tbuckley/cabot-search huggingface dataset:
Bush tells federal agencies to gather and share data on health quality and cost
Authors: Janice Tanne
Journal: BMJ (2006)

President George Bush has signed an executive order requiring four federal agencies to collect and share data on healthcare quality and costs and make the data available to users, such as people enrolled in health plans operated or supervised by the federal government.

Although the president's order called for improvement of the quality and efficiency of health care, it said federal agencies should not incur additional costs for the government. Agencies must begin complying with the order by January 2007.

The president has often recommended that consumers shop for quality health care at the best price. …
Risk of Complications After Abdominal Paracentesis in Cirrhotic Patients: A Prospective Study
Authors: Andrea De Gottardi, Thierry Thévenot, Laurent Spahr, Isabelle Morard, Solange Bresson–Hadni, Ferran Torres, Emiliano Giostra, Antoine Hadengue
Journal: Clinical Gastroenterology and Hepatology (2009)
Operative treatment in hypertrophic subaortic stenosis. Techniques, and the results of pre and postoperative assessments in 83 patients.
Authors: A G Morrow, B A Reitz, S E Epstein, W L Henry, D M Conkle, S B Itscoitz, D R Redwood
Journal: Circulation (1975)

The results of operative treatment in 83 patients with idiopathic hypertrophic subaortic stenosis (IHSS) are described. Most patients with the disease are asymptomatic, or derive satisfactory symptomatic improvement from nonoperative therapy: administration of propranolol, exerice limitation, control of arrhythmia, etc. Operation is required, however, in 10-15% of patients, those who remain severely symptomatic after nonoperative treatment or who become refractory to it. Operation relieves symptoms in IHSS by relieving obstruction to left ventricular outflow, and for a patient to be considered an operative candidate severe obstruction must be documented at left heart catheterization either under resting conditions or after provocative interventions. All 83 patients were severely incapacitated--58 in Class III and 24 in Class IV. Seventy had obstruction at rest (average gradient 96 mm Hg), and 13 had only provocable obstruction. At operation the hypertrophic interventricular septum was exposed via an aortotomy, and a vertical bar of muscle was resected between parallel myotomy incisions. There were six operative deaths (7%); no patient has died since 1970. Seven patients have died late after operation, five of them from causes unrelated to their heart disease or the operation. All surviving patients describe symptomatic improvement. Fifty-two patients with obstruction at rest preoperatively (average gradient 95 mm Hg) have been studied postoperatively: no resting gradient was evident in 47, while in the remaining five the gradient was less than 25 mm Hg. Recurrence of obstruction has never been observed at late catheterization (21 pts) or late echocardiographic examination (37 pts). Obstruction could not be provoked postoperatively in ten of the 11 patients who had large gradients only with the Valsalva maneuver or isoproterenol administration preoperatively. Obstructed and provocable obstructed patients had similar symptomatic improvement after operation. A variety of rhythm and conduction abnormalities were observed both pre and postoperatively, and these are described in detail. The results of operation in these 83 patients with IHSS demonstrate that gratifying symptomatic and hemodynamic improvement uniformly follows left ventriculomyotomy and myectomy. Relief of obstruction and amelioration of symptoms have proved to be long-lasting during postoperative observation periods extending to 14 years. Continued application of the operative procedure in properly selected patients appears to be indicated.
Endoscopic Induction of the Electromyogram from the Human Gastrointestinal Tract
Authors: Y. Akasaka, I. Niki, K. Sugawara, K. Kawai
Journal: Endoscopy (1975)

By our new method of recording the electromyograms with endoscopy (the direct endoscopic induction method), action currents of the peristaltic movements could be recorded easily, accurately, and safely from the human stomach and duodenum. The qualities of these action currents were similar to those induced by other induction methods. This method will be expected to resolve the patho-physiological aspects of gastrointestinal diseases.
Effect of stopping smoking after unstable angina and myocardial infarction
Authors: L. E Daly, R. Mulcahy, I. M Graham, N. Hickey
Journal: BMJ (1983)

simplistic interpretation to an obviously complex and difficult matter.The absence of randomisation (for which we cannot place blame on the investigators) has merely compounded the problem.In my opinion, whether or not stopping smoking after a coronary attack has a long term survival benefit is still an open question.The diffi- culties in this Irish study exemplify the complexity of the problem.
Expression of Autotaxin and Lysophosphatidic Acid Receptors Increases Mammary Tumorigenesis, Invasion, and Metastases
Authors: Shuying Liu, Makiko Umezu-Goto, Mandi Murph, Yiling Lu, Wenbin Liu, Fan Zhang, Shuangxing Yu, L. Clifton Stephens, Xiaojiang Cui, George Murrow, Kevin Coombes, William Muller, Mien-Chie Hung, Charles M. Perou, Adrian V. Lee, Xianjun Fang, Gordon B. Mills
Journal: Cancer Cell (2009)
Sex in the Forbidden Zone: When Men in Power— Therapists, Doctors, Clergy, Teachers, and Others—Betray Women's Trust
Authors: Domeena C. Renshaw
Journal: JAMA (1992)

The author is a psychiatrist who practices in San Francisco. He became particularly interested in the topic of sexual misconduct between a professional man in power and a woman entrusted to his care, employ, or protection after he struggled with and resisted an opportunity on a rainy evening to cross the sexual barrier between himself and a young woman patient. He reflected, was concerned, and consulted a colleague. He proceeded to collect data from colleagues and from women patients. Volunteer letters or calls reached him after he lectured widely on the topic. Women were the majority of those who told of being violated. A few men in power came to him to describe how they crossed ethical sexual boundaries and their subsequent reactions. Into the definitional gray area of sexual misconduct, Dr Rutter adds his new term "forbidden zone sex," which he describes as "Sexual behavior between a man and
Acid and non-acid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring
Authors: Inder Mainie, Radu Tutuian, Steven Shay, Marcelo Vela, Xin Zhang, Daniel Sifrim, Donald Castell
Journal: Gut (2006)

Empiric proton pump inhibitor (PPI) trials have become increasingly popular leading to gastroenterologists frequently evaluating gastro-oesophageal reflux disease (GORD) patients only after they have "failed" PPI therapy. Combined multichannel intraluminal impedance and pH (MII-pH) monitoring has the ability to detect gastro-oesophageal reflux (GOR) episodes independent of their pH and evaluate the relationship between symptoms and all types of GOR. Using this technique, we aimed to characterise the frequency of acid and non-acid reflux (NAR) and their relationship to typical and atypical GOR symptoms in patients on PPI therapy.Patients with persistent GORD symptoms referred to three centres underwent 24 hour combined MII-pH monitoring while taking PPIs at least twice daily. Reflux episodes were detected by impedance channels located 3, 5, 7, 9, 15, and 17 cm above the lower oesophageal sphincter (LOS) and classified into acid or non-acid based on pH data from 5 cm above the LOS. A positive symptom index (SI) was declared if at least half of each specific symptom events were preceded by reflux episodes within five minutes.A total of 168 patients (103 (61%) females and 65 (39%) males; mean age 53 (range 18-85) years) underwent combined MII-pH monitoring while taking PPIs at least twice daily. One hundred and forty four (86%) patients recorded symptoms during the study day and 24 (15%) patients had no symptoms during testing. Sixty nine (48%) symptomatic patients had a positive SI for at least one symptom (16 (11%) with acid reflux and 53 (37%) with NAR) and 75 (52%) had a negative SI. A total of 171 (57%) typical GORD symptoms were recorded, 19 (11%) had a positive SI for acid reflux, 52 (31%) for NAR, and 100 (58%) had a negative SI. One hundred and thirty one (43%) atypical symptoms were recorded, four (3%) had a positive SI for acid reflux, 25 (19%) had a positive SI for NAR, and 102 (78%) had a negative SI.Combined MII-pH identifies the relation of reflux of all types to persistent symptoms and the importance of NAR in patients taking PPIs.
L-Carnitine for Leg Ulcers
Authors: Henry L. Harrell
Journal: Annals of Internal Medicine (1990)

Letters and Corrections1 September 1990L-Carnitine for Leg UlcersHenry L. Harrell Jr., MDHenry L. Harrell Jr., MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-5-412_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editors: Ulcerations on the lower legs occur in up to 75% of adults with sickle cell anemia. Secondary infections are common, and there is often painful limitation of ankle motion. Treatment regimens generally have been unsatisfactory (1, 2). The pathophysiology leading to these lesions is not known with certainty, although the lesions are assumed to result from ischemia due to reduced or obstructed flow in the microcirculation.I have followed a 32-year-old man with homozygous sickle cell anemia for the past 17 years. At 27 years of age, he developed constant ulceration on both ankles and feet. The ulceration...References1. Serjeant G. Leg ulceration in sickle cell anemia. Arch Intern Med. 1974;133:690-4. CrossrefMedlineGoogle Scholar2. HellerHonig PG. Sickle cell disorders and their clinical implications. Surg Annu. 1974;6:41-59. MedlineGoogle Scholar3. Bremer J. Carnitine: metabolism and functions. Physiol Rev. 1983; 63:1420-80. CrossrefMedlineGoogle Scholar4. BrevettiChiarielloFerulano GMG. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, crossover study. Circulation. 1988;77: 767-73. CrossrefMedlineGoogle Scholar5. NitzschnerLiebsch HF. Anwendung von Karnitin bei bindegewebigen Erkrankungen (Use of carnitine in connective tissue diseases). Dermatol Monatsschr. 1971;157:538-42. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByInterventions for treating leg ulcers in people with sickle cell diseaseA treatment algorithm to identify therapeutic approaches for leg ulcers in patients with sickle cell diseaseInterventions for treating leg ulcers in people with sickle cell diseaseInterventions for treating leg ulcers in people with sickle cell diseaseInterventions for treating leg ulcers in people with sickle cell diseasePropionyl-L-carnitine in chronic leg ulcers of homozygous sickle cell disease: A pilot studyLEG ULCERS IN SICKLE CELL DISEASE 1 September 1990Volume 113, Issue 5Page: 412-412KeywordsAnemiaAnklesIschemiaLesionsUlcers Issue Published: 1 September 1990 PDF DownloadLoading ...
Avian Influenza and Pandemics
Authors: C. Shawn Tracy, Ross E.G. Upshur, Abdallah S. Daar
Journal: New England Journal of Medicine (2005)

To the Editor: With an eye to the ominous storm on the horizon that is avian influenza, in his editorial (Jan. 27 issue)1 Stohr proposes a much-needed research agenda — with one major oversight. In addition to clinical and epidemiologic questions, many ethical issues will undoubtedly be raised by an influenza pandemic. The outbreak of the severe acute respiratory syndrome taught us a number of important lessons, but the first was that we were ill prepared to respond.2 Among the greatest challenges faced were the duty to provide care in the context of unknown risk, the need to balance individual . . .
F-18 FDG PET/CT in the Management of Thyroid Cancer
Authors: Andrei Iagaru, Judith E. Kalinyak, I Ross McDougall
Journal: Clinical Nuclear Medicine (2007)

Purpose: There are approximately 32,000 new cases of thyroid carcinoma annually in the United States. F-18 FDG PET/CT has an established role in cancer management, including thyroid cancer, usually in patients who are thyroglobulin (Tg) positive/iodine negative. We reviewed our experience with F-18 FDG PET/CT in thyroid cancer, with an emphasis on correlation with Tg, and maximum standardized uptake values (SUV). We also analyzed the role of thyroid stimulating hormone (TSH) on PET/CT results. Materials and Methods: This is a retrospective study (January 2003 to December 2006) of 76 patients with differentiated thyroid cancer, who had F-18 FDG PET/CT scans. There were 44 women and 32 men, with age range of 20 to 81 years (average, 51.1 ± 18.1). The administered doses of F-18 FDG ranged from 396 to 717 MBq (15.8–19.4 mCi) (average, 566 ± 74.8) (15.3 ± 2). Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed. Results: A total of 98 PET/CT scans were analyzed (59 patients had 1 scan, 12 patients had 2, and 5 patients had 3). PET/CT was 88.6% sensitive (95% CI: 78.–94.3) and 89.3% specific (95% CI: 71.9–97.1). Mean Tg level was 1203 ng/mL (range, 0.5–28,357) in patients with positive PET/CT and 9.72 ng/mL (range, 0.5–123.0) in patients with negative PET/CT scans (P = 0.0389). Mean SUV max was 10.8 (range, 2.5–32) in the thyroid bed recurrence/residual disease and 7.53 (range, 2.5–26.2) in metastatic lesions (P = 0.0114). Mean SUV max in recurrent/residual disease in patients with TSH ≤30 mIU/L was 9.3 (range, 2.5–34.1) and in patients with TSH >30 mIU/L was 8.1 (range, 2.6–32) (P = 0.2994). Conclusion: F-18 FDG PET/CT had excellent sensitivity (88.6%) and specificity (89.3%) in this patient population. Metastatic lesions were reliably identified, but were less F-18 FDG avid than recurrence/residual disease in the thyroid bed. TSH levels at the time of PET/CT did not appear to impact the FDG uptake in the lesions or the ability to detect disease. In the setting of high or rising levels of Tg, our study confirms that it is indicated to include PET/CT in the management of patients with differentiated thyroid cancer.
British firm halts vaccine manufacture, research
Authors: C. Marwick
Journal: JAMA (1990)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Indoleamine 2,3-dioxygenase and tumor-induced tolerance
Authors: David H. Munn, Andrew L. Mellor
Journal: Journal of Clinical Investigation (2007)

Tumors arise from normal cells of the body through genetic mutation. Although such genetic mutation often leads to the expression of abnormal antigens, the immune system fails to respond effectively to these antigens; that is, it is tolerant of these antigens. This acquired state of tolerance must be overcome for cancer immunotherapy to succeed. Indoleamine 2,3-dioxygenase (IDO) is one molecular mechanism that contributes to tumor-induced tolerance. IDO helps create a tolerogenic milieu in the tumor and the tumor-draining lymph nodes, both by direct suppression of T cells and enhancement of local Treg-mediated immunosuppression. It can also function as an antagonist to other activators of antitumor immunity. Therefore, strategies to block IDO might enhance the effectiveness of tumor immunotherapy.
Guides on commissioning 28 surgical procedures aim to end postcode lottery
Authors: G. Iacobucci
Journal: BMJ (2013)

The Royal College of Surgeons is publishing new guidance for clinical commissioning groups to help iron out “unexplained variation” in the provision of surgical treatment in England.

The guidance, designed to act as an evidence based benchmarking tool for commissioners, will provide advice on whole pathways of care, and include new tools for monitoring data such as hospital day care rates.

More than a dozen new pieces of guidance are being released this month, with the scheme eventually covering 28 surgical procedures in specialties such as ear, nose and throat surgery, general surgery, urology, and orthopaedics.1

The move has been prompted by concerns that financial restraints to the NHS in parts of England are causing “postcode …
Use of Barnes's Dilators in Induction of Premature Labour
Authors: R. S. Cross
Journal: BMJ (1868)

the summer of last year, I was consulted by Mrs. S., a healthy young womaa aged about twenty-five, pregnant for the third time.I had attended her in the two previous labours, and had effected the deliverr in both instances by turmng (head-presentations), accomplishing it With the greatest possible difficulty, on account of narowpelvic brim, from projecting promontory of sacrum.The children were dead.I advised the induction of premature labour, and appointed a day in the second week of November for the pUrpose.I had in other cases brought this about either by rupturing the membranes, or by the ergot plan, as ad- vocated by the late Dr. Rigby in the Library of Medicine.I chose the latter.T7he treatment commenced with a warm bath on the evening of November i ith.
[779] ANTIVIRAL RESPONSE AT WEEK 12 FOLLOWING COMPLETION OF TREATMENT WITH ALBINTERFERON a-2b PLUS RIBAVIRIN IN GENOTYPE 1, IFN-NAIVE, CHRONIC HEPATITIS C PATIENTS
Authors: S. Zeuzem, Y. Benhamou, V. Bain, D. Shouval, S. Pianko, R. Flisiak, M. Grigorescu, V. Rehak, E. Yoshida, K. Kaita, P. Cronin, E. Pulkstenis, M. Subramanian, J. McHutchison
Journal: Journal of Hepatology (2007)
SHOs unaware of new August start date
Authors: T J S Chesser, F M E Wadsworth
Journal: BMJ (1994)

EDITOR, - The NHS Management Executive issued a directive on 4 January concerning the introduction of compulsory induction courses for new preregistration house officers starting in post this August.1 This entails changing the starting dates for hospital medical and dental posts. A compulsory extension of all junior doctors' contracts begins with those expecting to finish jobs on 31 July: they will now be required to remain in their present posts for the …
Prevention of the "Café Coronary"
Authors: Arthur M. Pruce
Journal: JAMA (1964)

<h3>To the Editor:—</h3> Haugen stressed the significance of sudden death due to meat bolus impaction in the hypopharynx and indicated that the unfortunates had false teeth (<i>JAMA</i><b>186</b>:142 [Oct 12] 1963). Artificial dentures do play a significant role in bolus death, since the hard palate is rendered insensitive by the denture and the swallowed object is under the reflex action of the constrictor muscles before the patient is aware of it. Twenty centuries ago, the Talmud indicated how this catastrophe is to be prevented: "One should not converse at meals lest the windpipe acts before the gullet and his life will thereby be endangered." [unk] [unk] [unk] [unk] [unk] [unk] [unk] [unk][unk] [unk] [unk] In Israel today there are wall signs in school cafeterias that remind the children, "DON'T TALK WHILE YOU EAT." [unk] [unk] [unk] [unk]
Complement-mediated regulation of the IL-17A axis is a central genetic determinant of the severity of experimental allergic asthma
Authors: Stephane Lajoie, Ian P Lewkowich, Yusuke Suzuki, Jennifer R Clark, Alyssa A Sproles, Krista Dienger, Alison L Budelsky, Marsha Wills-Karp
Journal: Nature Immunology (2010)
Active oxygen species in DNA damage induced by carcinogenic metal compounds.
Authors: S Kawanishi, S Inoue, K Yamamoto
Journal: Environmental Health Perspectives (1994)

Some carcinogenic metal compounds [chromate(VI), Fe(III) nitrilotriacetate, cobalt(II), and nickel(II)[ induced formation of various oxygen radical species in the presence of hydrogen peroxide. These oxygen radicals were suggested to give different kinds of site-specific DNA damage; 8-hydroxyl-2'-deoxyguanosine formation is included in the DNA damage. Using pulsed-field gel electrophoresis, nickel sulfide was shown to induce oxidative DNA cleavage in cultured cells. On the basis of these findings, we have emphasized the role of oxygen radicals in metal carcinogenesis.
Employment Status of Physicians Completing Training
Authors: Jonathan H. Sunshine
Journal: JAMA (1996)

To the Editor.  —Having studied the employment status of physicians completing training, 1,2 we want to congratulate Ms Miller and colleagues on their article. 3 It provides extensive information where very little had been available and thoughtfully addresses some of the analytic difficulties. Since they apparently plan to undertake the worthwhile task of providing annual updates, we would like to offer suggestions for improvements based on our experience.  The study's focus on residents is appropriate in fields such as family practice in which relatively few physicians take further training. However, where physicians predominantly go on to further training, as in diagnostic radiology, the focus should be on physicians completing their final training, typically a fellowship. Also, where many go on to further training, the study calculates a confusingly high rate of graduates without full-time jobs in their specialty because it removes residents going on to further training from the count of physicians seeking
The Pathology of Rheumatoid Arthritis
Authors: L. E. Glynn
Journal: Annals of the Rheumatic Diseases (1973)

The psychiatric histories in a group of patients who had previously undergone temporal lobectomy for intractable epilepsy, were analysed for the occurrence of psychosis. The data suggest that epileptic patients with left temporal lobe lesions are especially disposed to develop a schizophrenic-like psychosis.
Carcinoma of the Tail of the Pancreas-Reply
Authors: Charles S. LaMonte
Journal: JAMA (1962)

<h3>To the Editor:—</h3> Considering carcinoma of the entire pancreas, Dr. Trimble correctly points out that there are several long-term survivors. However, many authors have emphasized that carcinoma of the head of the pancreas is in many ways a different entity from carcinoma of the body and tail. Specifically, carcinoma of the head frequently produces jaundice, causes elevation of the serum alkaline phosphatase, and prompts early laparotomy, diagnosis, and definitive resection. The problem with carcinoma of the body and tail is that it fails to produce localizing signs, except as noted in our report. The 5 cases reported in Dr. Trimble's references, and nearly all other reported cases of 5-year survival with carcinoma of the pancreas, have had tumors of the head. To our knowledge, the patient reported by Gordon-Taylor and cited in our article is the only 5-year survivor with carcinoma of the body or tail.