tbuckley/cabot-search huggingface dataset:
Radiologic Examination of the Gastrointestinal Tract
Authors: John E. Gary, Richard Schatzki
Journal: New England Journal of Medicine (1954)

DuodenumDuodenal UlcerTempleton51 reiterates the truism that the only basis for a diagnosis of active ulcer is demonstration of a crater. He found that the deformity associated with ulcer appears shortly after the onset of symptoms and shows little change thereafter, regardless of healing or recurrence of the crater. Some ulcers heal without leaving a deformity. He favors periodic x-ray examination as a means of judging the efficacy of treatment.Ettinger52 presented cases of duodenal ulcer in which there was extensive scarring with a resultant wide, gaping pylorus. This made it difficult to locate the pylorus accurately and therefore . . .
Fibreoptic bronchoscopy: ten years on.
Authors: D M Mitchell, C J Emerson, J Collyer, J V Collins
Journal: BMJ (1980)

Fibreoptic bronchoscopy was introduced more than 10 years ago and is now in many centres a routine diagnostic procedure, having superseded rigid bronchoscopy. Its major role is in the diagnosis of bronchial carcinoma, where the results are as good as, if not better than, results with the rigid instrument. Other major applications have been found in investigating haemoptysis, transbronchial lung biopsy in interstitial lung disease, and in the critically ill patient in the intensive care unit. More recently, the instrument has been used to perform bronchoalveolar lavage in investigating interstitial lung diseases and to enable lobar and segmental lung function studies to be performed. Fibreoptic bronchoscopy is a major advance in the diagnosis of pulmonary diseases, but there will always be times when rigid bronchoscopy is preferable.
Deaths and Cardiovascular Events in Men Receiving Testosterone
Authors: Daniel M. Riche, William L. Baker, Christian A. Koch
Journal: JAMA (2014)

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
Effect of the Hemodialysis Prescription on Patient Morbidity
Authors: E. G. Lowrie, N. M. Laird, T. F. Parker, J. A. Sargent
Journal: New England Journal of Medicine (1981)

This report summarizes morbidity in 151 patients in a cooperative trial designed to evaluate the clinical effects of different dialysis prescriptions. Four treatment groups were divided along two dimensions: dialysis treatment time (long or short), and blood urea nitrogen (BUN) concentration averaged with respect to time (TACurea) (high or low). Dietary protein was not restricted. There was no difference in mortality between the groups. Withdrawal of patients from the high-BUN groups for medical reasons was significantly greater than withdrawal from the low-BUN groups. Hospitalization was also greater in the high-BUN groups, but dialysis treatment time had no significant effects. The data indicate that the occurrence of morbid events is affected by the dialysis prescription. Increased morbidity appears to accompany prescriptions associated with a relatively high BUN. Conversely, morbidity may be decreased by prescriptions associated with more efficient removal of urea if the dietary intake of protein and other nutrients is adequate.
Going on strike
Authors: M. Pugh
Journal: BMJ (1999)

For two weeks in the autumn of 1987 there were virtually no junior doctors present in the Republic of Ireland's hospitals. As a junior doctor at the time, I took part in the strike and even had a small part in organising it. The aim of the strike was to increase overtime payments in the belief that this would decrease the amount of overtime we would be expected to work.

Going on strike is not something any doctor will find easy. We want to help patients; using them as pawns runs counter to the reasons why we do medicine. There is the alarming possibility that patients may be harmed because of one's actions. Junior doctors also have the concern that going on strike may potentially damage their future careers. Thinking about strikes and money seems to change the nature of what we do from a medical vocation into an ordinary job. The change could detrimentally alter our commitment to medicine. How will the public view us afterwards? If all these concerns were realised, no doctor would strike. However, the experiences of previous medical strikes, including my own, do provide some answers.

I do not believe any patients suffered seriously because of the strike. Patients would have been inconvenienced by having routine work postponed for two weeks, but substantial morbidity or mortality did not occur. The media and the government would have been on the lookout for such problems, but I do not remember any cause for concern coming to light during or after the strike. More objectively, there are published studies that reassuringly show that hospital mortality did not increase during the course of hospital doctor's strikes in Israel1 and Sweden.2 It could be argued that during a strike mortality is just pushed into the community. However, during a …
449. Tumor Targeted, Systemic Delivery of Therapeutic Viral Vectors Using Hitch Hiking on Antigen Specific T Cells
Authors: Jian Qiao, Caroline Cole, Timothy Kottke, Rosa Maria Diaz, Luis Sanchez-Perez, Gregory Brunn, Jill Thompson, Richard Vile
Journal: Molecular Therapy (2005)

To achieve targeted, truly systemic therapeutic gene delivery to tumors, we exploited the observation that infection by a retrovirus proceeds initially through a non specific adsorption stage prior to envelope-receptor recognition/internalization. Antigen specific, primary murine OT-1 T cells can be incubated in vitro with retroviral stocks which adhere to the cell surface, which we have termed as viral hitch hiking. In vitro, virus can be handed off to target cells upon co-culture with the T cells. There was an inverse correlation between the ability of different viral envelopes to infect primary T cells and the availability of the particles for adhesion/hand off to target tumor cells. Hand off depended upon cell contact, envelope/receptor interactions and correlated with local heparanase expression as provided either by the malignant nature of target tumor cells and/or T cell activation upon encounter of antigen (ovalbumin) by the OT-1 T cells. Retroviral particles, pre-adsorbed to the surface of OT-1 T cells in vitro, were available for hand off in vivo to B16ova tumors distant from the site of T cell injection at high enough concentrations for therapeutic levels of gene transfer to occur. Release of an HSVtk virus killed metastatic tumor cells directly (curing over 60% treated mice), above the levels that the T cells alone could achieve (no cures), and generated immunity against B16 rechallenge (6 of 6 mice). There was no evidence by PCR of productive infection of a range of other organs, even though the OT-1 T cells distribute widely through the body. Adoptive transfer of (4070A)Tyr-HSVtk-loaded OT-1 T cells into lymphodepleted hosts conferred significantly added efficacy (90% of animals cured) compared to the transfer of OT-1 T cells alone (p<0.0001) and led to the expansion and persistence of OT-1 T cells in cured mice.
Hutchinson's sign: A reappraisal
Authors: Robert Baran, Paul Kechijian
Journal: Journal of the American Academy of Dermatology (1996)

Hutchinson's sign, periungual extension of brown-black pigmentation from longitudinal melanonychia onto the proximal and lateral nailfolds, is an important indicator of subungual melanoma. However, experience has demonstrated that Hutchinson's sign, although valuable, is not an infallible predictor of melanoma. Periungual pigmentation is present in a variety of benign disorders and, therefore, may lead to overdiagnosis of subungual melanoma. Periungual hyperpigmentation occurs in at least one nonmelanoma skin cancer, Bowen's disease of the nail unit. Hyperigmentation of the nail bed and matrix may reflect through the "transparent" nailfolds simulating Hutchinson's sign. "Pseudo-Hutchinson's sign" is a phrase coined to encompass these three simulants of Hutchinson's sign. Each represents a misleading clue to the diagnosis of subungual melanoma. Total reliance on the (apparent) presence or absence of periungual pigmentation may lead to overdiagnosis or underdiagnosis of subungual melanoma. All relevant clinical and historical information, including the presence or absence of periungual pigmentation, must be carefully evaluated in a patient suspected of having subungual melanoma. Ultimately, the diagnosis of subungual melanoma is made histologically.
Biology and Bach
Authors: F. J. Ingelfinger
Journal: New England Journal of Medicine (1972)

A priori, one might postulate that bird and biology watching would be very similar. Bird and biology watchers, however, can now testify otherwise. The bird-watcher divides, classifies and searches the individual. When he identifies a solitary Hudsonian Godwit, his ecstasy makes him oblivious of the totality of nature. The Biology-Watcher on the other hand – at least the type whose comments have now graced the Journal's pages for a year – is a monist, an observer who amalgamates into one organismic mass the myriad objects he detects among the branches of biology. Within this Unitarian scheme of things, the position . . .
Hepatic vein arrival time as assessed by contrast-enhanced ultrasonography is useful for the assessment of portal hypertension in compensated cirrhosis
Authors: Moon Young Kim, Ki Tae Suk, Soon Koo Baik, Hyoun A. Kim, Young Ju Kim, Seung Hwan Cha, Hwa Ryun Kwak, Mee Yon Cho, Hong Jun Park, Hyo Keun Jeon, So Yeon Park, Bo Ra Kim, Jin Heon Hong, Ki Won Jo, Jae Woo Kim, Hyun Soo Kim, Sang Ok Kwon, Sei Jin Chang, Gwang Ho Baik, Dong Joon Kim
Journal: Hepatology (2012)

The measurement of the hepatic venous pressure gradient (HVPG) for the estimation of portal hypertension (PH) in cirrhosis has some limitations, including its invasiveness. Hepatic vein arrival time (HVAT), as assessed by microbubble contrast-enhanced ultrasonography (CEUS), is negatively correlated with the histological grade of liver fibrosis because of the associated hemodynamic abnormalities. Anatomical and pathophysiological changes in liver microcirculation are the initial events leading to PH. However, the direct relationship between HVAT and PH has not been evaluated. The present study measured both HVPG and HVAT in 71 consecutive patients with compensated cirrhosis and analyzed the relationship between the two parameters (i.e., the derivation set). Results were validated in 35 compensated patients with cirrhosis at another medical center (i.e., the validation set). The derivation set had HVPG and HVAT values of 11.4 ± 5.0 mmHg (mean ± standard deviation; range, 2-23) and 14.1 ± 3.4 seconds (range, 8.4-24.2), respectively; there was a statistically significant negative correlation between HVPG and HVAT (r(2) = 0.545; P < 0.001). The area under the receiver operating characteristic curve (AUROC) was 0.973 for clinically significant PH (CSPH; HVPG, ≥ 10 mmHg), and the sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios for CSPH for an HVAT cut-off value of 14 seconds were 92.7%, 86.7%, 90.5%, 89.7%, 6.95, and 0.08, respectively. In addition, a shorter HVAT was associated with worse Child-Pugh score (P < 0.001) and esophageal varices (P = 0.018). In the validation set, there was also a significant negative correlation between HVAT and HVPG (r(2) = 0.538; P < 0.001), and AUROC = 0.953 for CSPH. HVAT was significantly correlated with PH. These results indicate that measuring HVAT is useful for the noninvasive prediction of CSPH in patients with compensated cirrhosis.
Complications From Surgery and Hospital Finances
Authors: William Weeks
Journal: JAMA (2013)

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
Promotion of family planning services in practice leaflets
Authors: M N Marshall, D J P. Gray, V Pearson, D R Phillips, M Owen
Journal: BMJ (1994)

relation between stress and smoking, suggesting that smoking relieves the stress of smoking withdrawal but that completely stopping smoking tends to lead to reduced stress, with stress increasing if smoking is resumed.33 4 This may mean that providing support for stopping smoking, such as nicotine replacement, would be more effective than expected.More direct policies might be considered, to use some of the additional revenue from higher cigarette taxes to compensate poor lone parents for the increased cost of living caused by the taxes.Thus, increased cigarette prices could provide a good incentive to stop smoking, while the increased income support would prevent penalisation of those unable to stop smoking.The increased support given to people who continued to smoke would be clawed back in cigarette tax. CONCLUSIONChanges in cigarette prices seem to have had a strong impact on smoking; the greatest impact is on groups that are least responsive to health publicity measures but have the highest prevalence of smoking.This suggests that real increases in the price of cigarettes will both reduce smoking and help to reduce the differences in the prevalence of smoking and smoking related diseases between socioeconomic groups.Special measures are necessary to ameliorate any effects on the cost ofliving ofthe most deprived families.
The Action of Alcohol
Authors: J. Ross
Journal: BMJ (1873)

inherited neurosis ; and this association is so constant that the intem.perance must be regarded, at least ultimately, as thze result, rather than the cause, of the insanity.Dipsomania has three forms-acute, periodic, and continuous.In the acuteformi, the patient, formerly temperate, takes suddenly to excessive drinking usually after some loss, shock, or disappointment, becomes utterly indifferent to all claims of family, business, or duty, and drinks himself to death as speedily as possible.The history of such a case is almost certain to reveal unstable nervous organisation ; and probably suicide in a more sudden form has been a consequence of similar moral causes in some other member of the family.The periodic or paroxysmzal form is yet more constantly associated with some hereditary neurosis.The patient is correct and abstemious in habits, irreproachable in character, and, perhaps, of superior attain- ments; but occasionally, from anxiety, overwork, or casual indulgence, he is seized with a fierce and uncontrollable craving for stimulants.At the same time, his whole nature seems changed, and he becomes in every respect the opposite of his former self ; he forgets and sacrifices everything in the gratification of this passionate craving, chooses the vilest associates, frequents the lowest haunts, resorts to cunning lies to conceal himself, lives chiefly on brandy, and is at length discovered, probably in some low pothouse, dirty, haggard, and exhausted, with the brandy by his side, for which he still craves even when the irritated stomach refuses to retain it.The attack is followed by utter loathing of alcohol and of himself for yielding to the temptation; but, after a varying number of months, the wretched experience is onlv too certain to be repeated.No form of brain-disorder is more definite than this ; and, as already said, it is almost invariably associated with a hereditary tendency to in- temperance, or to some form of nervous disease, which may or may not have been awakened by convivial habits, but in which habits the attacks ,often seem to begin.The third form-contintuous or-constant dipsomiiania-is that where
Induced hyperammonemia may compromise the ability to generate restful sleep in patients with cirrhosis
Authors: Alessia Bersagliere, Iolanda D. Raduazzo, Mariateresa Nardi, Sami Schiff, Angelo Gatta, Piero Amodio, Peter Achermann, Sara Montagnese
Journal: Hepatology (2011)

In patients with cirrhosis, hyperammonemia and hepatic encephalopathy are common after gastrointestinal bleeding and can be simulated by an amino acid challenge (AAC), or the administration of a mixture of amino acids mimicking the composition of hemoglobin. The aim of this study was to investigate the clinical, psychometric, and wake-/sleep-electroencephalogram (EEG) correlates of induced hyperammonemia. Ten patients with cirrhosis and 10 matched healthy volunteers underwent: (1) 8-day sleep quality/timing monitoring; (2) neuropsychiatric assessment at baseline/after AAC; (3) hourly ammonia/subjective sleepiness assessment for 8 hours after AAC; (4) sleep EEG recordings (nap opportunity: 17:00-19:00) at baseline/after AAC. Neuropsychiatric performance was scored according to age-/education-adjusted Italian norms. Sleep stages were scored visually for 20-second epochs; power density spectra were calculated for consecutive 20-second epochs and average spectra determined for consolidated episodes of non-rapid eye movement (non-REM) sleep of minimal common length. The AAC resulted in: (i) an increase in ammonia concentrations/subjective sleepiness in both patients and healthy volunteers; (ii) a worsening of neuropsychiatric performance (wake EEG slowing) in two (20%) patients and none of the healthy volunteers; (iii) an increase in the length of non-REM sleep in healthy volunteers [49.3 (26.6) versus 30.4 (15.6) min; P = 0.08]; (iv) a decrease in the sleep EEG beta power (fast activity) in the healthy volunteers; (v) a decrease in the sleep EEG delta power in patients.AAC led to a significant increase in daytime subjective sleepiness and changes in the EEG architecture of a subsequent sleep episode in patients with cirrhosis, pointing to a reduced ability to produce restorative sleep.
Noninvasive prediction of transvalvular pressure gradient in patients with pulmonary stenosis by quantitative two-dimensional echocardiographic Doppler studies.
Authors: C O Lima, D J Sahn, L M Valdes-Cruz, S J Goldberg, J V Barron, H D Allen, E Grenadier
Journal: Circulation (1983)

Recent studies suggest that maximal Doppler velocities measured within the jets that form downstream from stenotic valves can be used to predict aortic valve gradients. To test whether the Doppler method would be useful for evaluation and management of pediatric patients with right ventricular outflow obstruction, we evaluated pulmonary artery flow before catheterization in 16 children with pulmonary valve stenosis. We used a 3.5-MHz, quantitative, range-gated, two-dimensional, pulsed, echocardiographic Doppler scanner with fast Fourier transform spectral output and a 2.5-MHz phased array with pulsed or continuous-mode Doppler. Peak systolic pulmonary artery flow velocities in the jet were recorded distal to the domed pulmonary valve leaflets in short-axis parasternal echocardiographic views. The pulsed Doppler scanner, because of its limitations for resolving high velocities, could quantify only the mildest stenoses; but, especially with the continuous Doppler technique, a close correlation was found between maximal velocity recorded in the jet and transpulmonary gradients between 11 and 180 mm Hg. A simplified Bernoulli equation (transvalvular gradient = 4 x [maximal velocity]2) proposed by Hatle and Angelsen could be used to predict the gradients found at catheterization with a high degree of accuracy (r = 0.98, SEE = +/- 7 mm Hg). Our study shows that recording of maximal Doppler jet velocities appears to provide a reliable measure of the severity of valvular pulmonic stenosis.