tbuckley/cabot-search huggingface dataset:
Building the Best Team
Authors: Richard R. Babb
Journal: Annals of Internal Medicine (1998)

Letters15 February 1998Building the Best TeamRichard R. Babb, MDRichard R. Babb, MDPalo Alto Medical Clinic; Palo Alto, CA 94301Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-4-199802150-00043 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Nash and Nash [1] encourage physicians to “organize together” in organizations that are administratively nimble, deliver high-quality care, and have appropriate salary structures. We and other private multispecialty clinics have been doing just that for decades. They should leave academe and come visit.References1. Nash DB, Nash IS. Building the best team [Editorial]. Ann Intern Med. 1997; 127:72-4. Google Scholar Author, Article, and Disclosure InformationAffiliations: Palo Alto Medical Clinic; Palo Alto, CA 94301 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1998Volume 128, Issue 4Page: 328 Issue Published: 15 February 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Academic medicine: time for reinvention: Shorter training and shortage of doctors detrimentally affect research
Authors: M. W K Lim
Journal: BMJ (2004)

Editor—As a specialist registrar who successfully applied for research funding, I would add the shorter training and general shortage of doctors in the NHS to Bell's list of factors detrimentally affecting research.1

The time limited training as a specialist registrar meant that I had only a limited window to write up and submit applications. Yet overstretched departments were often reluctant to grant study time to work up those applications. From their perspective there was little to show for the time granted—that is, no audits and no papers. Little central support was given at the deanery, occupied with the task of shoring up clinical training against competing demands.

These remain systemic problems affecting a little publicised bottleneck into research: at the application and pre-entry point. Judging by how well the NHS is handling its current staffing problems, I seriously doubt these problems can be overcome in the near future. I suspect clinical research will remain moribund for a while yet.
Embedded Weapons-Grade Tungsten Alloy Shrapnel Rapidly Induces Metastatic High-Grade Rhabdomyosarcomas in F344 Rats
Authors: John F. Kalinich, Christy A. Emond, Thomas K. Dalton, Steven R. Mog, Gary D. Coleman, Jessica E. Kordell, Alexandra C. Miller, David E. McClain
Journal: Environmental Health Perspectives (2005)

Continuing concern regarding the potential health and environmental effects of depleted uranium and lead has resulted in many countries adding tungsten alloy (WA)-based munitions to their battlefield arsenals as replacements for these metals. Because the alloys used in many munitions are relatively recent additions to the list of militarily relevant metals, very little is known about the health effects of these metals after internalization as embedded shrapnel. Previous work in this laboratory developed a rodent model system that mimicked shrapnel loads seen in wounded personnel from the 1991 Persian Gulf War. In the present study, we used that system and male F344 rats, implanted intramuscularly with pellets (1 mm times 2 mm cylinders) of weapons-grade WA, to simulate shrapnel wounds. Rats were implanted with 4 (low dose) or 20 pellets (high dose) of WA. Tantalum (20 pellets) and nickel (20 pellets) served as negative and positive controls, respectively. The high-dose WA-implanted rats (n = 46) developed extremely aggressive tumors surrounding the pellets within 4-5 months after implantation. The low-dose WA-implanted rats (n = 46) and nickel-implanted rats (n = 36) also developed tumors surrounding the pellets but at a slower rate. Rats implanted with tantalum (n = 46), an inert control metal, did not develop tumors. Tumor yield was 100% in both the low- and high-dose WA groups. The tumors, characterized as high-grade pleomorphic rhabdomyosarcomas by histopathology and immunohistochemical examination, rapidly metastasized to the lung and necessitated euthanasia of the animal. Significant hematologic changes, indicative of polycythemia, were also observed in the high-dose WA-implanted rats. These changes were apparent as early as 1 month postimplantation in the high-dose WA rats, well before any overt signs of tumor development. These results point out the need for further studies investigating the health effects of tungsten and tungsten-based alloys.
A PERICARDIAL EFFUSION OF "GOLD-PAINT" APPEARANCE DUE TO THE PRESENCE OF CHOLESTERIN
Authors: J. S. Alexander
Journal: BMJ (1919)

o 463abdomen was slightly distended, nothing abnormal was felt, and there was no tenderness on pressure.There was a " squeaking " bruit just to the left of the sternum, and pulSa- tioii to the right of the sternum; the bruit was in all probability
Evaluation of Ephedrine Test
Authors: William Hamelberg, Peter P. Bosomworth
Journal: JAMA (1963)

RESERPINE, guanethidine sulfate, and some tranquilizers are known to modify the neuroeffector action of levarterenol bitartrate in animals.<sup>1, 2</sup>This fact and clinical experience have led anesthesiologists to recommend that elective operations be postponed until 2 or 3 weeks after therapy with these drugs has been discontinued. Recently Crandell<sup>3</sup>introduced the "ephedrine response test" to more accurately predict the time when patients receiving resperine would be suitable candidates for elective operation. This report presents our clinical findings concerning this test when used as a screening test to predict the occurrence of hypotension during anesthesia in patients receiving known or unknown antihypertensive or tranquilizing drugs. <h3>Method</h3><h3>Ephedrine Test.</h3> —With the patients in the supine position three baseline BP and pulse rate readings were obtained. Using a slightly different dosage schedule from that presented by Crandell, we gave our patients 5 mg of ephedrine sulfate intravenously. During the next
Diagnosis of Minute Cancers by the Endoscopic Congo Red - Methylene Blue Test
Authors: M. Tatsuta, S. Okuda, H. Taniguchi
Journal: Endoscopy (1983)

The clinicopathological features of minute cancers of the stomach were investigated, and the accuracy of diagnosis of minute cancers by routine endoscopic examinations and by the endoscopic Congo red - methylene blue test were compared.
USEFULNESS OF FOUR DIMENSIONAL ECHOCARDIOGRAPHY TO ASSESS LEFT VENTRICULAR MASS: VALIDATION WITH CARDIAC MRI
Authors: Masaomi Gohbara, Noriaki Iwahashi, Nobuhiko Maejima, Mitsuaki Endo, Kengo Tsukahara, Kiyoshi Hibi, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura
Journal: Journal of the American College of Cardiology (2012)
A Public Health Approach to Decreasing Obesity
Authors: Susan J. Blumenthal, Jennifer M. Hendi, Lauren Marsillo
Journal: JAMA (2002)

In concert with clinical medicine, which addresses diseases in individuals, the public health approach targets behavioral, sociocultural, and environmental factors that contribute to disease and injury in populations. For example, over the last 40 years, coordinated government efforts and efforts and private sector initiatives decreased smoking prevalence by almost half through taxation of tobacco products, smoking bans in public places, laws prohibiting tobacco sales to minors, advertising restrictions, and aggressive public education campaigns. Soon, however, obesity may surpass smoking as the leading cause of preventable death in the United States. Public health interventions to decrease obesity prevalence must apply the same kind of multifaceted and coordinated approach that reduced tobacco use in order to change individual behavior patterns and effectively address the environmental barriers to physical activity and healthful food choices.
alpha 1 Antitrypsin (PI) allotypes in rheumatoid arthritis.
Authors: P A Sanders, W Thomson, D A Browne, P A Dyer, D M Grennan
Journal: Annals of the Rheumatic Diseases (1986)

alpha 1 Antitrypsin (PI) phenotypes were defined in 144 patients with rheumatoid arthritis (RA) and in 223 normal controls. The frequencies of the rare F, S, and Z variants were similar in RA and control groups. No relationships were found between PI allotypes and rheumatoid disease severity or autoantibody titre. The PI M1M2 phenotype was increased in frequency in the RA group, and phenotype frequencies in DR4 positive and negative disease were similar. These results support the suggestion that genes on the 14th chromosome which are linked to PI predispose to RA.
Diet and Colon Cancer: Assessment of Risk by Fiber Type and Food Source
Authors: M. L Slattery, A. W. Sorenson, A. W. Mahoney, T. K. French, D. Kritchevsky, J. C. Street
Journal: JNCI Journal of the National Cancer Institute (1988)

How fiber in the diet is related to the development of colon cancer was assessed in a population-based study conducted on 231 cases and 391 controls in Utah between 1979 and 1983. Crude fiber consistently decreased risk associated with colon cancer in both males [odds ratio (OR) = 0.4] and females (OR = 0.5). Dietary fiber, as analyzed by the method of A. S. Bitner, and neutral detergent fiber were not consistently related to colon cancer risk. Of the noncellulose polysaccharides examined, mannose and galactose were protective against cancers in the ascending colon in males (ORs = 0.5 and 0.3, respectively), whereas galactose and uronic acid were protective against cancers in the ascending colon in females (ORs = 0.5). Highest quartiles of intake of fruits and vegetables were also associated with a decreased risk of colon cancer in males (ORs = 0.3 and 0.6, respectively) and in females (ORs = 0.6 and 0.3, respectively) compared with lowest quartile of intake, whereas high intake of grains was not protective.
Natural vs Synthetic Vitamins
Authors: Samuel Ayers
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Under QUESTIONS AND ANSWERS (225:73, 1973) a query as to whether there was any difference between natural and synthetic vitamins was answered by Margarita Nagy, MS, of the AMA Department of Foods and Nutrition, as follows: Biochemically, a vitamin has only one molecular structure; thus, whether a vitamin is extracted from a natural product or synthesized by the manufacturer, its structure is identical in either case, and possesses, consequently, the same biochemical activity... the human body utilizes vitamins without questioning whether they were synthesized by a plant or in the laboratory of a pharmaceutical company. This may be true of some vitamins, but it is definitely not true of vitamin E (tocopherol), in which the alpha fraction contains virtually all of the therapeutically active principle. D, αtocopheryl acetate is derived from natural sources, such as wheat germ oil, whereas dl α-tocopheryl acetate is the synthetic form. While
Caring for an Aging Population
Authors: Margaret A. Winker, Catherine D. DeAngelis
Journal: JAMA (2010)

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
INTRACRANIAL COMPLICATIONS OF FRACTURE OF SKULL INVOLVING FRONTAL SINUS
Authors: FRANK R. TEACHENOR
Journal: JAMA (1927)

A recent series of fractures of the skull involving the frontal sinus brought to my attention the amazing frequency of intracranial complications from this source, and likewise the pleasing success of prompt surgical drainage in the prevention of these complications.  In the last three years at the Kansas City General Hospital, where a large series of cranial injuries are handled annually, there have been ten deaths from intracranial infection following trauma. These resulted from fractures of the skull involving the following paranasal sinuses: frontal sinus, six; ethmoid sinus, one; sphenoid sinus, one, and mastoid and middle ear, two.  Although not of common occurrence, in my experience fractures involving the frontal sinus have been the source of intracranial infection with greater frequency than in all other fractures of the skull combined. I have also noted that the fractures involving the frontal sinus have been from extensions of fractures of the vault
ADDITIONAL NOTES ON EMPLOYMENT OF ABSORBABLE SUTURES IN THE OPERATION OF LOOPING THE TENDONS OF OCULAR MUSCLES.
Authors: JOHN O. McREYNOLDS
Journal: JAMA (1898)

In my original paper on this subject before thisAssociationin 1897, I briefly referred to a method of employing kangaroo tendon in the operation of shortening the ocular muscles, but additional experience has taught me the importance of certain modifications, which I will attempt to present for your consideration today. And I shall feel more than amply rewarded for the labor of this pleasant task, if the members present will kindly contribute their suggestions from their wealth of vast and varied experience. In the first place, I should like to say that the kind of suture material and also the method employed should vary according to the amount of correction desired. Speaking in general terms, I would consider that for the different forms of heterophoria of moderate degree, the catgut suture will supply the requirements and should be preferred because of the fact that it is practically absorbed within
Consolidation of Medical Societies.
Authors: S. E. Hampton
Journal: JAMA (1899)

Milton, Ky., April 4, 1899. <h3>To the Editor:</h3> —Your plea for consolidation of medical societies (videJournal, p. 717) is timely and good. I trust that a movement looking to this end will be started at our next meeting, and would suggest that State societies have semi-annual meetings instead of annual as at present; also that the village doctor be put on active duty. Yours truly, Thesale of liquor at Stockholm has fallen from over four millions liters a year to a little over a million and a half, since the introduction of the Gothenburg system.
Liver as a target for oligonucleotide therapeutics
Authors: Alfica Sehgal, Akshay Vaishnaw, Kevin Fitzgerald
Journal: Journal of Hepatology (2013)

Oligonucleotide-based therapeutics are an emerging class of drugs that hold the promise for silencing "un-druggable" targets,thus creating unique opportunities for innovative medicines. As opposed to gene therapy, oligonucleotides are considered to be more akin to small molecule therapeutics because they are small,completely synthetic in origin, do not integrate into the host genome,and have a defined duration of therapeutic activity after which effects recover to baseline. They offer a high degree of specificity at the genetic level, thereby reducing off-target effects.At the same time, they provide a strategy for targeting any gene in the genome, including transcripts that produce mutated proteins.Oligonucleotide-based therapeutics include short interfering RNA (siRNA), that degrade target mRNA through RISC mediated RNAi; anti-miRs, that target miRNAs; miRNA mimics, that regulate target mRNA; antisense oligonucleotides, that may be working through RNAseH mediated mRNA decay; mRNA upregulation,by targeting long non-coding RNAs; and oligonucleotides induced alternative splicing [1]. All these approaches require some minimal degree of homology at the nucleic acid sequence level for them to be functional. The different mechanisms of action and their relevant activity are outlined in Fig. 1. Besides homology,RNA secondary structure has also been exploited in the case of ribozymes and aptamers, which act by binding to nucleic acids or proteins, respectively. While there have been many reports of gene knockdown and gene modulation in cell lines and mice with all these methods, very few have advanced to clinical stages.The main obstacle to date has been the safe and effective intracellular delivery of these compounds in higher species, including humans. Indeed, their action requires direct interaction with DNA/RNA within the target cell so even when one solves the issues of tissue and cellular access, intracellular/intranuclear location represents yet another barrier to overcome. To date,hepatic delivery of oligonucleotides has been the area with greatest progress, and thus we have focused on liver-targeted therapeutics that have shown promise at the preclinical and/or clinical level.The liver is the largest internal organ in the body, playing a central role in metabolism, detoxification, synthesis, and secretion of major plasma proteins (carrier proteins, coagulation factors,complement components, hormones, and apolipoproteins),and iron homeostasis. It is therefore not surprising that a large number of disease targets reside in the liver where they are susceptible to modulation by oligonucleotide therapies.
PLEURAL EFFUSION DUE TO ARTIFICIAL PNEUMOTHORAX
Authors: CHARLES M. MONTGOMERY
Journal: JAMA (1913)

In a paper on the complications of artificial pneumothorax, Weiss<sup>1</sup>estimates that in about 50 per cent, of the cases an effusion develops on the treated side. In spite of this frequency there appear to be comparatively few American articles dealing with this subject, judging from the abstracted and complete papers which I have read. Harris<sup>2</sup>records two cases, one occurring during the course of treatment, the other five months after discontinuing treatment. Pleurisy with effusion is reported by Hamman and Sloan<sup>3</sup>in two of their cases, but the side affected is not mentioned. Sloan<sup>4</sup>speaks of four eases of pleural effusion occurring in six cases of artificial pneumothorax progressing favorably. Undoubtedly, the great majority of these effusions are insignificant in character. At times they pass unrecognized till they are revealed by the<i>x</i>-ray. As this subject is fully treated in the article by Weiss,
The Plea for Alcohol.
Authors: T. D. Crothers
Journal: JAMA (1899)

Hartford, Conn., Feb. 23, 1899. <h3>To the Editor:</h3> —In theJournalof February 11, Dr. D. E. Mattison has in a very courteous way expressed his opinion on the value of alcohol and referred to the decreasing number of persons who suffer keenly when asked to give up theories long held as facts. Some physicians, like theologians, dread the arrival of new facts and new truths, which necessitate change or readjustment. To them it is dangerous to reopen an old subject for new evidence. It is more pleasant to believe that the final truths have been reached and the last word said. Fortunately doubts, denials, and pleas for present theories are neither obstructive nor destructive, but stimulating to new inquiries; at the same time they are literal protests against old theories and welcomes for new truths. Theories of alcohol and its physiologic and medicinal action are as ancient and numerous
Suppression of Leukotriene B4 Biosynthesis by Endogenous Adenosine in Ligand-activated Human Neutrophils
Authors: Eric Krump, Serge Picard, Joseph Mancini, Pierre Borgeat
Journal: The Journal of Experimental Medicine (1997)

Adenosine (Ado) has been shown to suppress several functional responses of human polymorphonuclear leukocytes (PMNs). The current study investigated whether endogenous Ado regulates the biosynthesis of leukotriene (LT)B4 in ligand-stimulated PMNs. Measurements of Ado in PMN resuspended in Hanks' buffered salt solution (HBSS) or plasma showed a cell concentration– and time–dependent accumulation of the nucleoside. The removal of endogenous Ado with either Ado deaminase or the blockade of its action by the Ado A2a receptor antagonist, 8-(3-chlorostyryl) caffeine, markedly increased LTB4 biosynthesis upon ligand stimulation in HBSS. Similarly, LTB4 synthesis by ligand-stimulated PMNs in plasma (containing recombinant LTA4 hydrolase to allow the conversion of protein-bound LTA4) was strongly enhanced by addition of Ado deaminase. Addition of red blood cells to suspensions of PMNs in plasma mimicked the effect of adding Ado deaminase and LTA4 hydrolase in enhancing LTB4 biosynthesis upon ligand stimulation. This effect of red blood cells on LTB4 biosynthesis was blocked by dipyridamole, an inhibitor of Ado transport, or captopril, an inhibitor of LTA4 hydrolase. These results demonstrate that endogenous Ado efficiently downregulates ligand-stimulated LTB4 biosynthesis in PMN suspensions, pointing out a potentially important regulatory function of Ado in inflammatory exudates. These results also unveil a dual role for red blood cells in upregulating LTB4 biosynthesis, namely, the removal of endogenous Ado and the conversion of LTA4 released by activated PMNs.
Decreased expression of the interleukin 2 receptor on CD8 recipient lymphocytes in intestinal grafts rendered tolerant by liver transplantation in rats
Authors: S Sarnacki, H Nakai, D Calise, T Azuma, N Brousse, Y Révillon, N Cerf-Bensussan
Journal: Gut (1998)

Background —In a previous study, it was shown that a spontaneously tolerated DA (RT1a) liver allograft in a PVG (RT1c) recipient was able to induce tolerance of a DA small bowel graft performed 17 days later in spite of infiltration of the intestinal grafts by mononuclear cells. Aims —To compare the phenotype of graft infiltrating cells in rejecting and tolerated small bowel grafts in order to elucidate the mechanism(s) which block the graft infiltrating cells from mediating rejection. Methods —Multiparameter immunofluorescence was used to compare the phenotype and state of activation of donor and recipient cells isolated from intestinal grafts rejected or tolerated after liver transplantation. Results —Three differences were found. Firstly, there was a more rapid replacement of lamina propria (LP) cells by recipient lymphocytes in tolerated than in rejected grafts. Secondly, the proportion of LP recipient CD8αβ+ lymphocytes bearing the high affinity receptor for interleukin 2 was significantly less in tolerated grafts (1.1%, range 0–2%) than in rejected grafts (21.3%, range 9–26%). Finally, tolerated grafts contained significantly less NK lymphocytes (NKR-P1+) and macrophages than rejected intestinal allografts. Conclusions —These observations make it possible to delineate clear cut differences in the phenotype of cells infiltrating rejecting versus tolerated grafts. Furthermore, the data suggest that liver transplantation induces tolerance of intestinal grafts by hampering the activation of recipient TcRαβ+ CD8αβ+ T cells and subsequently the recruitment of non-specific effector cells.