tbuckley/cabot-search huggingface dataset:
Neurologic Hospitals and Neurologic and Psychiatric Wards in General Hospitals
Authors: F. W. Langdon
Journal: JAMA (1910)

<h3>To the Editor:</h3> The timely and instructive article, "The Dependence of Neurology on Internal Medicine: Plea for the Establishment of Neurologic Hospitals and of Neurologic Wards in General Hospitals," by Drs. Joseph Collins and Pearce Bailey of New York (The Journal, July 30, 1910, p. 393), seems worthy of more extended comment than would be feasible in the brief period allotted to discussion at the Section meeting. The contention of the writers that this important branch of medicine has received scant recognition in the past from the philanthropic founders of medical laboratories and institutions may be true, in a general sense, The statement, however, that "in all America there is scarcely a general hospital with neurologic wards worthy of the name, with the exception of a few hospitals and inaccessible city almshouses in which cripples and dotards are crowded together under the care of untrained house staffs without laboratory facilities,"
P227 Efficacy And Safety Of Budesonide-formoterol (bf) Spiromax(R) In Adults And Adolescents With Asthma: Randomised Comparison With Bf Turbuhaler(R)
Authors: J. Virchow, G. Gopalan, R. Rodriguez-Roisin, Y. Shu
Journal: Thorax (2014)

<h3>Background</h3> DuoResp Spiromax<sup>®</sup> (Teva Pharmaceuticals) is a dry-powder inhaler designed to deliver budesonide and formoterol fumarate (BF Spiromax<sup>®</sup>) with maximum ease of use. Pharmacokinetic studies have shown bioequivalence of BF Turbuhaler<sup>®</sup>. This study compared the efficacy and safety of these devices in patients with asthma. <h3>Methods</h3> This was a 12-week, multicentre, double-blind, randomised, controlled trial (N=605). Eligible patients (≥12 years old) had persistent asthma with FEV<sub>1</sub> 40–85% predicted, had used a SABA and ICS for ≥8 weeks before screening and were maintained on stable-dose ICS for 4 weeks. The primary objective was to demonstrate non-inferiority of twice-daily BF Spiromax<sup>®</sup> 160/4.5mcg to BF Turbuhaler<sup>®</sup> 200/6mcg, with respect to change from baseline in weekly average of daily trough morning PEF. <h3>Results</h3> This analysis was based on the per protocol population (N=290 and N=284 for BF Spiromax<sup>®</sup> and BF Turbuhaler<sup>®</sup> groups, respectively). The least squares mean change from baseline to Week 12 in morning PEF was 18.8 L/min with BF Spiromax<sup>®</sup> and 21.796 L/min with BF Turbuhaler<sup>®</sup>. Non-inferiority of BF Spiromax<sup>®</sup> vs BF Turbuhaler<sup>®</sup> was demonstrated, as the lower limit of the 95% two-sided CI (–9.02 L/min) is greater than –15 L/min. Similarly, no significant between-group differences were observed in secondary efficacy endpoints. Both devices were well tolerated, with no significant differences in the incidence of adverse events or asthma exacerbations. <h3>Conclusions</h3> This study has demonstrated the non-inferiority of BF Spiromax<sup>®</sup> vs BF Turbuhaler<sup>®</sup> in adults and adolescents with asthma. Further data are required to confirm whether BF Spiromax<sup>®</sup> can be used as an alternative to BF Turbuhaler<sup>®</sup> in other indications. Sponsor: Teva Pharmaceuticals.
The challenge of diagnosing atopic diseases: outcomes in Cuban children depend on definition and methodology
Authors: M. Wördemann, K. Polman, R. J. Diaz, L. T. Menocal Heredia, A.‐M. C. Madurga, K. A. Sague, B. Gryseels, M. B. Gorbea
Journal: Allergy (2006)

Background: Prevalences of childhood asthma and other atopic diseases are increasing worldwide, and so is the number of diagnostic methods and definitions used. We determined the occurrence of atopic diseases in Cuban children with a range of diagnostic approaches commonly used or proposed in epidemiological studies, and compared the different outcome measures. Methods: A total of 398 Cuban schoolchildren between 5 and 13 years of age were diagnosed by International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, clinical examination, pre‐ and post‐exercise spirometry, and skin prick testing. All results were considered separately, as well as jointly by using scores and definitions as described in the literature. Results: Using questionnaire‐based approaches, 21–39% of the children were positive for asthma, 9–19% for atopic dermatitis, and 15–46% for rhinoconjunctivitis. With spirometry, 7% of the children had asthma. Definitions based on a combination of questionnaire and spirometry results yielded asthma rates of 5%. Of all children, 6% wheezed on clinical examination, and only one child showed clinical signs of atopic dermatitis. Eleven percent of the children had a positive skin prick test. In total, 254 children (64%) had an atopic disease as based on the ISAAC questionnaire, and 263 (66%) based on all approaches used. Conclusion: Diagnostic outcomes on atopic diseases vary considerably depending on definition and methodology. Our results clearly demonstrate the need for consensus on diagnosing asthma and other atopic diseases in epidemiological studies. Based on the most commonly used ISAAC questionnaire, our data suggest prevalences of atopic diseases in Cuban children that rival those found in some other Latin American countries and developed nations with the highest prevalences in the world.
Re: Tim O’Brien, Eleanor Ray, Rajinder Singh, Bola Coker, Ralph Beard, British Association of Urological Surgeons Section of Oncology. Prevention of Bladder Tumours after Nephroureterectomy for Primary Upper Urinary Tract Urothelial Carcinoma: A Prospective, Multicentre, Randomised Clinical Trial of a Single Postoperative Intravesical Dose of Mitomycin C (the ODMIT-C Trial). Eur Urol 2011;60:703–10
Authors: Apul Goel, Sagorika Paul
Journal: European Urology (2011)
The vasopressin and copeptin response in patients with vasodilatory shock after cardiac surgery: a prospective, controlled study
Authors: Stefan Jochberger, Corinna Velik-Salchner, Viktoria D. Mayr, Günter Luckner, Volker Wenzel, Gerda Falkensammer, Hanno Ulmer, Nils Morgenthaler, Walter Hasibeder, Martin W. Dünser
Journal: Intensive Care Medicine (2008)
Desert island books: Pacific island views
Authors: J. Cunningham
Journal: BMJ (1976)

The Riddle of the Sands, Leigh Fermor's Mani, and Strachey's Eminent Victorians.And there is just room for my file of those precious 50 or so reprints that I have read a dozen times apiece.Well, David, that's it, and that's all.Knowing you well, don't be tempted to take fewer books than I did.Most of us are lesser men.We endanger ourselves by too close contact with very different others.The Schweitzers who calmly grow for half a century with God, Bach, and scalpel are few and far between.Such experiences as you risk either expand or shrink one.You can armour yourself with work, power, or getting
Expanding the theory: Nonverbal determination of referents in a joystick task
Authors: Katherine A. Leighty, Sarah E. Cummins-Sebree, Dorothy M. Fragaszy
Journal: Behavioral and Brain Sciences (2001)

The arguments of Stoffregen &amp; Bardy for studying perception based on the global array are intriguing. This theory can be examined in nonhuman species using nonverbal tasks. We examine how monkeys master a skill that incorporates a two-dimensional/three-dimensional interface. We feel this provides excellent support for Stoffregen &amp; Bardy's theory.
Expression of c-fos and c-jun during hepatocellular remodeling following ischemia/reperfusion in mouse liver
Authors: H Schlossberg, Y Zhang, L Dudus, J F Engelhardt
Journal: Hepatology (1996)

The expression of the immediate early genes (IEGs) c– fos and e– jun have been hypothesized to potentially play key roles in mediating cellular responses following injury to the liver. In this study, we sought to evaluate the potential involvement of c– jun and c– fos as determinants either of cellular regeneration or programmed cell death following ischemia/reperfusion (I/R) in mouse liver. To this end, we have analyzed the in situ messenger RNA (mRNA) expression patterns of c– jun and c– fos following lobar I/R in mouse liver. The expression patterns of c– jun and c– fos were correlated with four criteria for tissue repair and injury, including: 1) morphological determinations of regeneration using immunocytochemical detection of proliferating cell nuclear antigen (PCNA), 2) programmed cell death (apoptosis) using the in situ terminal deoxynucleotidyl transferase–mediated dUTP–biotin nick end–labeling (TUNEL) method, 3) histopathologic assessment of hepatocellular necrosis, and 4) serum glutamic pyruvic transaminase (GPT) levels. Increasing lengths of lobar ischemia for 3, 60, and 90 minutes followed by reperfusion directly correlated with the extent of liver injury as determined by serum transaminases and hepatocellular necrosis. PCNA expression in the liver was elevated at 1 to 6 hours following liver reperfusion and returned to baseline levels by 20 hours in both ischemic and nonischemic lobes. In contrast, apoptotic responses peaked only in ischemic lobes at 6 hours′ postreperfusion and remained elevated out to 20 hours. Two distinct patterns of c– jun and c– fos expression were observed during the acute (1–3 hours) and subacute (6–20 hours) phases of liver responses to I/R including: 1) coexpression of c– jun and c– fos mRNA within damaged regions of the liver at 1 to 3 hours′ postreperfusion, and 2) a decline in c– fos expression with sustained high levels of c– jun expression within a subset of cells bordering necrotic/apoptotic regions of the liver at 6 to 20 hours′ postreperfusion. These findings suggest that coexpression of both c– jun and c– fos may be involved in mediating early tissue repair processes in liver remodeling following I/R. In contrast, the onset of hepatocellular apoptosis correlated with sustained c– jun expression, in the absence of c– fos , and suggests that these changes in the molecular profile of immediate early gene expression may regulate cellular responses that signal hepatocytes for programmed cell death.
Estrogen-Androgen Imbalance in Hepatic Cirrhosis
Authors: INDER J. CHOPRA
Journal: Annals of Internal Medicine (1973)

Serum concentrations of testosterone, dihydrotestosterone, estradiol-17β (E2), and gonadotrophins were studied in 13 male patients with hepatic cirrhosis. The mean serum total and unbound testosterone concentrations were significantly lower in the cirrhotic patients than in normal men. Serum dihydrotestosterone levels were also subnormal in five of six patients studied. On the other hand, the mean serum total and unbound E2 concentrations were significantly higher in patients with cirrhosis than in normal men. The most consistent abnormality and the one uniformly present was a supranormal E2 to testosterone ratio, as calculated from serum concentration of total or unbound steroids. These findings suggest that changes in the relative balance between circulating estrogen and androgen may play some part in the pathogenesis of gynecomastia in hepatic cirrhosis. The mean serum luteinizing hormone concentration was elevated in patients with cirrhosis, whereas that of follicle-stimulating hormone did not differ from normal.
Comment on: Neutropenia and anemia with reduced serum vitamin B(12)
Authors: Sarah Kamel, Zhong Lu, Ken Sikaris
Journal: American Journal of Hematology (2011)

To the Editor: We read with interest the case report describing a patient with a clear morphological diagnosis of acute myeloid leukemia (given the presence of Auer rods) and a total B12 level below the lower limit of detection in that laboratory. The article states, “It is quite likely that there was no tissue deficiency of B12 despite the low serum concentration. Tissue delivery of vitamin B12 depends on transcobalamin concentration whereas assays are measuring also vitamin B12 bound to haptocorrin” [1]. The measurement of a total B12 level includes both holohaptocorrin (holoHC) and holotranscobalamin, the latter also known as “active B12” as this is the physiologically active component of total B12. We recently performed a review in our laboratory of bone marrow biopsies performed on patients who also had concurrent total and active B12 levels performed. We found that of the 11 patients diagnosed with acute myeloid leukemia (AML) between 2007 and 2011 (numbers limited as clinicians generally do not order B12 levels on these patients), four patients had a low total B12 (<140 pmol/L) but only two of these four had a low active B12 level (<23 pmol/L). Supporting a diagnosis of concurrent B12 deficiency, these two patients were the most anemic and thrombocytopenic—one had hemoglobin (Hb) of 49 g/L and platelet count of 8 × 109 per L; the other had Hb 66 g/L and platelet count of 26 × 109 per L. The mean Hb of the remaining nine patients was 99 g/L with a mean platelet count of 126 × 109 per L. Of 29 patients diagnosed with myelodysplasia on a bone marrow biopsy, four had a low total B12 level but none had a low active B12 level. A low total B12 level can be seen when the active B12 level is normal; this is well recognized in pregnancy where holoHC tends to fall [2, 3]. Of a total of seven patients with bone marrows biopsies showing chronic phase chronic myeloid leukemia (CML-CP), six had an unmeasurably high total B12 level with the remaining case also showing a high total B12 of 682 pmol/L. Six of seven patients had an active B12 level within the normal range and only one was elevated. A high total B12 level can be misleading in the presence of a high holoHC. This is particularly evident in some patients with a leucocytosis [4, 5]. An active B12 level should be performed in patients with hematological disorders involving the myeloid series if there is suspicion of B12 deficiency because of the apparent variability in holoHC levels in these patients. Sarah Kamel*, Zhong Lu*, Ken Sikaris*, * Sonic Healthcare, Melbourne Pathology, Australia.
Pathophysiology of the catastrophic antiphospholipid syndrome (CAPS)
Authors: Douglas A. Triplett, Ronald A. Asherson
Journal: American Journal of Hematology (2000)

Antiphospholipid antibodies (APA) are a common cause of acquired thrombophilia. APA recognize plasma phospholipid-binding proteins (e.g., β2-glycoprotein I, prothrombin, annexin V, etc.). Catastrophic antiphospholipid syndrome (CAPS) is an uncommon variant of the antiphospholipid syndrome. CAPS patients often present with multiorgan failure. Precipitating factors include surgical procedures, drugs, and discontinuation of anticoagulant therapy. Increasingly, infections are recognized as a major precipitating condition. The majority of patients present with renal involvement as well as evidence of acute respiratory distress syndrome (ARDS). This review discusses the clinical and pathophysiologic aspects of CAPS as well as the differenital diagnosis. Am. J. Hematol. 65:154–159, 2000. © 2000 Wiley-Liss, Inc.
Liver disease in cystic fibrosis: A prospective study on incidence, risk factors, and outcome
Authors: C Colombo
Journal: Hepatology (2002)

Incidence of liver disease (LD) associated with cystic fibrosis (CF) and its clinical characterization still is unsettled. We have assessed prospectively the incidence and risk factors of this complication, and its impact on the clinical course of CF. Between 1980 and 1990, we enrolled 177 CF patients without LD in a systematic clinical, laboratory, ultrasonography screening program of at least a 10-year duration. During a 14-year median follow-up (2,432 patient-years), 48 patients developed LD, with cirrhosis already present in 5. Incidence rate (number of cases per 100 patient-years) was 1.8% (95% confidence interval: 1.3-2.4), with sharp decline after the age of 10 years and higher risk in patients with a history of meconium ileus (incidence rate ratio, 5.5; 2.7-11), male sex (2.5; 1.3-4.9), or severe mutations (2.4; 1.2-4.8) at multivariate analysis. Incidence of cirrhosis was 4.5% (2.3-7.8) during a median period of 5 years from diagnosis of liver disease. Among the 17 cirrhotic patients, 13 developed portal hypertension, 4 developed esophageal varices, 1 developed liver decompensation requiring liver transplantation. Development of LD did not condition different mortality (death rate ratio, 0.4; 0.1-1.5) or higher incidence of other clinically relevant outcomes. In conclusion, LD is a relatively frequent and early complication of CF, whose detection should be focused at the first life decade in patients with history of meconium ileus, male sex, or severe genotype. Although LD does not condition a different clinical course of CF, in some patients it may progress rapidly and require liver transplantation.
Mechanisms of airway narrowing and hyperresponsiveness in viral respiratory tract infections.
Authors: R G Hegele, S Hayashi, J C Hogg, P D Paré
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Viral respiratory tract infections are associated with an acute increase in airway responsiveness in normal subjects and patients with asthma. Airway responsiveness is also increased at least transiently in animals during acute viral infections. In this article, we discuss possible mechanisms whereby viral infections can increase airway responsiveness, emphasizing the effects of viral-induced airway epithelial damage during acute lytic infection and the mechanical consequences of airway inflammation and edema, both internal and external to the smooth muscle layer. We also describe possible mechanisms by which acute lytic viral infections could induce chronic sequelae in atopic individuals and contribute to the development of persistence of asthma. Finally, results of recent studies from our laboratory that document adenoviral genome in lungs of patients with chronic obstructive pulmonary disease (COPD) and long-term persistence of respiratory syncytial viral genome and protein in an animal model are discussed in terms of the possible role of latent and persistent viral infections in the pathogenesis of asthma and COPD.
A Woman Experiencing Difficulty With Breastfeeding
Authors: Sujatha Pillai
Journal: JAMA (2001)

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
Serum and Muscle Alanine Aminotransferase Activities in Marathon Runners
Authors: Fred S. Apple
Journal: JAMA (1984)

<h3>To the Editor.—</h3> Marathon running has been shown to induce a variety of chemical changes in runners' serum.<sup>1</sup>In the clinical laboratory, increases in serum alanine aminotransferase (ALT) activity have been shown to be very hepatospecific.<sup>2</sup>Also, it has been suggested that ALT testing is potentially useful for screening blood donors to reduce incidence of non-A, non-B viral hepatitis.<sup>3,4</sup>This report describes the changes in skeletal muscle and serum ALT activities in runners before and after a marathon race and discusses the potential for false biochemical indices for liver damage. Serum was obtained from 22 male (aged 21 to 36 years) and eight female (aged 24 to 35 years) runners two days before and 24, 48, 72, and 96 hours after a marathon race (26.2 miles). Gastrocnemius muscle biopsy specimens were obtained nine weeks before, two days before, and one day after the race from 14 male
Malnutrition in the Field. Nigerian Civil War 1968-9
Authors: S. P. F. Hughes
Journal: BMJ (1969)

A short-term, large-scale medical and feeding programme has been provided for a population of 150,000 in the bush area near Udi in eastern Nigeria (Biafra). By January 1969 8,000 patients were receiving medical treatment each week for varying degrees of protein malnutrition (including kwashiorkor), vitamin deficiency, and dehydration; while 100,000 received weekly rations of a protein-supplemented diet. Close cooperation between the medical team-which consisted of one doctor, four nurses, and two relief workers-and the local Ibo people contributed to the success of the relief programme.
Making mischief over abortion
Authors: Geoff Watts
Journal: BMJ (2005)

How one paper seems to want it to become an election issue 

O n abortion the Independent knows exactly where it stands: “The last thing British politics needs before an election is a debate over abortion.” So ran the title of its first leader on 16 March.

Er… yes. But flip back to page one of that day's paper and you begin to wonder if the news editor was operating their own agenda. In a bid to do something distinctive with its front page, the Independent often devotes it to a polemicised take on one aspect of the news. On 16 March its choice was… abortion. And so that there can be no mistaking just how strongly the paper feels about the importance of not making abortion an issue, it followed the front page lead with two further articles by its health and political staff. Surely the simplest way of discouraging an ill timed debate is not to join it?

In fairness to the Independent its stories were triggered by an event not of its own …
Reliability of SMA-12
Authors: Claude O. Burdick
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I believe the answer given by Dr Barnett to the question of inaccurate automated chemical analysis (SMA 12) results was insufficient (233:911,1975). The problem described concerned a proportion of values that fell outside normal ranges: when second specimens were repeated by hand methods, they were found to be normal. Whenever a normal range is defined as 95% of a subject population's values, one must expect that one value in 20 will be abnormal. Since there are 12 channels for each patient, most panels will have at least one value outside the normal range. If these tests are repeated on a second specimen, whether by a specific method or by the same method, the results will very likely fall within the normal range. This statistical phenomenon is called "regression toward the mean" and probably accounts for much of the discrepancy noted. The hospital's clinical pathologist should make this
Team-Based Prevention of Catheter-Related Infections
Authors: Richard P. Wenzel, Michael B. Edmond
Journal: New England Journal of Medicine (2006)

Each year, 36 million patients are admitted to acute care hospitals in the United States, staying for 164 million days.1 Eleven percent (18 million days) of these hospitalizations are spent in intensive care units (ICUs). For 54% of the days (9.7 million) that patients are in ICUs, central venous catheters remain in place for the infusion of medications and fluids. Regrettably, the use of these devices results in 48,600 associated bloodstream infections (5 per 1000 catheter-days).2 The leading pathogens, in descending order, are coagulase-negative staphylococci, Staphylococcus aureus, enterococcus species, and candida species. Morbidity is significant with bloodstream infections. At least . . .