tbuckley/cabot-search huggingface dataset:
Crisis in General Practice
Authors: G. R. Foster
Journal: JAMA (1964)

<h3>To the Editor:—</h3> The number and quality of responses indicates thoughtful concern about this problem, not only among general practitioners but among educators and members of the specialty groups as well. There seems to be wide recognition that this problem addresses itself to the entire profession rather than any one of its subdivisions. There are understandable misgivings about "departments of general practice... in every teaching institution." To fit the current educational architecture, a general practice department would of necessity be primarily an administrative unit at the graduate level. The proper content of a general-practice training program remains to be clearly delineated. Any approach to this many-sided dilemma must begin with definitions of what, and to what depth, the general practitioner should be taught. A program that is too broad or too shallow, or too narrowly spotty in useless depth, must be avoided. Exception has been taken to the statement that
Clarification of the site of action of chlorothiazide in the rat nephron.
Authors: R T Kunau, D R Weller, H L Webb
Journal: Journal of Clinical Investigation (1975)

The saluretic effect of the thiazide diuretics has been attributed to inhibition of sodium reabsorption in the distal nephron of the kidney. Recent micropuncture studies have shown, however, that chlorothiazide administration can also inhibit sodium reabsorption in the proximal convolution. To clarify the site of the saluretic effect of chlorothiazide, these micropuncture studies examined the effect of chlorothiazide on chloride transport in the nephron. The effect of chlorothiazide on chloride transport was studied because chlorothiazide's effectiveness as a saluretic is largely due to its ability to enhance sodium chloride excretion; if only changes in sodium transport are examined, it would be then difficult to determine if sodium as bicarbonate or as chloride is affected, since chlorothiazide can inhibit carbonic anhydrase. One group of rats was studied before and after 15 mg/kg per h chlorothiazide. For comparison, another group of rats was studied before and after 2 mg/kg per h benzolamide, a carbonic anhydrase inhibitor. Fractional chloride delivery from the proximal tubule was similarly increased in both groups from 59.4 to 71.0% by chlorothiazide administration, Pless than 0.0001, and from 54.3 to 68.2% by benzolamide administration, P less than 0.001. The increased delivery very of chloride from the proximal tubule was largely reabsorbed before the early distal tubule as fractional chloride delivery to this site increased only from 5.08 to 7.40% after chlorothiazide administration, P less than 0.001, and from 4.50 to 6.29% after benzolamide administration, P less than 0.01. Benzolamide had no effect on chloride reabsorption in the distal convoluted tubule. However, chlorothiazide administration resulted in a marked decrease in distal tubular chloride reabsorption, the fraction of filtered chloride present at the late distal tubule incresing from 1.24 to 6.25%, P less than 0.001. Fractional chloride excretion in the urine increased from 0.29 to 3.44%, P less than 0.001, after chlorothiazide, but did not change after benzolamide. The influence of chlorothiazide on proximal chloride transport presumably is related to its ability to inhibit renal carbonic anhydrase. However, it is not the effect of chlorothiazide in the proximal convolution but rather its effect in the distal convoluted tubule which is primarily responsible for its ability to be an effective saliuretic.
Acute ischaemic preconditioning and chronic hypoxia independently increase myocardial tolerance to ischaemia
Authors: M. Tajima, D. Katayose, M. Bessho, S. Isoyama
Journal: Cardiovascular Research (1994)

Journal Article Acute ischaemic preconditioning and chronic hypoxia independently increase myocardial tolerance to ischaemia Get access Minori Tajima, Minori Tajima First Department of Internal Medicine, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980, Japan: M Tajima, D Katayose, S Isoyama; Eisai Research Laboratories, Eisai Company Ltd, Tokyo, Japan: M Bessho. Correspondence to Dr Isoyama. Search for other works by this author on: Oxford Academic PubMed Google Scholar Dai Katayose, Dai Katayose First Department of Internal Medicine, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980, Japan: M Tajima, D Katayose, S Isoyama; Eisai Research Laboratories, Eisai Company Ltd, Tokyo, Japan: M Bessho. Search for other works by this author on: Oxford Academic PubMed Google Scholar Motoaki Bessho, Motoaki Bessho First Department of Internal Medicine, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980, Japan: M Tajima, D Katayose, S Isoyama; Eisai Research Laboratories, Eisai Company Ltd, Tokyo, Japan: M Bessho. Search for other works by this author on: Oxford Academic PubMed Google Scholar Shogen Isoyama Shogen Isoyama First Department of Internal Medicine, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980, Japan: M Tajima, D Katayose, S Isoyama; Eisai Research Laboratories, Eisai Company Ltd, Tokyo, Japan: M Bessho. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 3, March 1994, Pages 312–319, https://doi.org/10.1093/cvr/28.3.312 Published: 01 March 1994 Article history Received: 12 August 1993 Accepted: 23 September 1993 Published: 01 March 1994
THE AMERICAN RHEUMATISM ASSOCIATION
Authors: A. R. Shands
Journal: JAMA (1941)

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
A synthetic peptide derived from the sequence of a type I collagen receptor inhibits type I collagen-mediated platelet aggregation.
Authors: T M Chiang, A H Kang
Journal: Journal of Clinical Investigation (1997)

A synthetic peptide-1, an 18 amino acid residue peptide derived from a hydrophilic domain of a cloned platelet type I collagen receptor, was used to study the role of the receptor on types I and III collagen-induced platelet aggregation and the release of ATP. The peptide inhibits the type I, but not the type III, collagen-induced platelet aggregation and the release of ATP in a dose-dependent manner. The [125I]peptide-1 specifically binds to type I collagen-coated microtiter wells in a dose-dependent manner (with Kd = 10 nM). The binding of [125I]peptide-1 can be inhibited by an excess of unlabeled peptide-1 suggesting that the binding is specific. The labeled peptide-1 does not bind to type III collagen-coated microtiter wells. Results from an enzyme-linked immunosorbent assay show that the peptide reacts with the poly- and monoclonal antibodies raised against the purified platelet type I collagen receptor (Mr 65 kD). The peptide also inhibits the adhesion of platelets on type I collagen matrix and rabbit aortic segments in a dose-dependent manner. These results suggest that the reactive site of the platelet receptor for type I collagen resides in this portion of the molecule.
Diseases of the Newborn
Authors: Stewart H. Clifford
Journal: New England Journal of Medicine (1945)

THE relatively high death rates that still prevail during early infancy are the cause of much concern throughout the country. The infant mortality during the first year of life for the United States in 1941 was 45.3 deaths per 1000 live births.1 Of these deaths 27.7, or 61 per cent, took place in the first month of life, while 18.1 or 29 per cent occurred in the first twenty-four hours of life.2,3The federal government, through the Children's Bureau, has taken a leading role in attempts to lower the incidence of such deaths. The Children's Bureau has encouraged state health . . .
Ambulatory Electrocardiography—Holter Monitor Electrocardiography
Authors: William H. Wehrmacher
Journal: JAMA (1979)

To show the utility of ambulatory ECG monitoring, Dr Chung of Jefferson Medical College has chosen representative ECG records of 100 selected patients and presents these records together with brief summaries of individual clinical case material. Both as a means of demonstrating the indications for monitoring and as a learning exercise for the reader, Professor Chung asks critical questions of the reader to bring out the notable diagnostic and therapeutic implications of the record. From this material it becomes evident that monitoring the patient's ECG continuously for 24 hours by tape recording will (1) aid in the diagnosis of cardiac arrhythmias, (2) improve the evaluation of such symptoms as dizziness, fainting, palpitation, and pain in the chest, (3) identify periods of transient myocardial ischemia, (4) evaluate antiarrhythmic drug therapy, and (5) demonstrate whether an electronic pacemaker is functioning appropriately. With specific examples, the author identifies those situations in which the
Success of coronary artery bypass grafts let down by poor organisation
Authors: Caroline White
Journal: BMJ (2008)

Poor organisation, communication, and teamwork are letting down patients who need heart surgery, a UK audit of outcomes and death rates after coronary artery bypass grafting has shown.

The investigation, which lasted three years, involved 39 NHS hospitals and 19 independent sector facilities in the United Kingdom.

Ian Martin, lead clinical coordinator of the National Confidential Enquiry into Patient Outcomes and Death, said that he was not surprised by the findings.

“This is not atypical of other areas of medicine we have looked at. Not having the proper systems in place is not unique to cardiac surgery,” …
90mTc-TEBOROXIME AND 201THALLIUM PLANAR MYOCARDIAL PERFUSION IMAGING: SEGMENTAL AND DIAGNOSTIC COMPARISON (CANADAN MULTICENTRE CLINICAL TRIAL)
Authors: R Taillefer, M Freeman, D Greenberg, M Picard, F Chen, F Lamoureux, D Humen, L Rosenthal, R Kloiber, J Frlede, A Fung, L Daigneault, L Lalonde
Journal: Clinical Nuclear Medicine (1991)

S of the Society of Nuclear Medicine in Canada and Prairie Provinces Chapter, SNM Conjoint Meeting: PDF Only
Cell kinetics in flat (avillous) mucosa of the human small intestine
Authors: N. Wright, A. Watson, A. Morley, D. Appleton, J. Marks
Journal: Gut (1973)

A new method for the analysis of small-intestinal crypt-cell kinetics using routine peroral diagnostic biopsies is described. Untreated patients with childhood and adult coeliac disease and adults with the gluten-sensitive enteropathy of dermatitis herpetiformis were studied, together with groups of adult and childhood controls. In the classical flat avillous mucosae the increase in crypt size was found to be three-dimensional. The number of proliferating cells per crypt was shown to be markedly increased, and an even greater rise in the crypt-cell production rate was demonstrated. A significant increase in the mitotic index was also confirmed in the avillous mucosae. On the basis of these findings it is suggested that the characteristic crypt morphology in glutensensitive enteropathy can be explained as an adjustment to accommodate the expanded mass of proliferating and maturing cells necessary to support the augmented cell production rate. We may speculate that this in turn is a response to a pathologically rapid loss of cells from the mucosal surface.
Prognostic significance of the treadmill exercise test performance 6 months after myocardial infarction
Authors: P. H. Stone, Z. G. Turi, J. E. Muller, C. Parker, T. Hartwell, John D Rutherford, A. S. Jaffe, D. S. Raabe, E. R. Passamani, J. T. Willerson
Journal: Journal of the American College of Cardiology (1986)
Dispatch from India
Authors: Atul Gawande
Journal: New England Journal of Medicine (2003)

The puzzle was how the surgeons in India do it. Take a town like Nanded, 400 miles east of Mumbai (as Bombay is now called), in the center of India. The public hospital in Nanded serves a district of 1400 villages and 2.3 million people. It has 500 beds, three operating rooms and, I found when I visited, just nine general surgeons. (Think Washington, D.C., with just nine surgeons.) Its two main buildings are four stories high and made of cement and stucco. Surgeons arrive each morning to a crush of several hundred people pressing their way into the clinics. . . .
Reclining While Dining
Authors: Daniel H. Manfredi
Journal: JAMA (1964)

<h3>To the Editor:—</h3> The old concept of "obstruction followed by stasis followed by precipitation and infection" is still applicable today. Among the predisposing factors of biliary duct obstruction are two which are often overlooked and deserve greater recognition. The first is "kinking" of the bile channels due to flexion and hyperflexion of the body. The second is adiposity in the region of the bile ducts, which, due to further pressure, enhances kinking. Recently, while exploring several ducts which emanated from a diseased gallbladder, I noted the ease with which the cystic duct was kinked when the body was flexed to a sitting or hyperflexed posture. This tubular structure buckled with almost complete closure of its lumen. When the body was re-extended, kinking was relieved. In bodies with excess adipose tissue in the bile duct areas, "kinkability" was enhanced and blockage was caused by a lesser degree of bodily flexion. Serum
Parapharyngeal Lymph Node Involvement in Papillary Thyroid Carcinoma
Authors: Hulya Ortapamuk, Pelin Arcan, Almýla Alp
Journal: Clinical Nuclear Medicine (2003)

Papillary thyroid cancer extends to lymphatic nodes in approximately 40% of cases. Node involvement often occurs in the internal jugular and recurrent laryngeal chain on the side of the lesion. To the authors’ knowledge, only 4 cases with I-131 uptake in pharyngeal metastatic nodes have been reported previously in the literature. The authors report parapharyngeal node involvement demonstrated by I-131 scintigraphy in a patient with papillary thyroid cancer.
Felty's Syndrome: Effects of Splenectomy Upon Granulocyte Count and Granulocyte-Associated IgG
Authors: THERESA M. BLUMFELDER
Journal: Annals of Internal Medicine (1981)

Clinical parameters and laboratory studies including granulocyte-associated IgG were documented in 15 patients with Felty's syndrome treated by splenectomy. Five patients did not benefit from splenectomy, six responded partially, and four completely. Response to splenectomy could not be predicted from age, sex, splenomegaly, preoperative granulocyte count, platelet count, lymphocyte count, bone marrow lymphocytosis, or granulocyte bound IgG. In contrast, marked elevation in preoperative serum granulocyte binding IgG predicted response to splenectomy. Furthermore, a postoperative fall in serum granulocyte binding IgG was associated with response. Thus, one beneficial effect of splenectomy in some Felty's syndrome patients is reduction of serum granulocyte binding immunoglobulin.
Those dreaded memes: The advantage of memetics over “symbolic inheritance”
Authors: Susan Blackmore
Journal: Behavioral and Brain Sciences (2007)

Abstract Jablonka &amp; Lamb (J&amp;L) reject “the dreaded memes,” but memetics can explain human uniqueness and culture (as a product of the ability to imitate) without depending on their slippery notion of symbolism. Modern memes show the beginnings of a division into replicators and vehicles, and the replacement of reconstructive processes with systems of blind copying, variation, and selection.
Hepatitis B surface antigen quantification: Why and how to use it in 2011 – A core group report
Authors: Henry Lik-Yuen Chan, Alex Thompson, Michelle Martinot-Peignoux, Teerha Piratvisuth, Markus Cornberg, Maurizia Rossana Brunetto, Hans L. Tillmann, Jia-Horng Kao, Ji-Dong Jia, Heiner Wedemeyer, Stephen Locarnini, Harry L.A. Janssen, Patrick Marcellin
Journal: Journal of Hepatology (2011)

Quantitative HBsAg had been suggested to be helpful in management of HBV, but assays were cumbersome. The recent availability of commercial quantitative assays has restarted the interest in quantitative serum hepatitis B surface antigen (HBsAg) as a biomarker for prognosis and treatment response in chronic hepatitis B. HBsAg level reflects the transcriptional activity of cccDNA rather than the absolute amount of cccDNA copies. Serum HBsAg level tends to be higher in hepatitis B e antigen (HBeAg)-positive than HBeAg-negative patients. Among patients with a low HBV DNA (<2000IU/ml), HBsAg <1000IU/ml in genotype D HBV infection and HBsAg <100IU/ml in genotype B/C HBV infection is associated with inactive carrier state in HBeAg-negative patients. The HBsAg reduction by nucleos(t)ide analogues (NA) is not as pronounced as by interferon treatment. On peginterferon treatment, sustained responders tend to show greater HBsAg decline than the non-responders. The optimal on-treatment HBsAg cutoff to predict response needs further evaluation in HBeAg-positive patients, but an absence of HBsAg decline together with a <2 log reduction in HBV DNA at week 12 can serve as stopping rule in HBeAg-negative patients with genotype D HBV infection. A rapid serum HBsAg decline during NA therapy may identify patients who will clear HBsAg in the long-term. There are early reports among Asian patients that an HBsAg level of <100IU/ml might predict lower risk of relapse after stopping NA treatment. In clinical practice, serum HBsAg level should be used together with, but not as a substitute for, HBV DNA.
REMOVAL of ONE FREE CALCIFIED, and TWO SUBSEROUS, PEDICULATED FIBROMYOMATA during PREGNANCY
Authors: A. J. Wallace
Journal: BMJ (1898)

origin of the appendix.The latter was perfectly healthy; there was no thickening of its wall, and it was quite free from any adhesions.The protruding mucous membrane having been reduced, the opening in the ocecum was closed by a single row of silk (Lembert) sutures, its margins having been liberated and refreshed.the opening in the abdominal wall was then closed, except at its centre, in which a small plug of iodoform gauze was left.There was no further escape of fiecal matter from the wound, which was healed at the end of three weeks, when the patient left ,the hospital and returned home.
Oesophageal cancer and gastro-oesophageal reflux: what is the relationship?
Authors: J Lagergren
Journal: Gut (2004)

There seems to be a causal link between reflux and oesophageal adenocarcinoma, and Barrett’s oesophagus is very likely an important, and possibly necessary, link in the causal pathway from reflux to oesophageal adenocarcinoma

The direct relation between reflux and adenocarcinoma of the oesophagus has recently been addressed in several well designed population based epidemiological studies, using different study designs.1–5 The studies are all in agreement that reflux is associated with an increased risk of oesophageal adenocarcinoma in a seemingly dose dependent manner.1–5

The specific role of Barrett’s oesophagus for this association was not addressed in these studies but the presence of Barrett’s oesophagus has been regarded as a potential link in the causal pathway. More speculatively, based on an interpretation of the results from a large population based study in Sweden, we hypothesised that the relation between reflux and oesophageal adenocarcinoma might be independent of Barrett’s oesophagus.2 This hypothesis was based on two …
Replacement of Operative Blood Loss of More Than 1 Liter With Hartmann's Solution
Authors: Benjamin Rigor
Journal: JAMA (1968)

A hundred patients each lost over 1,000 ml of blood while undergoing surgery and received two to three times that volume of Hartmann's solution. Postoperative mortality and morbidity were not affected by the lack of blood in the replacement regimen. Age group and physical condition of these patients were representative of the hospital population, and patients over 60 years old in American Society of Anesthesiologists (ASA) risk classifications 3 and 4 were included. Eighty-six percent of the group lost from 1 to 1.5 liters of blood; only 14% lost a larger amount. Serum electrolyte levels were unaffected. Hematocrit readings and total protein concentrations decreased but remained within physiologic limits. No unexpected complications were encountered in the postoperative period, and hospitalization was not prolonged. Only four patients required subsequent transfusions postoperatively.
The Etiology and Treatment of Eczema
Authors: L. Kesteven
Journal: BMJ (1908)

Poet mortem Ecamination.The sudden tragio end led me to expect to find a cerebral absacess ruptured into the ventricle, but all that was revealed was meningitis.REMARKS.Ballance says that when the following group of symptoms are present together septic thrombosis is certainly present:1.A history of purulent aural discharge for a year or more.
Rapidly Measured Indicators of Recreational Water Quality Are Predictive of Swimming-Associated Gastrointestinal Illness
Authors: Timothy J. Wade, Rebecca L. Calderon, Elizabeth Sams, Michael Beach, Kristen P. Brenner, Ann H. Williams, Alfred P. Dufour
Journal: Environmental Health Perspectives (2005)

Standard methods to measure recreational water quality require at least 24 hr to obtain results, making it impossible to assess the quality of water within a single day. Methods to measure recreational water quality in <or=2 hr have been developed. Application of rapid methods could give considerably more accurate and timely assessments of recreational water quality. We conducted a prospective study of beachgoers at two Great Lakes beaches to examine the association between recreational water quality, obtained using rapid methods, and gastrointestinal (GI) illness after swimming. Beachgoers were asked about swimming and other beach activities and 10-12 days later were asked about the occurrence of GI symptoms. We tested water samples for Enterococcus and Bacteroides species using the quantitative polymerase chain reaction (PCR) method. We observed significant trends between increased GI illness and Enterococcus at the Lake Michigan beach and a positive trend for Enterococcus at the Lake Erie beach. The association remained significant for Enterococcus when the two beaches were combined. We observed a positive trend for Bacteroides at the Lake Erie beach, but no trend was observed at the Lake Michigan beach. Enterococcus samples collected at 0800 hr were predictive of GI illness that day. The association between Enterococcus and illness strengthened as time spent swimming in the water increased. This is the first study to show that water quality measured by rapid methods can predict swimming-associated health effects.