in venous return in the transition zone. As venous return variations contribute to arterial pressure variations, the collapsible nature of the great veins may influence respiratory variations in systemic arterial pressure.
AN EXPERIMENTAL STUDY OF THE SYNOVIAL FLUID OF PATIENTS WITH ARTHRITIS AND SYPHILIS *
Authors: Alan M. Chesney, Jarold E. Kemp, Frederick H. Baetjer
Journal: Journal of Clinical Investigation (1926)

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Role of Imaging in Cardiac Stem Cell Therapy
Authors: Saskia L.M.A. Beeres, Frank M. Bengel, Jozef Bartunek, Douwe E. Atsma, Jonathan M. Hill, Marc Vanderheyden, Martin Penicka, Martin J. Schalij, William Wijns, Jeroen J. Bax
Journal: Journal of the American College of Cardiology (2007)
Quality of stroke care varies widely across England
Authors: H. Mooney
Journal: BMJ (2010)

There is too much variability in the quality of care provided by stroke services in English hospitals, particularly in the speed at which patients access scans and the specialist care they receive, says the public spending watchdog.

Edward Leigh, the chairman of the House of Commons Public Accounts Committee, said, “It is totally unacceptable that the likelihood of receiving a timely brain scan or accessing specialist care depends on where and when you have a stroke. In 2008, of all patients with a suspected stroke only three fifths had been scanned within 24 hours. It is also worrying that, despite …
NT-26 * PATHOLOGY OF CASES OF IMAGING PROGRESSION IN PATIENTS DIAGNOSED WITH GLIOBLASTOMA WHO HAVE BEEN TREATED WITH THE NOVOCURE - TTF DEVICE IN THE EF-14 TRIAL
Authors: P. New, S. Powell
Journal: Neuro-Oncology (2014)

INTRODUCTION: The diagnosis of glioblastoma carries a dismal prognosis with an average of 14 months survival with standard medical care, consisting of temozolomide during radiotherapy and adjuvant temozlomide. There is a need to explore other treatment modalities. Novocure Tumor Treating Fields (TTF) is an antimitotic treatment that delivers low intensity, intermediate frequency (200 kHz), alternating electric fields to a tumor. This results in an anti-microtubule effect, with inadequate mitotic spindle formation, mitotic arrest and apoptosis. Three cases are presented, all of whom had radiographic progression, with no neurological decline. METHODS: Three patients with newly diagnosed glioblastoma were enrolled in the trial, "A Prospective, Multi-CenterTrial of NovoTTF-100A Together with Temozolomide Compared to Temozolomide Alone in Patients with Newly Diagnosed GBM." (EF-14). All three patients underwent surgical resection when disease progression was suspected on follow-up MRI. They had been receiving treatment for 6 months or longer. RESULTS: Pathology from Case #1 revealed no viable tumor cells, treatment effect only. Case #2 revealed large pleomorphic cells with rare mitoses. Pathology review of Case #3 revealed reactive white matter, scattered atypical cells, rare mitoses. CONCLUSIONS: The pathology of these patients following treatment with Novocure-TTF is consistent with changes noted in vitro and in vivo, with cellular changes including increase in size of glioblastoma cells, and few mitoses. Adjustment of the treatment field may be necessary to effect cells on the periphery of the lesion, in a better effort to prevent progression. The addition of a chemotherapeutic agent with microtubule inhibition will also be of interest as there may be potential synergistic effect.
Adjuvant trastuzumab for breast cancer: An increasingly common ethical and economic conundrum
Authors: Matthew L Grove
Journal: BMJ (2005)

Adjuvant trastuzumab for breast cancer Assessing HER2/neu status incurs more costs for treatmentEditor-The results of recent trials are likely to continue to fuel the demand for trastuzumab in the adjuvant setting of early breast cancer, 1 as well as a possible neoadjuvant treatment in the near future.However, Dent and Clemons did not discuss the difficulty in obtaining accurate and reproducible assessment of HER2/neu gene overexpression.Immunohistochemical testing measures HER2/neu protein expression whereas in situ hybridisation measures gene amplification.Patients with equivocal immunohistochemical results require in situ hybridisation to determine definitive status because interobserver variability using immunohistochemical testing is appreciable.At least 20% of patients with positive immunohistochemical results will be truly negative for HER2/neu gene amplification; these patients would not benefit from trastuzumab. 2 These difficulties in assessing HER2/ neu status have been encountered in studies testing trastuzumab, and in situ hybridisation testing has been used as the gold standard. 3 As the clinical utility of trastuzumab widens guidelines on HER2/neu testing must be clear to ensure appropriate use of trastuzumab.Clearly this testing will incur additional costs to trastuzumab treatment.