tbuckley/cabot-search huggingface dataset:
A Program to Increase the Number of Family Physicians in Rural and Underserved Areas
Authors: Howard K. Rabinowitz, James J. Diamond, Fred W. Markham, Christina E. Hazelwood
Journal: JAMA (1999)

The shortage of physicians in rural areas is a longstanding and serious problem, and national and state policymakers and educators continue to face the challenge of finding effective ways to increase the supply of rural physicians.To determine the direct and long-term impact of the Physician Shortage Area Program (PSAP) of Jefferson Medical College (JMC) on the rural physician workforce.Retrospective cohort study.A total of 206 PSAP graduates from the classes of 1978 to 1991.The PSAP graduates currently practicing family medicine in rural and underserved areas of Pennsylvania, compared with all allopathic medical school graduates in the state, and with all US and international allopathic graduates. All PSAP graduates were also compared with their non-PSAP peers at JMC regarding their US practice location, medical specialty, and retention for the past 5 to 10 years.The PSAP graduates account for 21% (32/150) of family physicians practicing in rural Pennsylvania who graduated from one of the state's 7 medical schools, even though they represent only 1% (206/14710) of graduates from those schools (relative risk [RR], 19.1). Among all US and international medical school graduates, PSAP graduates represent 12% of all family physicians in rural Pennsylvania. Results were similar for PSAP graduates practicing in underserved areas. Overall, PSAP graduates were much more likely than their non-PSAP classmates at JMC to practice in a rural area of the United States (34% vs 11%; RR, 3.0), to practice in an underserved area (30% vs 9%; RR, 3.2), to practice family medicine (52% vs 13%; RR, 4.0), and to have combined a career in family practice with practice in a rural area (21% vs 2%; RR, 8.5). Of PSAP graduates, 84% were practicing in either a rural or small metropolitan area, or one of the primary care specialties. Program retention has remained high, with the number of PSAP graduates currently practicing rural family medicine equal to 87% of those practicing between 5 and 10 years ago, and the number practicing in underserved areas, 94%.The PSAP, after more than 22 years, has had a disproportionately large impact on the rural physician workforce, and this effect has persisted over time. Based on these program results, policymakers and medical schools can have a substantial impact on the shortage of physicians in rural areas.
Stimulated cytokineplasts from human polymorphonuclear leukocytes mobilize calcium and polymerize actin. Cytoplasts made in cytochalasin B retain a defect in actin polymerization.
Authors: D E Dyett, S E Malawista, P H Naccache, R I Sha'afi
Journal: Journal of Clinical Investigation (1986)

Biologically active fragments from polymorphonuclear leukocytes (PMN) are simplified systems that can be used to elucidate specific pathways by which cell function is altered. In the current study we have found that cytokineplasts, which are motile fragments derived from the leading front (protopod, lamellipodium) of human PMN, rapidly increase their intracellular free calcium concentration when stimulated by chemotactic formyl peptide or by leukotriene B4, as measured by Quin-2 acetoxymethyl ester fluorescence. As in the parent cell, extracellular EGTA blunts this response only partially. Hence, cytokineplasts retain a mobilizable internal calcium pool, despite a general lack of intracellular organelles. In addition, formyl peptide more than doubles the amount of cytoskeleton-associated (polymerized) actin. In contrast, cytoplasts made by high-speed, discontinuous gradient centrifugation of cytochalasin B-treated leukocytes also increase their intracellular free calcium on stimulation, but cytoskeleton-associated actin increases by only approximately 14%. Thus, defective motile function in the latter cytoplast is associated with compromised effector function (actin polymerization).
FDA panel recommends DNA test as first line cervical cancer screening test
Authors: M. McCarthy
Journal: BMJ (2014)

A US Food and Drug Administration advisory panel has voted unanimously (13-0) to recommend that a DNA test for the human papillomavirus (HPV) be approved as a first line cervical cancer screening test, challenging the role of the cytological smear test.

The FDA is not bound by its advisory panels’ recommendations, but it usually heeds their advice.

The Cobas HPV test, made by Roche Molecular Systems, uses DNA amplification with polymerase chain reaction and nucleic acid hybridization to provide specific genotype information for the highest …
A mutation of human cytochrome c enhances the intrinsic apoptotic pathway but causes only thrombocytopenia
Authors: Ian M Morison, Elisabeth M Cramer Bordé, Emma J Cheesman, Pak Leng Cheong, Andrew J Holyoake, Serge Fichelson, Robert J Weeks, Alexandra Lo, Stefan M K Davies, Sigurd M Wilbanks, Robert D Fagerlund, Mathew W Ludgate, Fernanda M da Silva Tatley, Melanie S A Coker, Nicholas A Bockett, Gillian Hughes, Diana A Pippig, Mark P Smith, Claude Capron, Elizabeth C Ledgerwood
Journal: Nature Genetics (2008)
Governing Medicine: Theory and Practice
Authors: Conor Brophy
Journal: BMJ (2004)

I 've a fantastic idea for a reality TV show. But it's one with a twist: the future of the NHS will be decided on the outcome. The show takes place in a hospital, and the contestants will be doctors and managers. The audience will be the patients, who vote on how to run the hospital. But they won't be told that the options are unworkable. The contestants know, given the equipment and information supplied to them, that the options are impossible. But they're out of the show (it's in their contracts) if they say anything …
VICARIOUS MENSTRUATION DURING PREGNANCY.
Authors: N. P. McGAY
Journal: JAMA (1906)

<h3>Patient.</h3> —M. D., aged 25, married about five years. <h3>History.</h3> —The patient had a miscarriage about three years ago, probably self induced. The uterus had to be "scraped out" about three weeks later. She has always been healthy and has had no disorders of menstruation up to this time. The flow occurred every thirty days, until May 30, 1905, since which time it has been decidedly irregular. On June 29 and 30, she had severe attacks of nose bleed, but no signs of menstrual flow. July 30 and 31, the same thing occurred. On August 19 she became alarmed at the non-appearance of menstruation and consulted me. I made a diagnosis of probable pregnancy from the symptoms then discernible. On August 30 and 31, she had a return of the menstrual flow but no nose bleed. In September and October, however, she again had severe attacks of epistaxis. On November
Health Professions Educational Assistance Act of 1976
Authors: Leonard D. Fenninger
Journal: JAMA (1976)

President Ford signed into law the Health Professions Educational Assistance Act of 1976 (PL 94-484) on Oct 12, 1976. A discussion of some of the issues that were considered during the prolonged development of this legislation appears elsewhere in this number ofThe Journal. Effective and suitable relationships between the federal government, including the Congress and the Executive, and the schools of the health professions have been at the heart of much of the debate. In fact, inherent in the differences, discussions, and deliberations has been the fundamental question of whether higher education, the individual students who are pursuing it, and the institutions that provide the setting for higher education should be subjected to federal regulation as the requirement for eligibility for resources collected from the public and redistributed by the federal government. Although the legislation itself applies directly only to the schools of the health professions, the regulatory provisions
Excessive Food Aversion, Compulsive Exercise and Decreased Height Gain Due to Fear of Obesity in a Prepubertal Girl
Authors: Takehiko Ohzeki, Hiroshi Tachikawa, Kaname Tanimoto, Keiichi Hanaki, Hiroko Motozumi, Hiroko Ohtahara, Hirofumi Urashima, Toshinori Tsukuda, Kazuo Shiraki
Journal: Psychotherapy and Psychosomatics (1994)

A case of a 7-year-old girl with a remarkable food aversion and excessive weight reduction caused by fear of obesity, which has been demonstrated in pubertal girls with symptoms partly similar to anorexia nervosa, is reported. Although the patient's weight was reduced to the upper limits of the normal range with diet and exercise, she reduced her food intake more strictly and did not at all eat food consisting of carbohydrates. Exercise was performed longer than before. Her weight continued to decrease and height velocity lowered from 6.0 to 4.1 cm/year (mean +/- SD of the age-matched normal girls: 5.5 +/- 0.74 cm/year). Her eating behavior was normalized without specific psychotherapy for anorexia nervosa. It is suggested that food aversion with weight loss and decrease in height gain due to fear of obesity may occur in prepubertal children as well as in adolescent girls.
Left Ventricular Performance and Remodeling in Rabbits After Myocardial Infarction
Authors: Kenneth W. Mahaffey, Thomas E. Raya, Gregory D. Pennock, Eugene Morkin, Steven Goldman
Journal: Circulation (1995)

Background Because the rat postinfarction model differs from human heart failure with respect to the composition of myosin heavy chain (MHC) isoforms and other contractile proteins, alternative animal models are needed for the development of new treatments for human heart failure. The purpose of this study was threefold: (1) to test the feasibility of using the V 3 (β,β) rabbit postinfarction model for the study of heart failure by characterizing the effects of chronic coronary artery occlusion on the left ventricle; (2) to determine whether the thyroid hormone analogue 3,5-diiodothyropropionic acid (DITPA) produces improvements in left ventricular function; and (3) to determine the effects of myocardial infarction and treatment with DITPA on MHC protein isoforms. Methods and Results Male New Zealand White rabbits underwent proximal circumflex coronary artery ligation. After infarction, rabbits were treated with DITPA (3.75 mg/kg body wt) or placebo for 21 days and then underwent conscious and open-chest hemodynamic studies. In separate groups of rabbits, β- and α-MHC isoforms were separated, and relative proportions were measured using gradient sodium dodecyl sulfate–polyacrylamide gel electrophoresis and laser densitometry. Infarction resulted in increased left ventricular end-diastolic pressure and prolonged left ventricular relaxation (τ) ( P =.001 for both variables). Postinfarction treatment with DITPA decreased left ventricular end-diastolic pressure and τ ( P =.002 and P =.001, respectively) and increased maximum positive and negative dP/dt ( P =.002 and P =.016, respectively). Infarcted rabbits treated with DITPA had no significant changes in heart rate or left ventricular systolic pressure compared with untreated rabbits with infarction. There were no significant differences in heart rate, positive dP/dt, peak systolic pressure, or τ between sham-operated rabbits and sham-operated rabbits treated with DITPA. Although infarction resulted in increased left ventricular diameter, there were no effects of DITPA on left ventricular remodeling. Neither myocardial infarction nor treatment with DITPA altered the ratio of MHC isoforms. Conclusions Rabbits that survive occlusion of the circumflex artery will develop myocardial dysfunction and left ventricular remodeling. Therapy with DITPA, a thyroid hormone analogue, produces improvement in ventricular performance and reduces end-diastolic pressure. The hemodynamic effects of DITPA were not associated with alterations of MHC isoforms. Whether DITPA represents the prototype of a previously undescribed class of agents for the treatment of heart failure will need to be determined by clinical trials.
Indirect Costs of Structural Interventions
Authors: Alexander C. Tsai
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
Prevalence of Helicobacter pylori infection and related gastroduodenal lesions in spouses of Helicobacter pylori positive patients with duodenal ulcer.
Authors: F Parente, G Maconi, O Sangaletti, M Minguzzi, L Vago, E Rossi, G Bianchi Porro
Journal: Gut (1996)

BACKGROUND: To date, very few studies have evaluated the risk of infection among spouses of Helicobacter pylori positive patients and their results are conflicting. AIM: To assess the seroprevalence of H pylori infection in spouse of H pylori positive patients with duodenal ulcer as compared with age and sex matched volunteer blood donors, as well as the frequency of endoscopic gastroduodenal lesions in these spouses, according to the presence or absence of gastrointestinal complaints. METHODS: Some 124 spouses (48% males) of patients with duodenal ulcer consecutively seen over a 10 month period were studied. They were all screened for serum IgG anti-H pylori antibodies and asked to complete a questionnaire with particular reference to the presence of chronic or recurrent dyspepsia. Upper gastrointestinal tract endoscopy with antral and corpus biopsy specimens taken for histological examination and urease rapid test was offered to all seropositive spouses. Volunteer blood donors (248), living in Milan and matched for age, sex, north-south origins, and socioeconomic status to the cases, were used as controls. RESULTS: Spouses of patients with duodenal ulcer had a significantly higher seroprevalence of H pylori infection than controls (71% v 58%, p &lt; 0.05); 30 of 88 (34%) H pylori positive spouses complained of dyspeptic symptoms compared with only four of 34 (12%) seronegative spouses (p &lt; 0.02). At endoscopy, H pylori infection was confirmed in 48 of 49 (98%) seropositive spouses. The endoscopic findings in those spouses showed active duodenal ulcer in eight (17%), duodenal scar and cap deformity in two (4%), active gastric ulcer in two (4%), erosive duodenitis in three (6%), antral erosions in two (4%), antral erosions plus duodenitis in one, and peptic oesophagitis in another patient. The prevalence of major endoscopic lesions was significantly higher in symptomatic spouses than in those who had never been symptomatic. CONCLUSIONS: These findings show that being the spouse of an H pylori positive patient with duodenal ulcer may increase the risk of H pylori colonisation and perhaps of peptic ulcer disease, and raises questions as to whether serological screening of cohabiting partners of H pylori positive patients with duodenal ulcer may be indicated.
Cartilage Oligomeric Matrix Protein Maintains the Contractile Phenotype of Vascular Smooth Muscle Cells by Interacting With α <sub>7</sub> β <sub>1</sub> Integrin
Authors: Li Wang, Jingang Zheng, Yaoyao Du, Yaqian Huang, Jing Li, Bo Liu, Chuan-ju Liu, Yi Zhu, Yuansheng Gao, Qingbo Xu, Wei Kong, Xian Wang
Journal: Circulation Research (2009)

Rational : Vascular smooth muscle cells (VSMCs) switching from a contractile/differentiated to a synthetic/dedifferentiated phenotype has an essential role in atherosclerosis, postangioplastic restenosis and hypertension. However, how normal VSMCs maintain the differentiated state is less understood. Objective : We aimed to indentify the effect of cartilage oligomeric matrix protein (COMP), a normal vascular extracellular matrix, on modulation of VSMCs phenotype. Methods and Results : We demonstrated that COMP was associated positively with the expression of VSMC differentiation marker genes during phenotype transition. Knockdown of COMP by small interfering (si)RNA favored dedifferentiation. Conversely, adenoviral overexpression of COMP markedly suppressed platelet-derived growth factor-BB-elicited VSMC dedifferentiation, characterized by altered VSMC morphology, actin fiber organization, focal adhesion assembly, and the expression of phenotype-dependent markers. Whereas α 7 integrin coimmunoprecipitated with COMP in normal rat VSMCs and vessels, neutralizing antibody or siRNA against α 7 integrin inhibited VSMC adhesion to COMP, which indicated that α 7 β 1 integrin is a potential receptor for COMP. As well, blocking or interference by siRNA of α 7 integrin completely abolished the effect of COMP on conserving the contractile phenotype. In accordance, ectopic adenoviral overexpression of COMP greatly retarded VSMC phenotype switching, rescued contractility of carotid artery ring, and inhibited neointima formation in balloon-injured rats. Conclusions : Our data suggest that COMP is essential for maintaining a VSMC contractile phenotype and the protective effects of COMP are mainly mediated through interaction with α 7 β 1 integrin. Investigations to identify the factors affecting the expression and integrity of COMP may provide a novel therapeutic target for vascular disorders.
ABDOMINAL PAIN AS EXEMPLIFIED IN ACUTE APPENDICITIS: A CLINICAL AND BIOLOGICAL CONSIDERATION
Authors: J. Morley
Journal: BMJ (1928)

ALMOST the first considerable contribution to our knowledge of the mechanism of abdominal pain was made by J. Ross of Manchester' in 1887.Ross held that there were two kinds of pain in visceral disease-true splanchnic pain, felt in the affected organ; and associated somatic pain, referred to the celebro-spinal nerves of the body wall.Lennander2 established the insensibility of the exposed gastro-intestinal tract to the ordinary painful stimuli, and attributed all abdominal pain to stimulation of nerves in the sensitive parietal peritoneum.Mackenzie, whose views form the orthodox teaching of the current *textbooks, accepted Ross's views on somatic pain, but rejected splanchnic pain as nion-e'xistent.He believed that painful stimuli
Improving Survival Trends in Primary Myelofibrosis: An International Study
Authors: Francisco Cervantes, Brigitte Dupriez, Francesco Passamonti, Alessandro M. Vannucchi, Enrica Morra, John T. Reilly, Jean-Loup Demory, Elisa Rumi, Paola Guglielmelli, Elisa Roncoroni, Ayalew Tefferi, Arturo Pereira
Journal: Journal of Clinical Oncology (2012)

Purpose Despite the lack of major improvements in the treatment of primary myelofibrosis (PMF), there are recent indications that the survival of patients might have increased over the years. This study was aimed at ascertaining whether survival prolongation has actually occurred in PMF. Patients and Methods A total of 802 patients diagnosed with PMF in four European countries were compared for the presentation of features and survival according to the diagnostic periods 1980 to 1995 (n = 434) and 1996 to 2007 (n = 368); relative survival was estimated for the two groups. Results Patients diagnosed between 1996 and 2007 more often had constitutional symptoms (31% v 23%) but a lower incidence of marked anemia (31% v 39%), leukocytosis greater than 25 × 10 9 /L (9% v 13%), and blood blasts (27% v 33%); risk distribution was comparable between the two groups. Median survival was 4.6 years (95% CI, 4.0 to 5.1) for patients from 1980 to 1995 and 6.5 years (95% CI, 5.5 to 7.4) for patients from 1996 to 2007 (P &lt; .001). The latter group of patients showed improved relative survival, especially for women, patients younger than age 65 years, and patients with low or intermediate-1–risk disease. Rates of PMF-attributable mortality at 5 and 10 years were significantly lower in the second period; this reduction in disease-specific mortality occurred across all patient subgroups, except in intermediate-2–risk or high-risk patients. Conclusion Survival of PMF is steadily improving, except in patients in poor-risk categories. This observation must be taken into account at the time of evaluating the survival impact of newer therapies for PMF, which are currently being tested in these patient subpopulations.
Clinical Lecture ON THE RIGHT SIDE OF THE HEART AND ITS RELATION TO OVERSTRAIN
Authors: W. Russell
Journal: BMJ (1916)

I ASK vour attentioni to-day to the consideration of the clinical phenomllena whclih, when correctly interpreted, enable us to arrive at certaini conclusions as to tlle con- dition of the righlt side of the hleart.At the outset we must recall tlle anatomical relations of the right heart.A frontal view of the heart is made up of right auricle and ventricle, and, at its left limit, of a strip of left ventricle about half an inch in breadtlh.The origin of the pul- monary artery, from that part of the right ventricle called the conus arteriosus, is in the second left intercostal space, wlhile its position, when naot thus situated, can often be precisely determined bv palpation and ausctultation, as these define thle poiiit at whihll the closure of the pul- monary cusps is best felt and lheard.Tlle right ventricle lies under the tllird, fourtlh, and fiftlh spaces, extending in the fifthi space to withliii half an inch to an inclh of the .apex of the left ventricle.Tlle righlt border of the heart forms an arc the convexity of which is to thle riglht, and wllicll lies in the third, fourth.and fifth intercostal spaces, extending in the fourth to an inch or one and a lhalf inches from the right sterlal border. METHODS OF EXAMINATICN.Percuassion.
Amyotrophic Lateral Sclerosis — A New Role for Old Drugs
Authors: Robert H. Brown
Journal: New England Journal of Medicine (2005)

A screening assay of FDA-approved drugs identified ceftriaxone and other β-lactam antibiotics as potential therapies for amyotrophic lateral sclerosis (ALS) and other neurologic disorders. The results of experiments in a mouse model of ALS provide support for this hypothesis and suggest that ceftriaxone could also be used to delay the onset of ALS.
Philosopher assisted suicide and euthanasia
Authors: C. Elliott
Journal: BMJ (1996)

Legal euthanasia and assisted suicide are beginning to look inevitable, yet many doctors seem uncomfortable with the idea. The BMA has opposed legalising euthanasia and so have many states and national medical organisations in the United States. A recent bill making Australia's Northern Territories the world's first jurisdiction to legalise active euthanasia was bitterly opposed by the Australian Medical Association. Even doctors who want to make euthanasia legal often say that they would not want to participate.

In this, as in other things, philosophers think differently. While there is certainly not unanimity among them—some moral philosophers express deep concerns about euthanasia—academic philosophers have been prominent among those arguing for ethical and legislative changes in current euthanasia policies. Philosophers have rightly pointed out that euthanasia brings about a quicker death for patients who are suffering, and on humanitarian grounds this is preferable to a more prolonged death. Philosophers have also argued, again persuasively, that it is difficult to make rational moral distinctions between withdrawal of life sustaining treatment, which doctors …