tbuckley/cabot-search huggingface dataset:
Reducing deaths among drug misusers
Authors: M. B Gabbay
Journal: BMJ (2001)

Rising drug related deaths alarm treatment providers, legislators, and society. The recent report from the Advisory Council on the Misuse of Drugs, Reducing Drug Related Deaths , suggests that lax prescribing is responsible for a significant proportion.1 It supports recent national guidelines on managing drug misuse, emphasising the supervised consumption of controlled drugs.2 On the same theme, the UK Home Office proposes extending the licensing system for addiction prescribing to cover all controlled drugs except NHS prescriptions for methadone mixture.3 Yet an expansion in the licensing system is likely to reduce accessibility of treatment and so increase drug related deaths. We believe that a clinical governance based solution would more successfully enhance treatment quality, safety, and accessibility.

Currently Home Office licences cover only heroin, cocaine, and dipipanone, and about 100 doctors (mainly specialist psychiatrists) have licences. The licences encompass prescriptions for about 500 patients, most of whom receive heroin. Monitoring is indirect and low key, aimed at detecting negligently aberrant prescribing and self …
Emergence of Azole Resistance in Aspergillus fumigatus and Spread of a Single Resistance Mechanism
Authors: Eveline Snelders, Henrich A. L van der Lee, Judith Kuijpers, Anthonius J. M. M Rijs, János Varga, Robert A Samson, Emilia Mellado, A. Rogier T Donders, Willem J. G Melchers, Paul E Verweij
Journal: PLoS Medicine (2008)

Resistance to triazoles was recently reported in Aspergillus fumigatus isolates cultured from patients with invasive aspergillosis. The prevalence of azole resistance in A. fumigatus is unknown. We investigated the prevalence and spread of azole resistance using our culture collection that contained A. fumigatus isolates collected between 1994 and 2007.We investigated the prevalence of itraconazole (ITZ) resistance in 1,912 clinical A. fumigatus isolates collected from 1,219 patients in our University Medical Centre over a 14-y period. The spread of resistance was investigated by analyzing 147 A. fumigatus isolates from 101 patients, from 28 other medical centres in The Netherlands and 317 isolates from six other countries. The isolates were characterized using phenotypic and molecular methods. The electronic patient files were used to determine the underlying conditions of the patients and the presence of invasive aspergillosis. ITZ-resistant isolates were found in 32 of 1,219 patients. All cases were observed after 1999 with an annual prevalence of 1.7% to 6%. The ITZ-resistant isolates also showed elevated minimum inhibitory concentrations of voriconazole, ravuconazole, and posaconazole. A substitution of leucine 98 for histidine in the cyp51A gene, together with two copies of a 34-bp sequence in tandem in the gene promoter (TR/L98H), was found to be the dominant resistance mechanism. Microsatellite analysis indicated that the ITZ-resistant isolates were genetically distinct but clustered. The ITZ-sensitive isolates were not more likely to be responsible for invasive aspergillosis than the ITZ-resistant isolates. ITZ resistance was found in isolates from 13 patients (12.8%) from nine other medical centres in The Netherlands, of which 69% harboured the TR/L98H substitution, and in six isolates originating from four other countries.Azole resistance has emerged in A. fumigatus and might be more prevalent than currently acknowledged. The presence of a dominant resistance mechanism in clinical isolates suggests that isolates with this mechanism are spreading in our environment.
Making Health Reform Work: The View From the States
Authors: William R. Fifer
Journal: JAMA (1995)

Contributors to this new book edited by DiIulio and Nathan include Lawrence D. Brown, James W. Fossett, Gerald Garvey, Donald F. Kettl, Michael S. Sparer, James R. Tallon, Jr, and Frank J. Thompson. The book was published just at the time the president and Congress jettisoned their health reform proposals for 1994. It loses no relevance, however, because health care reform is still a major policy issue and will reemerge in the Republican-dominated Congress in 1995. Indeed, one of the major policy initiatives of the new Congress is reviving a discussion of federalism, the division of power between the central government and the individual states. One major thrust of the book is that, while states have considerable administrative responsibility for Medicaid, environmental protection, and certificate-of-need legislation, they are unprepared to tackle the administrative burdens of health care reform at the state level. The authors cite Minnesota and Washington as examples
Acute leukemia evolving from multiple myeloma and co‐expressing myeloid and plasma cell antigens
Authors: A. K. Stewart, J. Freedman, M. B. Garvey
Journal: American Journal of Hematology (1990)

Abstract This report describes the development of acute myeloblastic leukemia in a patient after long‐term alkylator therapy for multiple myeloma. Despite chromosome deletions −5, −7, the patient lacked the histochemistry and clinical findings characteristic of therapy‐induced leukemia. In double‐labeled surface marker studies by flow cytometry, the leukemic blast cells co‐expressed myeloid and plasma cell surface markers. The findings may support the hypothesis of a single stem cell abnormality's being responsible for both the malignant plasma cells and the myeloid leukemic cells.
Urinary Monoamine Metabolites in Children with Minimal Brain Dysfunction
Authors: PAUL H. WENDER, RICHARD S. EPSTEIN, IRWIN J. KOPIN, EDNA K. GORDON
Journal: American Journal of Psychiatry (1971)

The authors hypothesized that children with minimal brain dysfunction not secondary to neurological injury might suffer from a biochemical abnormality characterized by diminished total production of monoamines. To test this hypothesis, 24-hour urinary excretion of the principal metabolites of these substances was measured in nine children with minimal brain dysfunction and in six normal controls. No differences were found beween the groups: the hypothesis was not supported.
The Feasibility of Adjuvant Carboplatin and Docetaxel in Patients with Curatively Resected Non-small Cell Lung Cancer
Authors: Thomas E. Stinchcombe, Harry D. Harper, Thomas A. Hensing, Dominic T. Moore, Jeffery M. Crane, James N. Atkins, Ellen M. Willard, Frank C. Detterbeck, Mark A. Socinski
Journal: Journal of Thoracic Oncology (2008)
The Acid-Base Vector of Open-Heart Surgery
Authors: FRANCIS A. PUYAU, RICHARD E. L. FOWLER, ROSALIND NOVICK, HAROLD ALBERT, BERT GLASS
Journal: Circulation (1962)

Fourteen patients submitted to open-heart surgery were studied by serial acid-base and electrolyte determinations in order to demonstrate the sequence and magnitude of disturbances associated with the procedure. Under conditions of the study, including the use of 100 per cent oxygen as the perfusing gas for the oxygenator, respiratory alkalosis develops as the initial change during perfusion but is followed by a "metabolic shift" characterized by falling pH and CO 2 content, while a stable, moderately low pCO 2 is maintained by the oxygenator. The resulting state of mixed respiratory alkalosis and metabolic acidosis changes into a state of relatively pure metabolic acidosis as pCO 2 and bicarbonate content rise while pH falls after perfusion. The factors involved in the "metabolic shift" responsible for development of metabolic acidosis are not identified by this study although length of perfusion, perfusion pressure, and rate of flow are considered as possible factors. Acidosis persists through the early phases of the recovery period but ordinarily resolves without administration of alkali. Serial sampling technics as used in this study may aid in the interpretation of postoperative acidosis, distinguishing between patients who are deteriorating and those who are passing through a transient phase in the process of recovery.
Regional choline acetyltransferase activity in the guinea pig heart.
Authors: P G Schmid, B J Greif, D D Lund, R Roskoski
Journal: Circulation Research (1978)

Choline acetyltransferase is the enzyme that catalyzes the biosynthesis of acetylcholine, the neurotransmitter of the pre- and postganglionic parasympathetic system. To assess the extent of parasympathetic innervation, enzyme activity was measured in specialized and contractile regions throughout the guinea pig heart. Enzyme activity in the right atrial appendage was 137 nmol g(-1) hr(-1). Activity was greatest in the region of the sinoatrial node (187 nmol g(-1) hr(-1). Also, enzyme activity was high in the regions of the atrioventricular node (153 nmol g(-1) hr(-1), the proximal conduction bundles (133 nmol g(-1) hr(-1), and the base of the anterior papillary muscle of the right ventricle (179 nmol g(-1) hr(-1), which contains the moderator band and Purkinje fibers. In contrast, the enzyme activity in the inferior interventricular septum and the free walls of the right and left ventricles, which are more predominantly contractile tissue, was 67 +/- 6,108 +/- 14, and 56 +/- 11 nmol g(-1) hr(-1), respectively. This activity is significantly lower than in the right atrial appendage. These results suggest that the density of parasympathetic innervation is similar in all the components of the conduction system, from the sinoatrial node to Purkinje tissues. Furthermore, the parasympathetic innervation of regions specialized for conduction is up to four times more dense than that of contractile regions.
Corticotropin-releasing hormone excites adrenocorticotropin-secreting human pituitary adenoma cells by activating a nonselective cation current.
Authors: K Takano, J Yasufuku-Takano, A Teramoto, T Fujita
Journal: Journal of Clinical Investigation (1996)

The mechanisms of corticotropin-releasing hormone (CRH) induced excitation of ACTH-secreting adenoma cells were investigated using the perforated whole-cell clamp technique and intracellular Ca2+ concentration ([Ca2+]i) measurement. CRH depolarized ACTH-secreting adenoma cells by activating a nonselective cation current that showed slight inward rectification. This channel did not seem to be a member of the Ca(2+)-activated cation currents because it was activated even when the [Ca2+]i was chelated below 50 nM. The activation of the current was induced by protein kinase A-mediated pathways. By [Ca2+]i measurement, CRH increased [Ca2+]i of these cells dependently on voltage-gated Ca2+ current. This CRH-induced [Ca2+]i increase was abolished in Na(+)-free extracellular solution, but was not abolished by the addition of 5 microM tetrodotoxin to the extracellular solution. CRH-induced ACTH secretion from the cultured adenoma cells was also abolished in Na(+)-free extracellular solution, but not in tetrodotoxin-containing extracellular solution. These data indicate that a Na+ current (maybe the nonselective cation current) other than voltage-gated Na+ current plays an important role in CRH-induced [Ca2+]i increase and ACTH secretion. CRH also activated a nonselective cation current in nonadenoma human corticotrophs, suggesting that the activation of a nonselective cation current is a physiological mechanism of CRH-induced excitation in human corticotrophs.
EXCELLENT SCORING SYSTEMS USING POST-OPERATIVE CARDIOPULMONARY EXERCISE TESTING PARAMETERS CAN PREDICT MORTALITY AND FUTURE EXPLANTATION AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION
Authors: Teruhiko Imamura, Koichiro Kinugawa, Toshiro Inaba, Hisataka Maki, Masaru Hatano, Osamu Kinoshita, Kan Nawata, Minoru Ono
Journal: Journal of the American College of Cardiology (2015)
AMA Auxiliary Activities 1979-1980
Authors: Ben Johnson
Journal: JAMA (1980)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Depression and Anxiety Among Partners of European-American and Latino Patients With Type 2 Diabetes
Authors: Lawrence Fisher, Catherine A. Chesla, Marilyn M. Skaff, Joseph T. Mullan, Richard A. Kanter
Journal: Diabetes Care (2002)

OBJECTIVE—To assess the levels of and the independent contributors to depressive affect and anxiety among partners of patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—The partners of 75 Latino and 113 European-American patients with type 2 diabetes were assessed for level of depressive affect and anxiety and for three groups of potential stressors: demographics (age, gender, and education), patient disease status (time since diagnosis, HbA1c, comorbidities, and BMI), and family stress (disease impact, spouse conflict, and family closeness). Dependent variables were partner depressive affect (Center for Epidemiological Studies-Depression scale) and anxiety (Symptom Checklist [SCL-90] anxiety). Predictors of partner depressive affect and anxiety and partner-patient concordance rates were computed. RESULTS—Levels of depressive affect and anxiety and rates of likely depression (21.4%) were as high for partners as they were for patients. No differences were found on depressive affect or anxiety by ethnicity, but female partners scored higher than male partners on both measures. Partner-patient concordance rates were low. The family level variables accounted for the most variance in both depressive affect and anxiety, with demographics and disease status variables contributing modest or nonsignificant independent variance. CONCLUSIONS—Partners of patients with type 2 diabetes experience levels of psychological distress as high or even higher than patients, especially if the partner is female. Low levels of concordance suggest that partners can be distressed even if patients are not. Many life stresses contribute to psychological distress among partners, not just disease-related indicators. The findings suggest the utility of evaluating both partners and patients using a life-centered rather than a disease-focused perspective.
The Physician and the Civic Self
Authors: Don E. Detmer
Journal: JAMA (1980)

How does a physician serve? How should he serve? Peter Dans, MD, has written a quietly provocative article on physicians and health policy that makes a number of apt observations about physicians and the big picture (p 1451). He presents these views in the context of a brief description of the Institute of Medicine's Robert Wood Johnson Health Policy Fellows Program (not to be confused with the Robert Wood Johnson Clinical Scholars Program)—a program that has been a success by all indications. Since its inception, competition for the fellowships has been keen. But what happened to the fellows themselves after leaving the program? What of their reentry? Have the physicians among them remained clinically active? If not, should they have? How should these physicians serve? How should any physician serve?  For centuries the socialization process in medicine has overwhelmingly emphasized the values of philanthropy and technophilia. Historically, physicians have held
Thyroid function and endocrine abnormalities in elderly patients with severe chronic obstructive lung disease.
Authors: P D Semple, R Hume, G H Beastall, W S Watson
Journal: Thorax (1988)

Hypothermic protection (26-25C) without perfusion cooling for surgery of congenital cardiac defects using prolonged occlusion.SIR,-The use of periods of circulatory arrest under the protection ofprofound hypothermia (less than 20C) is a well established technique to permit surgery that may be impossible on cardiopulmonary bypass.The time limits are debatable, so the statement by Professor EE Litasova and Dr VN Lomivorotov (March 1988;43:206-1 1) that "The results obtained without perfusion under deep (26-25'C) hypother- mic protection suggest that 75 minutes is a safe time, in terms of brain damage, for circulatory arrest" merits critical attention.25-26'C is quite a modest degree of hypothermia at which to seek prolonged cerebral protection from ischaemia and 75 minutes is a long period of circulatory arrest by any standards.The anaesthetic and surgical techniques are detailed in the "Methods" section but no criteria or objective methods for establishing neurological function were employed.It appears that time to waking has to suffice.The issue of ischaemic brain damage is largely side stepped by attributing unsatis- factory outcome to air embolism or poor myocardial func- tion.A relation was detected between duration of ischaemic time and the number of neurological complications that were recognised, and even by these rather generous criteria it does not suggest that "75 minutes is a safe time."The authors provide nine references, of which six are to Russian publications.Their key reference, from 1963, is fully a quarter ofa century old and maybe none the worse for that, but it may be!The use of circulatory arrest with surface cooling was well established in the 1950s.On the basis of oxygen consumption data-for example, those provided by
Brain Injury and After: Towards Improved Outcome
Authors: D. Gentleman
Journal: BMJ (1996)

Ed F D Rose, D A Johnson Wiley, £15.99, pp 218 ISBN 0 471 96288 0

Recent advances have reduced mortality from severe brain injury, but survivors are often left with wide ranging problems that bewilder them and their families and blight their lives. The professional response to this has often been inadequate, more concerned with care and containment than with rehabilitation. Provision of rehabilitation services in Britain is inadequate compared with that in North America or continental Europe, and whether or not a patient with serious head injury …
ANALYSIS OF FOOTBALL INJURIES
Authors: THOMAS N. HORAN
Journal: JAMA (1934)

The present study includes a record of major and minor injuries through four consecutive seasons at Cranbrook School, where 80 per cent of the boys play football; the average school attendance is 200 boys. The analysis of the injuries is taken from notes entered each afternoon and evening during the season. These injuries are summarized in the tables and presented pictorially in the accompanying illustration. The use of broad descriptive terms — e. g., chest wall in preference to ribs, intercostal muscles, costal cartilages, and ligaments—simplifies and condenses the report to the seventeen items listed in table 1 in the order of frequency. The total number of injuries decreases: 243 in 1930, 112 in 1931, 68 in 1932 and 75 in 1933. This interesting reduction developed gradually as the causes for special regional injuries were examined in respect to the anatomic strength or vulnerability of the part, the character and
Tumour necrosis factor in synovial exudates.
Authors: F S Di Giovine, G Nuki, G W Duff
Journal: Annals of the Rheumatic Diseases (1988)

The actions of tumour necrosis factor (TNF) include resorption of bone and cartilage, suggesting a potential role in the pathogenesis of arthritis. TNF activity was looked for in synovial fluids from 137 patients with different rheumatic diseases. Unfractionated samples were tested in the L929 bioassay. Significant TNF activity that was neutralised by monoclonal antibody to TNF alpha occurred in 13 (30%) of 44 samples. Raised TNF levels were not associated with any particular disease type or routine laboratory markers of inflammation but were related to disease duration in osteoarthritis. The finding of biologically active TNF in symptomatic joints of arthritic patients supports the idea that it may contribute to the pathogenesis of joint damage in chronic rheumatic diseases.
The potent bile acid sequestrant colesevelam is not effective in cholestatic pruritus: Results of a double-blind, randomized, placebo-controlled trial
Authors: Edith M. M. Kuiper, Karel J. van Erpecum, Ulrich Beuers, Bettina E. Hansen, Bing H. Thio, Robert A. de Man, Harry L. A. Janssen, Henk R. van Buuren
Journal: Hepatology (2010)

Colesevelam is an anion-exchange resin with a 7-fold higher bile acid–binding capacity and fewer side effects than cholestyramine, the current first-line treatment option for cholestatic pruritus. The aim of this trial was to compare the effects of colesevelam and a placebo in patients with cholestatic pruritus. In a randomized, double-blind, investigator-initiated, multicenter trial, patients with cholestatic pruritus, both treatment-naive and previously treated, received 1875 mg of colesevelam or an identical placebo twice daily for 3 weeks. The effect on pruritus was assessed with daily visual analogue scales, quality-of-life scores, and evaluations of cutaneous scratch lesions. The predefined primary endpoint was the proportion of patients with at least a 40% reduction in pruritus visual analogue scale scores. Thirty-eight patients were included, and 35 were evaluable: 17 took colesevelam, 18 took the placebo, 22 were female, 8 were treatment-naive, 14 had primary biliary cirrhosis, and 14 had primary sclerosing cholangitis. The mean serum bile acid levels were comparable between the groups before treatment ( P = 0.74), but they were significantly different after treatment ( P = 0.01) in favor of patients treated with colesevelam. Thirty-six percent of patients in the colesevelam group reached the primary endpoint versus 35% in the placebo group ( P = 1.0). There were no significant differences between the groups with respect to pruritus scores, quality-of-life scores, and severity of cutaneous scratch lesions. Mild side effects occurred in one colesevelam-treated patient and four placebo-treated patients. Conclusion: Although colesevelam significantly decreased serum bile acid levels, this trial was unable to demonstrate that it was more effective than a placebo in alleviating the severity of pruritus of cholestasis. (Hepatology 2010)
Women Kept Out of Salt Lake Medical Society.
Authors: Ellen Curtis Gage
Journal: JAMA (1893)

Salt Lake City, Utah, Dec. 5, 1893. <h3>To the Editor:</h3> —I have been a member of theAmerican Medical Associationfor seven years I think; sponsored at my admission by Dr. Etheridge and Prof. W. S. Haines, my preceptors. I have paid my dues and appreciated the distinction of membership. When I came to Utah, almost six years ago, I was, so far as I was able to learn, the only member of the parent society in this Territory. The profession turned a cold shoulder to me, but I insisted upon thriving. In course of time, a well-meaning man presented my name to the local society for admission and I was turned down, one noble exponent of the art of medicine saying, " if I were admitted (he admitting that my claims to fellowship were beyond controversy), " all the d— hags in town would want in " —he referred to the women