tbuckley/cabot-search huggingface dataset:
What is the role of ultrasound evaluation of lymph nodes in patients with high-grade squamous cell carcinoma of the head and neck?
Authors: P. Cousen, K. Chow, G. Colver
Journal: British Journal of Dermatology (2010)

Conflicts of interest: none declared. Madam, Cutaneous squamous cell carcinoma (SCC) has an incidence of 16 per 100 000 people in central Europe and in many countries its incidence is rising.1, 2 Most patients with cutaneous SCC of the head and neck are at low risk (< 5%) of developing metastases in regional lymph nodes.3 However, patients with unfavourable clinicopathological factors remain at higher risk for developing nodal disease and dying.3 These include thick or deeply invasive lesions (4–5 mm), large tumour diameter (> 2 cm), local recurrence, immunosuppression, high‐grade histopathology, perineural invasion, lymphovascular invasion and location on or around the ear.3, 4 Brantsch et al.1 found that in those patients who develop nodal metastasis 73% occurred in the first year after resection. Some metastases were detected at baseline or immediately thereafter. In an Australian series of thick SCC on the scalp 10 of 27 patients similarly had metastasis at the time of primary treatment.5
GMC appeals against judgment on withholding treatment
Authors: Clare Dyer
Journal: BMJ (2004)

The General Medical Council filed an appeal last week against a high court ruling which has cast doubt on key aspects of the GMC's guidance on the circumstances in which doctors can properly withhold or withdraw treatment which prolongs life.

The ruling was won last July by Leslie Burke, aged 44 ( BMJ 2004;329:309, 7 Aug). He has cerebellar ataxia and told the court that he feared that doctors might withdraw artificial feeding and let him die if he lost the ability to communicate.

Ruling in his favour, …
Angiotensin II receptor antagonists prevent neointimal proliferation in a porcine coronary artery organ culture model
Authors: D Wilson
Journal: Cardiovascular Research (1999)

Objectives: Angiotensin II (AngII) generation in response to vascular injury has long been assumed to influence neointimal proliferation contributing to restenosis. This concept has been supported by evidence that ACE inhibition and AT1 receptor blockade effectively limits restenosis in the rat. On the other hand, ACE inhibition has proven ineffective in clinical trails. The present study examines the response of the porcine coronary artery after angioplasty in vitro and compares the actions of an ACE inhibitor to AngII receptor antagonists. Methods and results: Captopril, an ACE inhibitor, and the AngII receptor antagonists, losartan and PD123319, were evaluated for their ability to attenuate neointimal proliferation in a porcine organ culture model of coronary restenosis. The neointima was significantly increased by 300% after angioplasty compared to non-angioplasty controls. The AT1 receptor antagonist, losartan, produced a significant reduction in neointimal index at 10−5 mol/l, while its in vivo metabolite, EXP3174, reduced neointimal proliferation at 10−6 mol/l. PD123319, a selective antagonist of the AT2 receptor, also restricted neointimal proliferation at 10−5 mol/l. Treatment with captopril (10−6 mol/l) increased the neointimal proliferation by approximately 200% after angioplasty. Conclusions: Direct blockade of AngII receptors effectively inhibits cell proliferation and restenosis post-angioplasty in vitro. ACE inhibition, exclusive of flow, does not attenuate proliferative restenosis. These data suggest that AngII contributes to neointimal proliferation and validates the concept that receptor antagonists could contribute to the therapeutic management of restenosis.
French government announces new plans for elderly care
Authors: B. Spurgeon
Journal: BMJ (2003)

The French government plans to drop a public holiday to finance a new health programme to prevent another system failure of the kind that caused the deaths of nearly 15 000 people in a heat wave in August.

Last week Prime Minister Jean-Pierre Raffarin announced €;9bn (£6.2bn; $10.4bn) of funding over the next four and a half years to improve the medical care and welfare of elderly people and those living with a disability.

The programme, which has to be approved by parliament, aims to improve medical facilities in …
Thyroid Supplements and Breast Cancer
Authors: Marilyn D. Farber
Journal: JAMA (1976)

To the Editor.—  The article by Kapdi and Wolfe provides some very interesting data, but in order to assess its clinical and epidemiologic significance, we would like to make the following observations.  First, it is very important to note that women receiving thyroid medication are older than the control group of women not receiving thyroid medication (median age of 46 to 55 years vs 35 to 45 years). Also, women taking thyroid medication for more than 15 years are older than women taking the medication for less than 15 years (in the group receiving thyroid medication for 1 to 5 years, 47% are >45 years old; receiving thyroid medication for 6 to 15 years, 60% are >45 years old; and receiving thyroid medication for >15 years, 75% are >45 years old).  Since the risk of developing breast cancer increases with age and length of exposure to thyroid medication is directly
CIMETIDINE AND HYPERPARATHYROIDISM
Authors: Sissay Awoke, GeorgeD. Lawrence, K.E. Pettengell, M.J. Grayson, G. Graziani, A. Aroldi, G. Colussi, M. Surian, C. Benvenuti, C. Ponticelli
Journal: The Lancet (1980)
Changing the law on decision making for mentally incapacitated adults
Authors: E. Gadd
Journal: BMJ (1998)

Who takes decisions concerning the medical treatment of adults when they can no longer decide for themselves because of mental incapacity? Such incapacity may be temporary, resulting for example from a toxic state; fluctuating in some cases of mental illness; or permanent as a result of severe dementia, severe learning disability, or the persistent vegetative state. Such patients may receive care in a wide range of settings, and their numbers are growing, particularly as a result of an aging population, emphasising the need for legal clarity for patients, their carers, and health professionals. Most doctors will at some time be faced with the care of such a patient and thus need to be aware of the implications for medical practice of proposed changes to the law.

In 1995 the Law Commission proposed that the legal provisions governing decisions on health, welfare, and financial affairs in cases of mental incapacity should be brought under a single statutory instrument.1 Last month the government issued a green paper seeking public …
Increasing Colorectal Cancer Screening Adherence
Authors: Audrey H. Calderwood, Hemant K. Roy
Journal: JAMA Internal Medicine (2012)

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 Internal Medicine 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 Internal Medicine journal
Gallic Acid Antagonizes P-Selectin–Mediated Platelet–Leukocyte Interactions
Authors: Chantal C.M. Appeldoorn, Arnaud Bonnefoy, Bianca C.H. Lutters, Kim Daenens, Theo J.C. van Berkel, Marc F. Hoylaerts, Erik A.L. Biessen
Journal: Circulation (2005)

Current paradigm attributes the low incidence of cardiovascular disorders in Mediterranean countries despite a high saturated fat intake, the "French paradox," to the antioxidant capacity of red wine polyphenols. Conceivably, other antiinflammatory pathways may contribute to at least a similar extent to the atheroprotective activity of these polyphenols. We have investigated whether gallic acid (GA), an abundant red wine polyphenol, modulates the activity of P-selectin, an adhesion molecule that is critically involved in the recruitment of inflammatory cells to the vessel wall and thus in atherosclerosis.GA potently inhibited the binding of a peptide antagonist (IC50, 7.2 micromol/L) and biotin-PAA-Le(a)-SO3H, an established high-affinity ligand, to P-selectin (IC50, 85 micromol/L). Under dynamic flow conditions, GA markedly and dose dependently attenuated the rolling of monocytic HL60 cells over P-selectin-transfected Chinese hamster ovary cells (EC50, 14.5 micromol/L) while increasing the velocity of P-selectin-dependent rolling of human blood leukocytes over a platelet monolayer. In vivo tests established that GA administration to normolipidemic C57/Bl6 and aged atherosclerotic apolipoprotein E-deficient mice impaired the baseline rolling of conjugates between activated platelets and circulating monocytes over femoral vein endothelium, as judged by online video microscopy (ED50, 1.7+/-0.3 and 1.5+/-0.4 mg x kg(-1) x h(-1), respectively).Our findings provide a solid mechanistic foundation through which GA intervenes in major inflammatory pathobiologies by binding and antagonizing P-selectin.
Streptozotocin-induced hyperglycemia exacerbates left ventricular remodeling and failure after experimental myocardial infarction
Authors: Tetsuya Shiomi, Hiroyuki Tsutsui, Masaki Ikeuchi, Hidenori Matsusaka, Shunji Hayashidani, Nobuhiro Suematsu, Jing Wen, Toru Kubota, Akira Takeshita
Journal: Journal of the American College of Cardiology (2003)
Influence of Angiotensin-Converting Enzyme and Angiotensin II Type 1 Receptor Gene Polymorphisms on Aortic Stiffness in Normotensive and Hypertensive Patients
Authors: Athanase Benetos, Sylvie Gautier, Sylvain Ricard, Jirar Topouchian, Roland Asmar, Odette Poirier, Emile Larosa, Louis Guize, Michel Safar, Florent Soubrier, Franc¸ois Cambien
Journal: Circulation (1996)

Background Clinical and experimental studies have demonstrated a major role of the renin-angiotensin system in the functional and structural changes of the large arteries in hypertension. Because genetic studies may help us to understand the mechanisms underlying the involvement of this system in arterial regulation, the present study was designed to assess the contribution of polymorphisms of the ACE insertion/deletion (I/D) and angiotensin II type 1 receptor (AGTR 1 A 1166 C) genes on aortic stiffness regulation. Methods and Results This study included 311 untreated hypertensive and 128 normotensive subjects. Aortic stiffness was evaluated by measurement of the carotid-femoral pulse-wave velocity (PWV). In normotensive subjects, the two polymorphisms did not influence any of the studied parameters. In hypertensive subjects, there was a decreasing trend of mean PWV with the number of ACE D alleles, but this association became significant only after adjustment for blood pressure ( P &lt;.05). Conversely, the AGTR 1 A 1166 C polymorphism was independently associated with aortic stiffness. Mean values of PWV were 11.6±2.7 m/s in AGTR 1 AA homozygotes, 13.3±3.3 m/s in AC heterozygotes, and 15.3±4.3 m/s in CC homozygotes ( P &lt;.0001 and P &lt;.00001 after adjustment for age and mean blood pressure, respectively). The percentage of variance of PWV explained by AGTR 1 A 1166 C polymorphism (11.6%) was much larger than that of ACE I/D polymorphism (1.7%). Conclusions These results suggest that in hypertensive but not normotensive subjects, the AGTR 1 and ACE geno-types are involved in the regulation of aortic rigidity. The presence of the AGTR 1 C allele is a strong independent determinant of aortic stiffness, whereas presence of the ACE I allele is weakly associated with increased stiffness.
Liver disease activity and hepatitis B virus replication in chronic delta antigen-positive hepatitis B virus carriers
Authors: Stephanos J. Hadziyannis, Morris Sherman, Harvey M. Lieberman, David A. Shafritz
Journal: Hepatology (1985)

Delta antigen is currently thought to reflect superinfection of the liver with a defective RNA virus (delta agent), requiring helper function from hepatitis B virus for its replication. To assess the influence of delta agent on hepatitis B virus replication in patients persistently infected with both viruses and showing chronic liver disease, we measured serum and liver hepatitis B virus DNA in HBsAg-positive chronic liver disease patients who were either positive or negative for delta antigen in the liver. Hepatitis B virus DNA was assayed in the serum of 21 patients with delta antigen-positive/HBsAg-positive chronic liver disease and in 21 patients with delta antigen-negative/HBsAg-positive chronic liver disease matched for HBeAg/anti-HBe status and underlying liver histology. HBcAg and delta antigen in liver was determined by immunofluorescence or immunoperoxidase staining. In delta antigen-positive/HBsAg-positive chronic liver disease, serum hepatitis B virus DNA was detected transiently in 4 of 21 cases (19%) and was present in these patients at low levels (trace to 2+). In contrast, 9 of 21 (43%) delta antigen-negative/HBsAg-positive chronic liver disease patients were serum hepatitis B virus DNA positive, and five of these had high serum hepatitis B virus DNA levels (3+ to 4+). Serum HBsAg and anti-HBc titers were significantly lower in delta antigen-positive cases and correlated with reduced amount of HBcAg in the liver. There was a reduction in the proportion of delta antigen-positive/HBsAg-positive carriers showing virion or replicating hepatitis B virus DNA forms in the liver (2 of 13), as compared to liver hepatitis B virus DNA in delta antigen-negative/HBsAg-positive carriers (9 of 12). These findings indicate that in delta antigen-positive chronic hepatitis, synthesis of hepatitis B virus genomes and gene products remain suppressed, whereas production of delta components continues at high levels. These observations may be of value in understanding the pathobiology of chronic delta antigen infection and suggest that liver disease activity in delta antigen-positive/HBsAg-positive carriers is more related to persistent delta infection than to continued hepatitis B virus replication.
Reducing Clostridium difficile infection in acute care by using an improvement collaborative
Authors: M. Power, N. Wigglesworth, E. Donaldson, P. Chadwick, S. Gillibrand, D. Goldmann
Journal: BMJ (2010)

<b>Problem</b> In 2006, despite a focus on infection control, Salford Royal had the fourth highest rate of <i>Clostridium difficile </i>infection in north west England. <b>Design</b> Interrupted time series in five collaborative wards (intervention group) and 35 non-collaborative wards (control group). <b>Setting</b> University teaching hospital with 850 acute beds. <b>Key measures for improvement</b> Number of cases of <i>C difficile </i>infection per 1000 occupied bed days. <b>Strategies for change</b> In February 2007, a newly formed antimicrobial team led the implementation of revised guidelines in all wards and departments. From March to December 2007, five wards participated in an improvement collaborative. Since December 2007, the changes from the collaborative have been collated and implemented throughout the organisation. <b>Effects of change</b> At baseline the non-collaborative wards had 1.15 (95% CI 1.03 to 1.29) cases per 1000 occupied bed days. In August 2007 cases reduced 56% from baseline (0.51, 0.44 to 0.60), which has been maintained since that time. In the collaborative wards, there were 2.60 (2.11 to 3.17) cases per 1000 occupied bed days at baseline. A shift occurred in April 2007 representing a reduction of 73% (0.69, 0.50 to 0.91) from baseline, which has been maintained. <b>Lessons learnt</b> Careful use of antimicrobial drugs is important in reducing the number of cases of <i>C difficile </i>infection. A collaborative learning model can enable teams to test and implement changes that can accelerate, amplify, and sustain control of <i>C difficile</i>.
Quantifying the distribution of inhalation exposure in human populations: distribution of minute volumes in adults and children.
Authors: J A Beals, L M Funk, R Fountain, R Sedman
Journal: Environmental Health Perspectives (1996)

Assessments of inhalation exposure to environmental agents necessitate quantitative estimates of pulmonary ventilation rates. Estimating a range of exposures in a given population requires an understanding of the variability of ventilation rates in the population. Distributions of ventilation rates (Ve) were described based on the results of a large study where Ve were measured while subjects performed a variety of physical tasks. Three distinct ventilation levels were identified using cluster analyses of the mean Ve and then various activities were assigned to the three levels using a k-means procedure. Separate distributions were identified for the three Ve levels for adult males, adult females, and children. The variability of Ve was consistent with a lognormal distribution for all groups. An aggregate daily inhalation rate can be estimated based on the distributions of Ve.
Troponin I phosphorylation plays an important role in the relaxant effect of β-adrenergic stimulation in mouse hearts
Authors: J Peña
Journal: Cardiovascular Research (2004)

Objective: The present study was designed to address the question of the contribution of cardiac troponin I (cTnI) phosphorylation to the enhanced rate of relaxation during β-adrenergic stimulation in hearts in situ. Methods: In situ hemodynamic measurements were performed in mouse hearts that (1) express normal level of phospholamban (PLB) and either express cTnI (PLB/cTnI) or the slow skeletal isoform of TnI (PLB/ssTnI) that cannot be phosphorylated by protein kinase A (PKA) or (2) do not express PLB and either express cTnI (PLBKO/cTnI) or ssTnI (PLBKO/ssTnI). Results: In the basal state, there was no difference in heart rate (HR), developed pressure (DP), left ventricular end-diastolic pressure (LVEDP) or rate of contraction (+dP/dt) between PLB/cTnI and PLB/ssTnI groups. However, hearts expressing ssTnI (PLB/ssTnI) showed a significantly decreased rate of relaxation (−dP/dt) when compared with hearts expressing cTnI (PLB/cTnI). In response to β-adrenergic agonist, isoproterenol (ISO), HR increased similarly in both groups. At the two highest doses of ISO, the rate of relaxation (−dP/dt) was significantly smaller in PLB/ssTnI than in PLB/cTnI hearts. In the basal state, there was no difference in HR, DP, LVEDP,+dP/dt and –dP/dt between PLBKO/cTnI and PLBKO/ssTnI hearts. In response to ISO, HR increased similarly in both groups and was only slightly smaller in PLBKO/ssTnI group at the lowest dose of ISO. However, during ISO perfusion, when cTnI was phosphorylated, the rate of relaxation was significantly slower in PLBKO/ssTnI compared to PLBKO/cTnI hearts. Conclusion: Our data support the hypothesis that phosphorylation of cTnI significantly contributes to the enhanced rate of relaxation during β-adrenergic stimulation.
Aberrant Origin of Circumflex Coronary Artery From Left Subclavian Artery
Authors: Chuan-Bao Li, Yan-Wen Bi, Wen-Yu Sun, Rui-Jian Li, Gui-Shuang Li, Bei-An You, Wen-Qiang Chen, Da-Qing Li, Yu-Guo Chen, Yun Zhang
Journal: Journal of the American College of Cardiology (2010)
A Liaison Department of Psychiatry
Authors: C.P. Kimball
Journal: Psychotherapy and Psychosomatics (1973)

Psychiatry, in an attempt to attain scientific and academic respectability, has increasingly adopted the methods and organization of other disciplines. In doing so, it tends to lose many of the unique concerns and approaches that it brings to the area of patient care throughout the hospital and in the community. In order to preserve for and communicate to students and other physicians its unique conceptual approaches, psychiatry needs to develop liaison approaches in teaching, research and patient care that are collaborative and integrative rather than fragmented and segregative. Out of such activities, new formulations about the relationships between the environmental, psychological and physiological may be forthcoming.
421 FIB-4 SCORE IS A STRONGER PREDICTOR OF VIROLOGICAL RESPONSE THAN LIVER BIOPSY (METAVIR) IN HEPATITIS C GENOTYPE 1 PATIENTS: INTERIM DATA FROM THE PROPHESYS TRIAL
Authors: P. Ferenci, P. Marcellin, M. Puoti, A. Orlandini, M. Bozic, J. Schuller, J.P. Mulkay, A. Tice, J. Pruthi, A. Craxi, D. Messinger, F. Tatsch, A. Horban
Journal: Journal of Hepatology (2011)
The GPEP Report: II. Clinical Education
Authors: JEREMIAH A. BARONDESS
Journal: Annals of Internal Medicine (1985)

Editorials1 August 1985The GPEP Report: II. Clinical EducationJEREMIAH A. BARONDESS, M.D.JEREMIAH A. BARONDESS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-2-286 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptConclusion 4 of Physicians for the Twenty-First Century (1), the American Association of Medical Colleges' report issued last fall and already widely known as the GPEP Report, addresses the clinical education of the medical student and recommends that:1. Medical faculties should make explicit the knowledge, skills, attitudes, and values that they wish the clinical clerkship to instill.2. The clinical settings appropriate to these goals should be described and provided.3. Faculty concerned with clinical education should operate in the framework of the goals of the clerkship and should have adequate preparation, time, and resources for this purpose.4....References1. Physicians for the Twenty-First Century: Report of the Panel on the General Professional Education of the Physician and College Preparation for Medicine. Washington, D.C.: Association of American Medical Colleges; 1984. Google Scholar2. BARONDESS J. The doctor, the patient, and the system: reflections on education for clinical careers. Perspect Biol Med. 1983;26:261-73. CrossrefMedlineGoogle Scholar3. ROGERS D. Some musings on medical education: is it going astray? Pharos. 1982;45:11-4. Google Scholar4. BARONDESS J. Voluntary clinical faculty—the hope of the future? Arch Intern Med. 1983;143:338-40. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cornell University Medical College New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byInternal Medicine Clinical Teaching Unit: Is it an Inappropriate Site for Student Learning?INFORMATION FOR CLINICIANSExpanded medical education in primary care — Is this the next step?Malpractice Concerns Enter the Medical School Classroom 1 August 1985Volume 103, Issue 2Page: 286-288KeywordsFallsMedical education Issue Published: 1 August 1985 PDF downloadLoading ...
ACUTE INTESTINAL OBSTRUCTION DUE TO JACKSON'S MEMBRANE
Authors: F. C. Pybus
Journal: BMJ (1918)

during thte war.OnI MIay 24tlh, 1889, I read a paper oni the subject before tlhc Clinical Society of London adti at the same timtie shlowedl a .suiccessfuilcase..In a leaderette ill thle 13RITIshIIMEDICAL JOUL-NAL for JLIne 1st, 1889, OCCIurS the followingc statemeilnt:Aiiioiig tl lciapers reyl hast FcidIl-at tIe Clinical SocietyV was; one whicli ciroii ielees another advaitce in conserva-tive surgery, showing that another tissne of the b)odyI-(telldlon) Canl be sUccessfulllx grafted as skin, bonie, andl nerve ltaze been.