tbuckley/cabot-search huggingface dataset:
The Adverse Effects of Belladonna Alkaloids in Benign Pyloric Obstruction
Authors: Philip Kramer
Journal: New England Journal of Medicine (1954)

BELLADONNA alkaloids are frequently prescribed in the treatment of patients with chronic peptic ulcer, including those with the complication of gastric retention.1 , 2 The rationale underlying such therapy is usually developed as follows: gastric retention is the result of pyloric stenosis; pyloric stenosis is caused to a variable degree by antral or pyloric spasm; gastrointestinal spasm is said to be inhibited by belladonna alkaloids; and therefore, belladonna alkaloids lessen the degree of pyloric stenosis and benefit gastric retention. This chain of reasoning, however, ignores the fact that the size of the pyloric outlet is only one determinant affecting gastric evacuation. Others . . .
The Clinical Presentation of the High-Mitotic-Rate Melanoma
Authors: Samuel J. Balin, Raymond L. Barnhill
Journal: JAMA Dermatology (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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Dermatology journal
Oxamniquine for treating Schistosoma mansoni infection in Sudan.
Authors: A H Omer
Journal: BMJ (1978)

The efficacy and acceptability of oral oxamniquine were assessed in Sudanese patients infected with Schistosoma mansoni. Cure rates, determined by the absence of viable eggs in the stools six months after treatment, were 94.9% in patients treated with a total of 60 mg/kg, 78.8% in patients treated with 40 mg/kg, and 68.9% in patients treated with 30 mg/kg. All treatment regimens considerably reduced the egg count in those patients not cured. The drug was well tolerated and the side effects were minimal and transient, the most common being dizziness. Most of the patients noticed a reddish discoloration of their urine, which was probably caused by a metabolite of the drug. In patients who received 60 mg/kg oxamniquine there were transient rises in eosinophil counts and in serum alanine aminotransferase concentrations. Though 60 mg/kg was by far the most effective dose in terms of cure rate, egg counts were significantly reduced on all three doses. The lower doses could therefore be useful in a low-cost control programme in reducing transmission of S mansoni infection.
Credo for Creeping Paralysis
Authors: Pauline L. Rabin
Journal: JAMA (1983)

THREE years ago my husband developed the initial symptoms of amyotrophic lateral sclerosis (ALS). The diagnosis was determined clinically and unequivocally confirmed by electromyography. We were devastated by the diagnosis. Since we are both physicians, the full implications were immediately realized. The course that the illness followed was straight out of a textbook. Stiffness of the legs was followed by weakness. Footdrop developed first on the left, then on the right, and thereafter the disease process progressed inexorably to paralysis of the lower limbs. Weakness of the hands led quickly to global wasting of the small muscles and loss of function of the upper limbs. The paralysis extended more proximally, resulting in total quadraplegia. Bulbar symptoms followed with wasting of the tongue, dysarthria, dysphonia, and dysphagia. The most common response I have had from physicians who discussed the illness with me left me shocked and confused. A neurologist said, "It's
Value of Endoscopic Marking of the Z-Line for Detecting Short Esophagus Before Repeat Surgery for Recurrent Paraesophageal Hernias
Authors: Á. Altorjay, B. Paál, A. Horváth, L. Horváth, M. Ükös, Z. Than
Journal: Endoscopy (2006)

With the increasing use of antireflux surgery in the treatment of gastroesophageal reflux disease, the need has arisen for an accurate method of assessing the length of the esophagus. The enigmatic finding of short esophagus is a continuing matter of controversy with regard to prevalence, cause, and management. Short esophagus precludes a tension-free intra-abdominal antireflux procedure. The most effective treatment for the condition is an esophagus-lengthening procedure using a Collis gastroplasty. Alternative procedures, such as intrathoracic fundoplication or esophageal resection, are not widely accepted. The risk of encountering a short esophagus requiring a Collis gastroplasty is significantly greater in the presence of paraesophageal hernia, Barrett’s esophagus, an esophageal stricture, and repeat surgery [1]. Esophagography has been reported to have a sensitivity of 66 % and a positive predictive value of 27 % for diagnosing short esophagus, whereas the length as measured by manometry had a sensitivity of 43 % and a positive predictive value of 25 % [2]. Intraoperative techniques have also been described that combine laparoscopic with endoscopic methods to determine the position of the gastroesophageal junction. The length of the intra-abdominal esophagus is determined by using a probe to measure the distance between the esophagogastric junction and the crura of the diaphragm [3]. Recurrent paraesophageal hernia is the most challenging scenario for repeat laparoscopic surgery, and the one most likely to require conversion to an open procedure. Some 30 - 80 % of patients with paraesophageal hernias 5 cm or larger require gastroplasty [4] [5].
A Prescription for Health
Authors: R. W. Luxton
Journal: BMJ (1957)

Except for parts of the Maritimes and Quebec, in every province there is at least one voluntary insurance plan for medical services in the home, surgery, and hospital, sponsored by the Provincial Medical Association.Medical practi- tioners are asked to enter into a contract with this plan, agreeing to accept payment from the scheme directly on sub- mission of a bill by the physician to the plan for services rendered by him to an insured patient.The schedules of fees used by the plans are close to the minimum recommended by the Provincial Medical Associations, and, with some variations from province to province, physicians agree to accept these fees as payment in full for their services.In Quebec, Ontario, Manitoba, and the Maritimes, Blue Cross plans also pay physicians for services in hospitals only, on a somewhat similar basis, although the physicians more often make additional charges to the patients.About one-quarter of all payments to physicians in Canada are now made through voluntary or commercial insurance companies.Through the extension of such plans the Canadian Medical Association hopes to anticipate a Government health service.In conclusion, it is generally accepted that there are immense opportunities for young people, both lay and medical, who wish to emigrate to this young and vigorous Dominion.Nevertheless, in the last resort it must remain a highly individual and personal matter involving difficult decisions of adjustment to a new climate no less than to a new culture.As Dr. Geggie (1955), a Canadian returning home after seven months in Britain, wrote: " Lest the picture look too bright, let me point out that no doctor, except the dead one, knows security in Canada.The foreign doctor must be willing to cornfcrm with Canadian ways and to cater night and day to a very demanding public.Nor is a higher degree, including British degrees, of any great assistance.The Canadian doctor has to prove himself to his public-and a very discerning public it is."
Three-dimensional transmural mechanical interaction between the coronary vasculature and passive myocardium in the dog.
Authors: K May-Newman, J H Omens, R S Pavelec, A D McCulloch
Journal: Circulation Research (1994)

The "garden hose" effect of coronary perfusion on diastolic left ventricular (LV) mechanics has been proposed to cause changes in systolic function by altering diastolic sarcomere length. We measured transmural distributions of three-dimensional shape change using radiopaque markers implanted in the LV free wall of eight isolated arrested canine hearts as functions of coronary arterial perfusion pressure (Pp) and LV pressure (PLV) and related these deformations to the local muscle fiber architecture. Increased Pp from 0 to 110 mm Hg produced a 10% reduction in LV chamber volume (P &lt; .01) and 25% to 40% decreases in local three-dimensional wall strain at matched PLV, indicating myocardial stiffening. Significant decreases in the magnitudes of local deformation occurred preferentially in the cross-fiber and radial directions (P &lt; .02), with no change in fiber strain. This suggests that changing coronary Pp does not alter diastolic fiber length; hence, the Frank-Starling law may not mediate the Gregg effect. Since the myocardial microvessels are primarily oriented parallel to the muscle fibers, the observed myocardial stiffening occurs in the directions transverse to the microvessels rather than along their length. Local myocardial wall volume in the unloaded LV demonstrated a uniform 5% increase from the unperfused state to Pp of 50 mm Hg. With further increases in Pp up to 110 mm Hg, the change in regional wall volume from the unperfused state developed a substantial transmural gradient increasing by 7% at the epicardium and 15% at the subendocardium. This reflects a significant increase (P &lt; .02) in intramyocardial coronary capacitance from epicardium to endocardium, which may be related to a transmural gradient in coronary distensibility or vascularity.
An approach to the development of quantitative models to assess the effects of exposure to environmentally relevant levels of endocrine disruptors on homeostasis in adults.
Authors: N Ben-Jonathan, R L Cooper, P Foster, C L Hughes, P B Hoyer, D Klotz, M Kohn, D J Lamb, G M Stancel
Journal: Environmental Health Perspectives (1999)

The workshop "Characterizing the Effects of Endocrine Disruptors on Human Health at Environmental Exposure Levels" was held to provide a forum for discussions and recommendations of methods and data needed to improve risk assessments of endocrine disruptors. This article was produced by a working group charged with determining the basic mechanistic information that should be considered when designing models to quantitatively assess potential risks of environmental endocrine disruptors in adults. To reach this goal, we initially identified a set of potential organ system toxicities in males and females on the basis of known and/or suspected effects of endocrine disruptors on estrogen, androgen, and thyroid hormone systems. We used this integrated, systems-level approach because endocrine disruptors have the potential to exert toxicities at many levels and by many molecular mechanisms. Because a detailed analysis of all these untoward effects was beyond the scope of this workshop, we selected the specific end point of testicular function for a more detailed analysis. The goal was to identify the information required to develop a quantitative model(s) of the effects of endocrine disruptors on this system while focusing on spermatogenesis, sperm characteristics, and testicular steroidogenesis as specific markers. Testicular function was selected because it is a prototypical integrated end point that can be affected adversely by individual endocrine disruptors or chemical mixtures acting at one specific site or at multiple sites. Our specific objective was to gather the information needed to develop models in the adult organism containing functional homeostatic mechanisms, and for this reason we did not consider possible developmental toxicities. Homeostatic mechanisms have the potential to ameliorate or lessen the effects of endocrine disruptors, but these pathways are also potential target sites for the actions of these chemicals.
Emergency Department Bypass for ST-Segment–Elevation Myocardial Infarction Patients Identified With a Prehospital Electrocardiogram
Authors: Akshay Bagai, James G. Jollis, Harold L. Dauerman, S. Andrew Peng, Ivan C. Rokos, Eric R. Bates, William J. French, Christopher B. Granger, Matthew T. Roe
Journal: Circulation (2013)

Background— For patients identified before hospital arrival with ST-segment–elevation myocardial infarction, bypassing the emergency department (ED) with direct transport to the catheterization laboratory may shorten reperfusion times. Methods and Results— We studied 12 581 ST-segment–elevation myocardial infarction patients identified with a prehospital ECG treated at 371 primary percutaneous coronary intervention–capable US hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network Registry–Get With The Guidelines, including those participating in the American Heart Association Mission: Lifeline program from 2008 to 2011. Reperfusion times with primary percutaneous coronary intervention and in-hospital mortality rates were compared between patients undergoing ED evaluation and those bypassing the ED. ED bypass occurred in 1316 patients (10.5%). These patients had a lower frequency of heart failure and shock on presentation and nonsystem reasons for delay in percutaneous coronary intervention. ED bypass occurred more frequently during working hours compared with off-hours (18.3% versus 4.3%); ED bypass rate varied significantly across hospitals (median, 3.3%; range, 0%–71%). First medical contact to device activation time was shorter (median, 68 minutes [interquartile range, 54–85 minutes] versus 88 minutes [interquartile range, 73–106 minutes]; P &lt;0.0001) and achieved within 90 minutes more frequently (80.7% versus 53.7%; P &lt;0.0001) with ED bypass. The unadjusted in-hospital mortality rate was lower among ED bypass patients (2.7% versus 4.1%; P =0.01), but the adjusted mortality risk was similar (adjusted odds ratio, 0.69; 95% confidence interval, 0.45–1.03; P =0.07). Conclusions— Among ST-segment–elevation myocardial infarction patients identified with a prehospital ECG, the rate of ED bypass varied significantly across US hospitals, but ED bypass occurred infrequently and was mostly isolated to working hours. Because ED bypass was associated with shorter reperfusion times and numerically lower mortality rates, further exploration of and advocacy for the implementation of this process appear warranted.
Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot
Authors: François-Pierre Mongeon, Michelle Z. Gurvitz, Craig S. Broberg, Jamil Aboulhosn, Alexander R. Opotowsky, Joseph D. Kay, Anne Marie Valente, Michael G. Earing, George K. Lui, Susan M. Fernandes, Deborah R. Gersony, Stephen C. Cook, Jennifer Grando Ting, Michelle J. Nickolaus, Michael J. Landzberg, Paul Khairy
Journal: Circulation (2012)

Background— Although aortic root pathology has been described in patients with tetralogy of Fallot, the scope of the problem remains poorly defined. We sought to determine the prevalence and predictors of aortic root dilatation in adults with repaired tetralogy of Fallot. Methods and Results— A multicenter cross-sectional study was conducted with standardized reassessment of echocardiographic parameters in 474 adults (≥18 years) with surgically repaired tetralogy of Fallot or pulmonary atresia with ventricular septal defect. The aortic root was measured in a parasternal long-axis view, in diastole, at the level of the sinus of Valsalva. Prevalence and predictors of an absolute diameter ≥40 mm and of an observed-to-expected ratio &gt;1.5 were assessed. The aortic root dimension was ≥40 mm in 28.9% (95% confidence interval, 26.9%–30.9%). In multivariate analyses, the only independently associated factor was male sex (odds ratio, 4.48; 95% confidence interval, 1.55–12.89; P =0.006). The prevalence of an observed-to-expected aortic root dimension ratio &gt;1.5 was 6.6% (95% confidence interval, 5.3%–7.9%). It was associated with pulmonary atresia and moderate or severe aortic regurgitation in univariate analyses, but no independent predictor was identified. The side of the aortic arch was not associated with aortic root dimension. The prevalence of moderate or severe aortic regurgitation was 3.5% (95% confidence interval, 2.7%–4.2%). Conclusions— Although nearly one third of adults with repaired tetralogy of Fallot have an aortic root diameter ≥40 mm, the prevalence of a dilated aortic root, when defined by an indexed ratio of observed-to-expected values, is low. Similarly, moderate or severe aortic regurgitation is uncommon.
Family Violence and the Insurance Industry: Education, Not Discrimination-Reply
Authors: Robert E. McAfee
Journal: JAMA (1995)

<h3>In Reply.</h3> —Dr Tyson is correct in identifying that medical costs associated with family violence, which includes domestic violence, child abuse, and elder abuse, represent a staggering and impressive part of the total health bill of the United States. It is important that such costs be identified and that all participants, including insurance companies, assist in preventive and educational efforts to minimize this cost. The program described by Tyson appears to be this kind of program, and he and the Pennsylvania Blue Shield Institute need to be congratulated. I am further heartened that Tyson agreed with the need to eliminate discrimination in the insurance industry for victims of family violence. Certainly, those instances in which an attempt either not to insure or to increase substantially the rate for individuals identified as victims of family violence seem inappropriate and even actuarially questionable. In July 1995, Timothy Flaherty, MD, an AMA trustee,
Effect of a fetal surveillance unit on admission of antenatal patients to hospital.
Authors: P W Soothill, R Ajayi, S Campbell, J Gibbs, R Chandran, D Gibb, K H Nicolaides
Journal: BMJ (1991)

OBJECTIVE--To analyse the effect of a fetal surveillance unit, which undertakes a wide range of maternal and fetal tests on an outpatient or inpatient basis, on the number and length of antenatal hospital admissions. DESIGN--A comparison of the number and length of antenatal admissions six months before and five months after the opening of the unit on 1 July 1990. MAIN OUTCOME MEASURES--Admission rate, antenatal bed occupancy, and interval from admission to discharge or delivery. RESULTS--The antenatal bed occupancy rate fell by 22% from 174/100 deliveries during the six months before the unit was opened to 136/100 deliveries in the five months after it was opened. The difference in distribution of lengths of admission after the unit was opened from before was highly significant (Mann-Whitney test = 5.14, n = 752 and 679; p less than 0.0001), and this was due to shorter intervals from admission to discharge and from admission to delivery. In contrast, the antenatal admission rate did not change significantly (50/100 deliveries v 49/100 deliveries). There was no significant change in the stillbirth rate (6/1294 births v 8/1372 births; difference between rates = 0.0012, 95% confidence interval-0.0043 to 0.0067). CONCLUSION--Obstetricians are more prepared to discharge antenatal patients from hospital and, similarly, admit patients for delivery rather than for assessment if the patients are reliably monitored on an outpatient basis. If this change in practice is sustained substantial financial and social benefits will result as well as improvements in organisation, audit, teaching, and research.
Prolonged molecular remission after PML/RARα-positive autologous peripheral blood stem cell transplantation in acute promyelocytic leukemia: is relevant pretransplant minimal residual disease in the graft?
Authors: MA Sanz, J de la Rubia, S Bonanad, E Barragán, A Sempere, G Martín, JA Martínez, C Jiménez, J Cervera, P Bolufer, GF Sanz
Journal: Leukemia (1998)
Abstract 193: Prognostic impact of miR-146 polymorphism in patients with resected colorectal cancer
Authors: Byung Woog Kang, Soo Jung Lee, Joon Ho Moon, Yee Soo Chae, Sang Kyun Sohn, Jong Gwang Kim
Journal: Cancer Research (2012)

Abstract Background: MicroRNAs (miRNAs) are small noncoding RNAs with regulatory functions as tumor suppressors and oncogenes. The rs2910164 is a C to G polymorphism located within the sequence of miR-164a precursor, which leads to a change from a C:U pair to a G:U mismatch in its stem region. Recent evidence suggested that the rs2910164 SNP in miR-146a was associated with development of familial breast and ovarian cancers, and prostatic cancer. The aim of this study was to investigate the association between this genetic variant and prognosis of colorectal cancer (CRC) operated curatively. Methods: A total of 343 CRC patients underwent curative surgery were consecutively enrolled between 2004 and 2006. DNA was extracted from fresh frozen normal tissue and miR-146 polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: With a median follow up of 42.3 months, the combined GG+CG genotype demonstrated a better survival outcome compared with the CC genotype in a Kaplan-Meier survival analysis. Multivariate analysis showed that the G allele of miR-146 was associated with better progression-free and disease-specific survival as a dominant model adjusted to age, sex, histologic grade and stage [HR=0.54 and 0.49; P = 0.018 and 0.025, respectively]. Moreover, the tumors containing the G allele were histologically associated with more prominent lymphovascular invasion. Conclusions: Our results suggest that miR-146 polymorphism is possible prognostic marker in operated CRC patients in Korean. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 193. doi:1538-7445.AM2012-193
Complications with I.U.D.s.
Authors: D. F. Hawkins
Journal: BMJ (1969)

SIR,-It is regrettable that your leading article cii angina pectoris (19 April, p. 134) again fails to stress the importance of a search for and correction of anaemia in the management of this condition.I have recently seen two patients, (one with iron deficiency and one with vitamin B12 de- ficiency) presenting with classical effort angina.In both cases the angina was totally relieved by appropriate treatment of the anaemia.-Iam, etc.,
Help a Snorer
Authors: E. L. C. Broomes
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Do you know of a snoring problem? Advise the use of a cervical collar at bedtime, the same kind that is used for treating a sprained neck. It works. Physiologically, the rationale is justifiable. The discordant notes of snoring are usually at the maximum when the sleeping perpetrator is lying on his back with the head sagging on the chest. This causes a bending of the trachea and a resulting compression of the respiratory tube. In this way, there is an obstruction to the ingress and egress of the breathed air. This, on the same principle by which the sound from a flute is explained, causes the harsh sounds emitted that we call snoring. The cervical collar will keep the chin elevated and so prevent the flexing of the trachea that causes the compression and results in the harsh emitted sound.