tbuckley/cabot-search huggingface dataset:
Are Physicians Doing Too Much Colonoscopy? A National Survey of Colorectal Surveillance after Polypectomy
Authors: Pauline A. Mysliwiec, Martin L. Brown, Carrie N. Klabunde, David F. Ransohoff
Journal: Annals of Internal Medicine (2004)

Background: Increasing use of colonoscopy for colorectal cancer screening and surveillance of colorectal adenomas after polypectomy has given rise to concerns about the availability of endoscopic resources in the United States. Guidelines recommend surveillance after polypectomy at 3 to 5 years for a small adenoma, and follow-up is not advised for hyperplastic polyps. The intensity of physicians' surveillance is largely unstudied. Objective: To survey practicing gastroenterologists and general surgeons about their perceived need for the frequency of surveillance after polypectomy, to compare survey responses to practice guidelines, and to identify factors influencing their recommendations for surveillance. Design: Survey study conducted by the National Cancer Institute. Setting: A nationally representative study of physicians in the United States. Participants: 349 gastroenterologists and 316 general surgeons. Measurements: Questionnaires mailed in 1999 and 2000 assessed physicians' recommendations for surveillance after polypectomy in asymptomatic, average-risk patients. Results: Response rates were 83%. Among gastroenterologists (317 of 349) and surgeons (125 of 316) who perform screening colonoscopy, 24% (95% CI, 19.3% to 28.7%) of gastroenterologists and 54% (CI, 44.9% to 62.5%) of surgeons recommend surveillance for a hyperplastic polyp. For a small adenoma, most physicians recommended surveillance colonoscopy and more than 50% recommended examinations every 3 years or more often. Physicians indicated that published evidence was very influential in their practice (83% [CI, 78.8% to 87.2%] of gastroenterologists and 78% [CI, 72.5% to 86.8%] of surgeons). By contrast, only half of respondents reported that guidelines were very influential. Limitations: The study was based on physicians' self-reported practice patterns. Results may overestimate or underestimate the performance of surveillance colonoscopy. Conclusions: Some surveillance colonoscopy seems to be inappropriately performed and in excess of guidelines, particularly for hyperplastic polyps and low-risk lesions such as a small adenoma. These results suggest unnecessary demand for endoscopic resources.
Preserving Immunogenicity of Lethally Irradiated Viral and Bacterial Vaccine Epitopes Using a Radio- Protective Mn2+-Peptide Complex from Deinococcus
Authors: Elena K. Gaidamakova, Ian A. Myles, Dennis P. McDaniel, Cedar J. Fowler, Patricia A. Valdez, Shruti Naik, Manoshi Gayen, Paridhi Gupta, Anuj Sharma, Pamela J. Glass, Radha K. Maheshwari, Sandip K. Datta, Michael J. Daly
Journal: Cell Host & Microbe (2012)
Mutations Affecting G-Protein Subunit α<sub>11</sub>in Hypercalcemia and Hypocalcemia
Authors: M Andrew Nesbit, Fadil M Hannan, Sarah A Howles, Valerie N Babinsky, Rosie A Head, Treena Cranston, Nigel Rust, Maurine R Hobbs, Hunter Heath, Rajesh V Thakker
Journal: New England Journal of Medicine (2013)

Familial hypocalciuric hypercalcemia is a genetically heterogeneous disorder with three variants: types 1, 2, and 3. Type 1 is due to loss-of-function mutations of the calcium-sensing receptor, a guanine nucleotide-binding protein (G-protein)-coupled receptor that signals through the G-protein subunit α11 (Gα11). Type 3 is associated with adaptor-related protein complex 2, sigma 1 subunit (AP2S1) mutations, which result in altered calcium-sensing receptor endocytosis. We hypothesized that type 2 is due to mutations effecting Gα11 loss of function, since Gα11 is involved in calcium-sensing receptor signaling, and its gene (GNA11) and the type 2 locus are colocalized on chromosome 19p13.3. We also postulated that mutations effecting Gα11 gain of function, like the mutations effecting calcium-sensing receptor gain of function that cause autosomal dominant hypocalcemia type 1, may lead to hypocalcemia.
Study of Post-war Incidence of Breast-feeding
Authors: F. H. M. Dummer
Journal: BMJ (1949)

TREATMENT OF INFLUENZAL MENINGITIS BRmsH intracisternal as well as intraventricular penicillin.Case 4 had 40,000 units of penicillin intrathecally for eight days and intramuscular penicillin, 320,000 units daily, for 17 days.After an immediate good response there was a recurrence of meningitis at the end of the third week, and this was controlled completely by much larger dosage.Cases 6, 7, 8, and 9 were given 40,000 units intrathecally daily and 960,000 units intramuscularly in three-hourly doses.In no case was there any evidence of meningeal reinfection after the illness was once under control, and in no case was intracisternal or intraventricular therapy required.In one case a severe convulsion occurred after the fifth intrathecal injection, but with no ultimate ill effect.In this last group the cerebrospinal fluid became sterile on the third to fifth day, clinical improvement was apparent in two to three days, and the meningitis seemed to be well under control by the end of a week, though the temperature did not settle completely so long as intramuscular penicillin was given.Also the cell count in the cerebrospinal fluid did not return to normal while the patient was under treat- ment.This was presumably due to reaction to the penicillin, but in those patients whose C.S.F. has been examined several months after cessation of treatment an ultimate return to normal is indicated.The persistence of pyrexia and cellular reaction, however, made it difficult to decide when to stop treatment: we may have given an unnecessary amount of intrathecal penicillin.There seems to be no need to continue this for more than a week after the fluid is sterile, provided adequate intramuscular penicillin, 960,000 units daily, is continued for about three 'weeks.2. Sulphadiazine, Penicillin, and Streptomnycin (3 cases).-In Cases 12 and 13 a change was made from penicillin to strepto- mycin on the fourth and fifth day respectively, but in each case improvement in the C.S.F.-a fall in cells from 380 to 80 and a rise in sugar from 0 to 35 mg. per 100 ml. in one, and a fall in cells from 2,540 to 70 and a rise in sugar from 21 mg. to 30.5 mg. per 100 ml. in the other-had already taken place.The second patient had a convulsion after one of the intrathecal injections of penicillin.In the third (Case 14), a change to streptomycin was made on the second day of treatment.In none of these cases can it be said that penicillin had failed: it had not been given time to succeed.All recovered.3. Sulphadiazine anzd Streptoinycin.-One patient (Case 15) was treated with this combination with complete success.
Transfer of specific unresponsiveness to organ allografts by thymocytes. Specific unresponsiveness by thymocyte transfer.
Authors: W. S. Hendry, N. L. Tilney, William M Baldwin, M. J. Graves, E. Milford, T. B. Strom, C. B. Carpenter
Journal: The Journal of Experimental Medicine (1979)

Prolonged survival of vascularized organ allografts has been produced in unmodified inbred rats by transfer of thymocytes from enhanced, engrafted, syngeneic animals. For these thymocytes to increase significantly the survival of test allografts they must be harvested 6-9 d after transplantation. Thymectomy of the enhanced, engrafted animals during the same critical period causes acute rejection of othewise long surviving grafts. For optimal effect, the enhanced thymocyte donor must be actively and passively immunized and receive a cardiac allograft. The necessity for erythrocytes in the initial active immunization regimen is noted. Additionally, the antigenic specificity of the suppressor effect has been established with two histoincompatible donor rat strains. Cellular and humoral host responses mounted by test graft recipients after thymocyte transfer from enhanced, engrafted donors are different from those mounted either by unmodifed animals acutely rejecting their grafts or by enhanced rats bearing well-functioning grafts. Numbers of T lymphocytes are reduced in the grafted hearts and in the spleens of test graft recipients, a finding paralleled by the complete absence of specific direct lymphocyte-mediated cytotoxicity. In contrast, cytotoxic antibody production, although delayed, is increased in magnitude, peaking around the time of graft rejection. These studies provide evidence that different biological manipulations can modify separate pathways in the complex cellular and humoral responses towards organ allografts. They demonstrate that cellular immunity is critically involved in immunological enhancement of vascularized organ allografts, a phenomenon hitherto considered primarily humoral. It seems clear that cells with suppressor activity are present within the thymus during the early phases of immunological enhancement.
Carpal tunnel syndrome, humeral epicondylitis, and the cervical spine: a study of clinical and dimensional relations.
Authors: C F Murray-Leslie, V Wright
Journal: BMJ (1976)

Forty-three patients with idiopathic carpal tunnel syndrome, confirmed by nerve conduction studies and treated by surgery, were compared clinically and radiologically with 43 age- and sex-matched control patients. Patients with carpal tunnel syndrome had a significantly greater prevalence of lateral humeral epicondylitis (tennis elbow) (33%) than controls (7%). Randomised reading of the cervical spine radiographs in ignorance of the groups to which they belonged showed no significant difference in the prevalence of either intervertebral disc degeneration or intraforaminal osteophyte protruion using conventional grading methods. Measurement of the minimum anteroposterior diameter of the cervical spinal canal, the anteroposterior diameters of the cervical vertebral bodies, and the ratio of intervertebral disc height to adjacent vertebral body height in the cervical spine, however, showed a consistent trend to smaller measurements in the carpal tunnel group. Differences were significant at several vertebral levels in each of these dimensions. The narrowing of the intervertebral discs relative to the vertebral bodies in patients with carpal tunnel syndrome may indicate connective tissue changes, which might also occur in the common extensor origin at the elbow or in the contents of the carpal tunnel.
Efficacy of ‘Functional Relaxation’ in Comparison to Terbutaline and a ‘Placebo Relaxation’ Method in Patients with Acute Asthma
Authors: T.H. Loew, K. Tritt, W. Siegfried, H. Bohmann, P. Martus, E.G. Hahn
Journal: Psychotherapy and Psychosomatics (2001)

&lt;i&gt;Background:&lt;/i&gt; ‘Functional relaxation’ (FR) according to Marianne Fuchs is a body-oriented psychotherapy that involves teaching the patient a type of relaxation techniques aimed at maintaining equilibrium of the nervous system. &lt;i&gt;Methods:&lt;/i&gt; In order to determine whether the practice of elementary parts of this therapy has an immediate beneficial effect on pulmonary function, a randomized, single-blind, prospective crossover study was done with 21 asthmatics with acute bronchoconstriction. On 3 consecutive days they were given either (1) a 5-min verbal standard instruction in elementary exercises of FR (eFR), which they were to practice during subsequent bodyplethysmographic measurement or (2) inhalative terbutaline (IT), a β&lt;sub&gt;2&lt;/sub&gt;-sympathomimetic drug, or (3) an unspecific ‘placebo relaxation’ technique (PRT), so that all subjects tried all 3 treatments in random order. Spirometric variables were assessed. &lt;i&gt;Results:&lt;/i&gt; There was a significant decrease in specific airway resistance with eFR, which, though not as pronounced as with IT, was significantly greater than with PRT. This study shows that clinically relevant effects can be achieved for patients with asthma through mind-body interaction, which can be triggered by reproducible procedures. &lt;i&gt;Conclusion:&lt;/i&gt; Further development of the FR approach could lead to a nonpharmacological and effective supplementary treatment for asthma, which is in high demand by many patients.
THE EMBRYOLOGY OF THE DENTAL PULP.
Authors: R. R. ANDREWS
Journal: JAMA (1902)

At the invitation of the secretary of our section to present a paper on some subject connected with the dental pulp, I shall consider at this time the dental pulp in its embryologic aspect. Such an aspect appeals to me the more strongly from the fact that I have given special attention in earlier research work to dental embryology. In a general way. I shall consider the growth of the dentine germ from the earliest signs of its development, the formation of the dentine from the germ, and lastly, the fully formed and functionally mature pulp. This subject may not offer anything that is particularly new, but there are several points that I have recently been trying to clear up, and a discussion of them may prove of general interest to the Section on Stomatology. At about the end of the second and the beginning of the third month of
Electron-Beam Computed Tomography for Coronary Calcium
Authors: Dariush Mozaffarian
Journal: JAMA (2005)

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
Dietary Protein in the Genesis of Hepatic Coma
Authors: Robert Schwartz, Gerald B. Phillips, J. Edwin Seegmiller, George J. Gabuzda, Charles S. Davidson
Journal: New England Journal of Medicine (1954)

IN the past decade the therapy of severe liver disease has been directed toward the provision of a high or adequate protein and caloric intake.1 , 2 A syndrome resembling impending hepatic coma has been observed to follow the administration of certain nitrogenous substances to some patients with severe cirrhosis of the liver.3 , 4 This has resulted in an increased awareness of the intolerance of patients to these materials, including dietary protein.This communication describes 3 additional patients with chronic alcoholism, cirrhosis of the liver and neurologic complications who manifested an intolerance to the administration of dietary protein and on whom the provision . . .
Radiofrequency ablation for hepatocellular carcinoma in so-called high-risk locations
Authors: Takuma Teratani, Haruhiko Yoshida, Shuichiro Shiina, Shuntaro Obi, Shinpei Sato, Ryosuke Tateishi, Norio Mine, Yuji Kondo, Takao Kawabe, Masao Omata
Journal: Hepatology (2006)

We evaluated the efficacy and safety of radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) in presumably high-risk locations. Between February 1999 and December 2001, we performed RF ablation on 1,419 nodules in 636 consecutive HCC patients, of which 231 nodules in 207 patients were in high-risk locations, defined as less than 5 mm from a large vessel or an extrahepatic organ. Eighty-one patients had a nodule adjacent to a large vessel, 145 patients had a nodule adjacent to an extrahepatic organ, of whom 19 also had one adjacent to a large vessel. Early complications and local tumor progression were analyzed with regard to the location of each nodule. The mean nodule diameter and average number per patient were 27 mm and 2.3, respectively. Early complications, within 30 days after ablation, occurred in 12 of 207 patients (5.8 %) with a nodule in a high-risk location and in 15 of 429 patients (3.5 %) without ( P = .1776). There was no significant difference in local tumor progression rate between nodules in high-risk locations (1 year: 2.1%, 2 years: 3.1%, 3 years: 3.1%) and those elsewhere (1 year: 0.6%, 2 years: 1.7%, 3 years: 2.5%) ( P = .2745). In conclusion , HCC nodules adjacent to a large vessel or extrahepatic organ were treated with RF ablation without compromising the efficacy of the procedure. However, even though without significant difference, some complications occurred at risky locations and need to be carefully considered. (Hepatology 2006;43:1101–1108.)
Cholinergic Abnormalities, Endosomal Alterations and Up-Regulation of Nerve Growth Factor Signaling in Niemann-Pick Type C Disease
Authors: Carolina Cabeza, Alicia Figueroa, Oscar M Lazo, Carolina Galleguillos, Claudia Pissani, Andrés Klein, Christian Gonzalez-Billault, Nibaldo C Inestrosa, Alejandra R Alvarez, Silvana Zanlungo, Francisca C Bronfman
Journal: Molecular Neurodegeneration (2012)

Abstract Background Neurotrophins and their receptors regulate several aspects of the developing and mature nervous system, including neuronal morphology and survival. Neurotrophin receptors are active in signaling endosomes, which are organelles that propagate neurotrophin signaling along neuronal processes. Defects in the Npc1 gene are associated with the accumulation of cholesterol and lipids in late endosomes and lysosomes, leading to neurodegeneration and Niemann-Pick type C (NPC) disease. The aim of this work was to assess whether the endosomal and lysosomal alterations observed in NPC disease disrupt neurotrophin signaling. As models, we used i) NPC1-deficient mice to evaluate the central cholinergic septo-hippocampal pathway and its response to nerve growth factor (NGF) after axotomy and ii) PC12 cells treated with U18666A, a pharmacological cellular model of NPC, stimulated with NGF. Results NPC1-deficient cholinergic cells respond to NGF after axotomy and exhibit increased levels of choline acetyl transferase (ChAT), whose gene is under the control of NGF signaling, compared to wild type cholinergic neurons. This finding was correlated with increased ChAT and phosphorylated Akt in basal forebrain homogenates. In addition, we found that cholinergic neurons from NPC1-deficient mice had disrupted neuronal morphology, suggesting early signs of neurodegeneration. Consistently, PC12 cells treated with U18666A presented a clear NPC cellular phenotype with a prominent endocytic dysfunction that includes an increased size of TrkA-containing endosomes and reduced recycling of the receptor. This result correlates with increased sensitivity to NGF, and, in particular, with up-regulation of the Akt and PLC-γ signaling pathways, increased neurite extension, increased phosphorylation of tau protein and cell death when PC12 cells are differentiated and treated with U18666A. Conclusions Our results suggest that the NPC cellular phenotype causes neuronal dysfunction through the abnormal up-regulation of survival pathways, which causes the perturbation of signaling cascades and anomalous phosphorylation of the cytoskeleton.
Second Thoughts about HMOs for Medicare Patients
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1987)

The Reagan administration's efforts to create a competitive alternative to Medicare's traditional way of financing medical care have yielded several important, though not altogether painless, lessons for its sponsor, the Health Care Financing Administration (HCFA). The agency has learned that elderly people will enroll voluntarily in alternative health care systems in substantial numbers and that an increasing number of physicians are prepared to treat them on a prepaid, fixed-cost basis as well. But the HCFA has also learned that contractual arrangements with alternative health plans must be monitored closely, not treated in the more laissez faire manner favored by the . . .
EXPERIMENTS ON THE RUSTING OF INSTRUMENTS IN STERILIZATION BY BOILING.
Authors: EDMUND ANDREWS
Journal: JAMA (1897)

Every one knows that if steel instruments are sterilized by boiling in pure water, they become covered with spots of rust. It is usual to guard against this by adding to the water 1 per cent. of sodium carbonate. Some surgeons complain that this process gives no uniformity of result, their instruments sometimes coming out bright, and sometimes badly spotted. As the rusting is a simple chemic process, the results ought always to be the same if the conditions are uniform. The following experiments were made to ascertain the effect of boiling under different conditions. A quantity of thin polished steel plates, each one inch wide and two inches long, were made for me by a cutler. These were washed well in ether, and then soaked in a bath of ether for some hours to remove all oily matter from the surface. Also two plates of aluminium, each two inches
Quality and effect of single dose versus split dose of polyethylene glycol bowel preparation for early-morning colonoscopy
Authors: J. Park, C. Sohn, S. Hwang, H. Choi, J. Park, H. Kim, D. Park, Y. Cho, W. Jeon, B. Kim
Journal: Endoscopy (2007)

See also: Commentaire de travail de J. S. Park et al., pp. 616Endoscopy 2007; 39(07): 758-758DOI: 10.1055/s-0032-1306954
Deficits in affiliative reward: An endophenotype for psychiatric disorders?
Authors: Alfonso Troisi, Francesca R. D'Amato
Journal: Behavioral and Brain Sciences (2005)

depue &amp; morrone-strupinsky's (d&amp;m-s's) model of affiliation meets the criteria advanced for the definition of behavior systems and endophenotypes. we argue that its application in psychiatry could be useful for identifying a biological pathophysiology common to a variety of conditions that are currently classified in very different categories of psychiatric nosography, including autism, schizoid personality, primary psychopathy, and dismissing attachment.
Medicalisation costs $77 billion in US, study says
Authors: B. Roehr
Journal: BMJ (2010)

The direct cost of medicalisation—the categorising of events or behaviours as requiring medical treatment—was $77.1bn (£53.6bn, €62.3bn) in the United States in 2005, or 3.9% of total domestic healthcare expenditure, according to what is believed to be the first ever study quantifying those costs ( Soc Sci Med 2010;70:1943-7).

Investigators tried to be “fairly rigorous” in what to include under medicalisation in the analysis, lead author Peter Conrad, a researcher at Brandeis University, near Boston, told the BMJ . They chose conditions for which there was broad agreement and where data were available.

They ended up with a dozen: anxiety disorders, …
A rite to drop
Authors: L. Rangecroft
Journal: BMJ (1995)

There are no medical reasons for excising a normal foreskin. Paediatricians and paediatric surgeons have been preaching this message for decades, and the population of boys being circumcised in the United Kingdom has now fallen to less than 10%. The practice of so called female circumcision has recently received considerable adverse publicity, but ritual male circumcision has been relatively unchallenged. The Jewish journalist Victor Schonfeld's programme for Channel 4's War Cries series went a long way to redress the balance. It seemed inconceivable to the supporters of the practice interviewed that any Jewish, Moslem, or African male should not have his foreskin removed. …