tbuckley/cabot-search huggingface dataset:
Miss, Mister, Doctor: To protect and serve the patient
Authors: Farhad B Naini, Daljit S Gill
Journal: Journal of the Royal Society of Medicine (2006)

How we are titled is of little consequence I found the editorial (April 2006 JRSM 1 ) on how we are titled most interesting.This is a continuation of the debate that the dental profession has been having for many years, fuelled by both an influx of overseas graduates styling themselves as 'Doctor', and by the development of the role of dentists from 'toothwrights' to practitioners with a more holistic approach encompassing the oral health and wellbeing of those in their care.However all of us, physicians, surgeons, general practitioners and dentists have one thing in commonpatients.But that may be about to change.The same week as the editorial appeared, the chief executive of the Sussex Partnership NHS Trust ordered staff not to refer to people receiving medical care as patients but as clients.This not only demonstrates a misunderstanding of our roles but also devalues both practitioners and those that we care for.Patients are not simply clients or users of health services.Patients are those receiving care, who are given time, are listened to and treated with sympathy, understanding and expertise.There is something special about the term patient, and although to give a precise dictionary definition is difficult, it is well understood by those who deliver the care.How we are titled may well, as the editorial states, be of little consequence; far more important is how we refer to, and perceive, those in our care.
Netherlands approves introduction of competition into health service
Authors: Tony Sheldon
Journal: BMJ (2005)

The Dutch Senate this week approved major changes to the Dutch health service, despite widespread concerns among the medical profession. The changes will introduce competition and market forces into the system. Ninety per cent of GPs staged a three day strike in connection with the changes last month ( BMJ 2005;330:1287, 4 Jun).

The health minister, Hans Hoogervorst, won Senate approval with a series of promises, including a pledge to consider his own position if the changes, due to start on 1 January, result in chaos.

The vote ends …
The Erythrocyte Sedimentation Rate and Chronic Renal Failure
Authors: Neil Shusterman, Gail Morrison, Irwin Singer, Paul Kimmel, Frederick Kiechle
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 November 1986The Erythrocyte Sedimentation Rate and Chronic Renal FailureNEIL SHUSTERMAN, M.D., GAIL MORRISON, M.D., IRWIN SINGER, M.D., PAUL KIMMEL, M.D., FREDERICK KIECHLE, M.D., Ph.D.NEIL SHUSTERMAN, M.D.Search for more papers by this author, GAIL MORRISON, M.D.Search for more papers by this author, IRWIN SINGER, M.D.Search for more papers by this author, PAUL KIMMEL, M.D.Search for more papers by this author, FREDERICK KIECHLE, M.D., Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-5-801_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The review on the clinical use of the erythrocyte sedimentation rate by Sox and Liang (1) in the April issue presented a comprehensive evaluation of this popular test. However, there was no discussion of chronic renal failure and its effect on this test. In several studies of markedly elevated sedimentation rates, renal failure was thought to be the underlying cause in 8% to 17% of cases (2, 3). It was unclear, though, whether renal failure alone or a secondary complicating disease process was responsible.To clarify this issue, we studied the role of chronic renal failure in...References1. SOXLIANG HM. The erythrocyte sedimentation rate: guidelines to rational use. Ann Intern Med. 1986;104:515-23. LinkGoogle Scholar2. ZACHARSKIKYLE LR. Significance of extreme elevation of erythrocyte sedimentation rate. JAMA. 1967;202:264-6. CrossrefMedlineGoogle Scholar3. FORDINNESPARRISHALLANHORNMUNRO MJFNDJ. The significance of gross elevations of the erythrocyte sedimentation rate in a general medical unit. Eur J Clin Invest. 1979;9:191-4. CrossrefMedlineGoogle Scholar4. SHUSTERMANKIMMELKIECHLEWILLIAMSMORRISONSINGER NPFSGI. Factors influencing erythrocyte sedimentation in patients with chronic renal failure. Arch Intern Med. 1985;145:1796-9. CrossrefMedlineGoogle Scholar5. BULLBRAILSFORD BJ. The zeta sedimentation ratio. Blood. 1972;40:550-8. CrossrefMedlineGoogle 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 byValidation of a fractional model for erythrocyte sedimentation rateBlood: tests used to assess the physiological and immunological properties of bloodWhy Shouldn't We Determine the Erythrocyte Sedimentation Rate? 1 November 1986Volume 105, Issue 5Page: 801-801KeywordsErythrocyte sedimentation rateRenal failure Issue Published: 1 November 1986 PDF downloadLoading ...
Induction of granule release by intracellular application of calcium and guanosine-5′-O-(3-thiotriphosphate) in human eosinophils
Authors: Toshiya Aizawa, Yasunori Kakuta, Kohei Yamauchi, Yuichi Ohkawara, Nobuhiro Maruyama, Yuko Nitta, Gen Tamura, Hidetada Sasaki, Tamotsu Takishima
Journal: Journal of Allergy and Clinical Immunology (1992)
Alkylphenol Xenoestrogens with Varying Carbon Chain Lengths Differentially and Potently Activate Signaling and Functional Responses in GH <sub>3</sub> /B <sub>6</sub> /F10 Somatomammotropes
Authors: Mikhail Y. Kochukov, Yow-Jiun Jeng, Cheryl S. Watson
Journal: Environmental Health Perspectives (2008)

BackgroundAlkylphenols varying in their side-chain lengths [ethyl-, propyl-, octyl-, and nonylphenol (EP, PP, OP, and NP, respectively)] and bisphenol A (BPA) represent a large group of structurally related xenoestrogens that have endocrine-disruptive effects. Their rapid nongenomic effects that depend on structure for cell signaling and resulting functions are unknown.ObjectivesWe compared nongenomic estrogenic activities of alkylphenols with BPA and 17β-estradiol (E2) in membrane estrogen receptor-α–enriched GH3/B6/F10 pituitary tumor cells. These actions included calcium (Ca) signaling, prolactin (PRL) release, extracellular-regulated kinase (ERK) phosphorylation, and cell proliferation.MethodsWe imaged Ca using fura-2, measured PRL release via radioimmunoassay, detected ERK phosphorylation by fixed cell immunoassay, and estimated cell number using the crystal violet assay.ResultsAll compounds caused increases in Ca oscillation frequency and intracellular Ca volume at 100 fM to 1 nM concentrations, although long-chain alkylphenols were most effective. All estrogens caused rapid PRL release at concentrations as low as 1 fM to 10 pM; the potency of EP, PP, and NP exceeded that of E2. All compounds at 1 nM produced similar increases in ERK phosphorylation, causing rapid peaks at 2.5–5 min, followed by inactivation and additional 60-min peaks (except for BPA). Dose–response patterns of ERK activation at 5 min were similar for E2, BPA, and PP, whereas EP caused larger effects. Only E2 and NP increased cell number. Some rapid estrogenic responses showed correlations with the hydrophobicity of estrogenic molecules; the more hydrophobic OP and NP were superior at Ca and cell proliferation responses, whereas the less hydrophobic EP and PP were better at ERK activations.ConclusionsAlkylphenols are potent estrogens in evoking these nongenomic responses contributing to complex functions; their hydrophobicity can largely predict these behaviors.
Care for people with dementia 50 years out of date, report says
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Services for people with dementia in England lag 50 years behind other specialties, such as cancer and stroke services, with early diagnoses and interventions too scarce, says a report from the NHS spending watchdog.

The report, from the National Audit Office, calls for a strong and transparent leadership from the Department of Health to champion and coordinate improvements in dementia services, in the same way that national targets and national services frameworks have helped to modernise services for people with cancer and heart disease.

The report says that dementia care in England is similar to cancer care in the 1950s, when there were few effective treatments, and the diagnosis was withheld from patients to avoid distress.

“Services for dementia are not very adequate and have been given too low a priority within the department of health,” said Karen Taylor, director of health …
Perspectives on Adolescent Substance Use
Authors: Thomas N. Robinson
Journal: JAMA (1987)

We asked 1447 tenth graders to complete a survey on physical activity, nutrition, stress, and substance use and to undergo basic physical assessments. In a multiple regression analysis, increased level of substance use by both boys and girls was most strongly predicted by friends' marijuana use. For boys, this was followed by perceived safety of cigarette smoking; poor school performance; parents' education; and use of diet pills, laxatives, or diuretics for weight control, accounting for 44% of the overall variation in substance use. For girls, friends' marijuana use was followed by poor school performance; self-induced vomiting for weight control; perceived safety of cigarette smoking; use of diet pills, laxatives, or diuretics for weight control; parents' education; perceived adult attitudes about cigarettes; and nonuse of seat belts, accounting for 53% of the overall variance. Separate multiple regression analyses for each substance produced similar results. The homogeneity of the study population precluded ethnic comparisons. These findings suggest that for many purposes substance use may be considered a single behavior regardless of the specific substance(s) used and that substance use may exist as part of a syndrome of adolescent problem behaviors. In addition, the potent influence of perceived social environment suggests that a social influence resistance model may represent the most successful preventive strategy. (<i>JAMA</i>1987;258:2072-2076)
Staphylococcal Infections in an Obstetric Unit
Authors: Donald N. Wysham, Marie E. Mulhern, George C. Navarre, Gerald D. LaVeck, Alfred L. Kennan, W. R. Giedt
Journal: New England Journal of Medicine (1957)

PUERPERAL mastitis, which is primarily a disease of nursing mothers, is usually caused by Staphylococcus aureus. In earlier concepts of the pathogenesis of this disease, it was assumed that staphylococci gain access to the mother's lactiferous ducts and breast tissue through fissures in the nipple. Accordingly, the prophylaxis of mastitis consisted largely in efforts to prevent the development of fissured nipples, and in treating them properly if they appeared.1 , 2 Observations made by Duncan and Walker3 elucidated the source of staphylococci as a cause of puerperal mastitis, and thereby cast doubt upon earlier concepts of its pathogenesis. These authors demonstrated that . . .
Macrolides and Bronchiectasis
Authors: J. Stuart Elborn, Michael M. Tunney
Journal: JAMA (2013)

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
Still too early for the gold rush.
Authors: M Guslandi
Journal: Annals of the Rheumatic Diseases (1993)

Letters to the editor/Matters arising that it does cause significant morbidity.Furthermore, although in this series cases were drawn from multiple disciplines, six of the 12 patients presented to the rheumatology unit, highlighting the need for rheumatologists to be aware of the condition.On plain x ray films, sacral fractures are notoriously difficult to detect, particularly in association with osteopenia.The diagnosis hinges on clinical suspicion and the correct interpretation of technetium-99m bone scanning.The diagnosis can be confirmed by computed tomography, but in the typical setting this is not mandatory.
Unilateral Absence of a Palpable Vas Deferens
Authors: Henry Schneiderman
Journal: JAMA (1989)

<h3>To the Editor.—</h3> The article on unilateral absence of a palpable vas deferens by Donahue and Fauver<sup>1</sup>is an important contribution. I wonder if the authors have data on whether the presence of bilateral vasa deferentia excludes unilateral renal agenesis. This would be most helpful and, if substantiated in large series, could avoid the use of excretory urograms or ultrasound studies merely to establish the presence of two kidneys in, for example, potential renal donors. If the authors do not have data on a substantial number of patients with solitary kidneys as established by conventional imaging, I would propose the creation of a registry to address this issue. On another issue, in the age of infection control and universal precautions, I would recommend one modification in their technique for physical examination of the vas deferens, namely, the use of gloved hands bilaterally. Sensitivity for palpation with a glove on
'Benign' Monoclonal Gammopathy
Authors: Robert A. Kyle
Journal: JAMA (1984)

A series of 241 patients with monoclonal protein but no evidence of multiple myeloma, macroglobulinemia, amyloidosis, or lymphoma (benign monoclonal gammopathy) were followed up for more than ten years. The patients were classified as follows: group 1, patients without increase of monoclonal serum protein during follow-up (benign) (37%); group 2, patients with greater than 50% increase of monoclonal protein or development of monoclonal urine protein (5%); group 3, patients who died of unrelated causes (39%); and group 4, patients in whom myeloma, macroglobulinemia, amyloidosis, or related diseases developed (19%). The median interval from recognition of the monoclonal protein to diagnosis of multiple myeloma was 98 months; macroglobulinemia, 115 months; and systemic amyloidosis, 92 months. No laboratory or clinical data initially differentiated patients with benign gammopathy from those in whom serious diseases developed. Consequently, serial measurement of serum monoclonal protein is essential. (<i>JAMA</i>1984;251:1849-1854)
Comparison of oestradiol and prostaglandin E2 vaginal gel for ripening the unfavourable cervix
Authors: A. J Gordon
Journal: BMJ (1981)

I was most interested in the results reported by Mr. Phillip M. Tromans and his colleagues (February 28 p 679) comparing the ability of estradiol and (PGE2) prostaglandin E2 to ripen the unfavorable cervix before induction of labor.  Following work with Dr. A.A. Calder on the ripening effect of estradiol on the unfavorable cervix I compared the effect of estradiol (150 mg in 6 ml hydroxyethylmethylcellulose gel) with that of PGE2 (400 mcg in 6 ml hydroxyethylmethylcellulose gel).  There were 25 primigravidas in each group with cervical scores of 3 or less and the treatment was given extraamniotically the night before planned induction.  There were no significant differences in the maternal age height weight or length of gestation and all patients had a singleton cephalic presentation.  The results are shown in an accompanying table.  The indications for cesarean section were cephalopelvic disproportion in both patients in the PGE2 group and fetal distress in 2 cases and failure to progress in the estradiol group.  The only statistically significant difference between the 2 groups was in the number of patients going into labor following cervical ripening.  12 of the 25 patients treated with PGE2 went into labor but only 1 of the estradiol group did so (p=0.0005).  This lack of uterine stimulation may make estradiol pretreatment preferable where placental function is suspect.  Although the vaginal application may be more convenient than the extraamniotic route the high cesarean section rate reported (23% and 27%) by Mr. Tromans and his colleagues may make further studies on the best route of application worth while as the cesarean section rates in my series were 8% and 12%.  Insertion of a Foley catheter may change the shape of the cervix.  In a study comparing routes of administration of PGE2 to ripen the cervix Toplis and Sims found that the incidence of cesarean section following 3 mg vaginal paste was 15% compared with only 5% for 500 mcg given extraamniotically.  (Authors modified)
S19 Real time PCR in the identification and management of Aspergillus in CF
Authors: C. G. Baxter, A. M. Jones, A. K. Webb, D. W. Denning
Journal: Thorax (2010)

<h3>Purpose</h3> The reported prevalence of <i>Aspergillus fumigatus</i> in CF sputum varies widely from 12 to 57%. While patients with ABPA are routinely treated with antifungals, it is not know whether colonised or sensitised patients would benefit from antifungal treatment. To aid treatment decisions and to monitor response more accurate methods to detect <i>Aspergillus</i> in sputum are needed. This study aimed to identify CF patients with <i>Aspergillus</i> colonisation, using real time PCR, and examine the relationship of colonisation to markers of sensitisation. <h3>Methods</h3> 108 adult CF patients provided a sputum sample and a blood sample. Serological tests included total IgE, specific <i>A. fumigatus</i> IgE and specific <i>A. fumigatus</i> IgG performed by Phadia ImmunoCAP<sup>®</sup> assay, and <i>A. fumigatus</i> precipitins by counter immunoelectrophoresis. Sputum was homogenised with sputasol and sonication. 10 μl was cultured on sabouraud agar (Oxoid, UK) for 72 h. The remaining sample was used in a commercial real time PCR assay, MycAssay Aspergillus. Patients on antifungal treatment were excluded from serological data analysis. <h3>Results</h3> 30% of the 108 sputum samples were positive for <i>Aspergillus</i> species by standard culture whereas 80% were positive for <i>Aspergillus</i> species by PCR. 15 patients were on antifungal therapy of whom 7 were PCR positive. Of the serological tests, only specific IgG correlated to positive PCR. Using a ROC curve, a specific IgG level above 65 mg/l gave 85% sensitivity and 100% specificity for positive PCR. 12 patients met the 2003 consensus minimum criteria for ABPA. All were PCR positive supporting the use of antifungals for ABPA. 38 patients were sensitised to <i>aspergillus</i> (specific IgE &gt;0.4 KUa/l), 28 of these were PCR positive. A group of 32 patients was identified that had a rise in specific IgG and positive PCR but no IgE rise. They may represent ‘<i>aspergillus</i> bronchitis’. All patients with negative serology were PCR negative. <h3>Conclusion</h3> Real time PCR can accurately identify CF patients with <i>Aspergillus</i> in their sputum, including those in whom antifungal therapy is inadequate. However, PCR alone cannot distinguish between ABPA, sensitisation and colonisation. Positive PCR correlates to a specific IgG &gt;65 mg/l. A randomised trial of antifungal therapy is required to determine if there is clinical benefit in treating PCR positive patients.
410 HBsAg LOSS IS CORRELATED WITH LESS BASELINE VIRAL DIVERSITY IN GENOTYPE A, HBeAg+ CHRONIC HEPATITIS B (CHB) SUBJECTS TREATED WITH TENOFOVIR DF (TDF) LONG-TERM
Authors: P. Charuworn, P. Hengen, R.A. Schall, P. Dinh, D. Ge, A. Corsa, K.M. Kitrinos
Journal: Journal of Hepatology (2013)
Treatment of stable angina
Authors: T. F Luscher
Journal: BMJ (2000)

Papers p 73 

Angina pectoris is a common manifestation of coronary artery disease. Effective treatment was not available until Brunton introduced nitrate of amyl in 1867.1 Drugs for the treatment of chronic angina became available much later, first the long acting nitrates, β blockers in the 1960s, and calcium antagonists in the 1970s. At the same time, bypass surgery and, later, percutaneous transluminal coronary angioplasty were introduced.

In this issue of the BMJ Bucher and colleagues report a meta-analysis of randomised controlled trials comparing percutaneous transluminal coronary angioplasty and medical treatment for non-acute coronary artery disease (p 73).2 The treatment of stable angina aims to reduce chest pain and prevent cardiovascular events. 1 3 Bypass surgery is more effective than medical treatment, at least according to trials carried out in the 1970s, but it is expensive, is associated with morbidity and mortality, and needs patients to stay longer in hospital.3 Percutaneous transluminal coronary angioplasty can be performed immediately after a diagnostic procedure and is less invasive than surgery, and patients can leave the hospital next day.4 However, it has periprocedural complications, and restenosis limits its benefits in certain patients.

Of the drug treatments, there is evidence that only β blockers reduce …
Effect of nitroglycerin with and without systemic hypotension on canine regional myocardial tritiated water deposition
Authors: N. F. PARADISE, M. R. TRIPP, H. B. BURCHELL, D. A. GERASCH, C. R. SWAYZE, I. J. FOX
Journal: Cardiovascular Research (1976)

A marked alteration in the transmural distribution of left ventricular blood flow, with a relative increase in subendocardial and mid-wall flows, but with no change in the distribution of the relative blood flow to the two ventricles occurred when nitroglycerin was administered and the systemic arterial blood pressure in the upper body maintained near control levels in anaesthetized, open-chested dogs. The relative increase in subendocardial and mid-wall flows may have resulted from a direct action of nitroglycerin on the coronary vasculature. On the other hand, the intravenous administration of nitroglycerin, when followed by the hypotension which it produces, did not alter the transmural distribution of blood flow in the left ventricle of the dog. Blood flow to the right ventricle relative to flow to the left ventricle increased in this situation.
Clinical, cytogenetic and molecular characteristics of 14 T-ALL patients carrying the TCRβ-HOXA rearrangement: a study of the Groupe Francophone de Cytogénétique Hématologique
Authors: B Cauwelier, H Cavé, C Gervais, M Lessard, C Barin, C Perot, J Van den Akker, F Mugneret, C Charrin, M P Pagès, M-J Grégoire, P Jonveaux, M Lafage-Pochitaloff, M J Mozzicconacci, C Terré, I Luquet, P Cornillet-Lefebvre, B Laurence, G Plessis, C Lefebvre, D Leroux, H Antoine-Poirel, C Graux, L Mauvieux, P Heimann, C Chalas, E Clappier, B Verhasselt, Y Benoit, B D Moerloose, B Poppe, N Van Roy, K D Keersmaecker, J Cools, F Sigaux, J Soulier, A Hagemeijer, A D Paepe, N Dastugue, R Berger, F Speleman
Journal: Leukemia (2006)