tbuckley/cabot-search huggingface dataset:
Diagnosis of Cholestatic Jaundice
Authors: Luke K. LiCalzi
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Although we agree with Fischer et al that the differentiation of hepatocellular from extrahepatic obstructive (surgical) jaundice is greatly facilitated by ultrasonography and liver biopsy, we disagree on the subsequent approach to the patient with "surgical" jaundice. The diagnosis of pancreatic cancer in a patient with jaundice is of a different nature than the diagnosis of the same disease in a nonicteric patient. The patient with jaundice and dilated biliary ducts will require either surgical or radiological decompression. The use of multiple preoperative investigations outside of ultrasonography to detect the presence of gallstones, dilated biliary ducts, or both and PTC to determine the level of the obstruction is unwarranted in operative candidates. Furthermore, temporary or permanent percutaneous catheter drainage of the bile ducts is possible only via PTC and not ERCP, and such drainage in severly jaundiced patients has been shown to lower operative mortality.<sup>1</sup>Since
Preference-based quality-of-life values in patients with chronic hepatitis C: Results from the German hepatitis C quality-of-life study
Authors: U. Siebert, W. Greiner, U. Ravens-Sieberer, G. Sroczynski, J.B. Wong, J.M.Graf von der Schulenburg, M. Bullinger, S. Rossol
Journal: Journal of Hepatology (2003)
The effects of l-arginine on neointimal formation and vascular function following balloon injury in heritable hyperlipidaemic rabbits
Authors: Carol Greenlees, Roger M Wadsworth, Piero A Martorana, Cherry L Wainwright
Journal: Cardiovascular Research (1997)

Objective: The aims of this study were to determine the morphological and functional consequences of balloon angioplasty of the left subclavian artery of Froxfield heritable hyperlipidaemic (FHHL) rabbits and the influence of oral l-arginine therapy on these changes. Methods: Sixteen-week-old FHHL rabbits were subjected to balloon injury of the left subclavian artery under halothane anaesthesia. Control rabbits (n = 7) were given free access to food and normal tap water. l-Arginine-treated rabbits were given l-arginine (5 g·l−1) in the drinking water for 2 days prior to angioplasty and then for either 2 weeks (n = 7) or 4 weeks (n = 7) after surgery. All rabbits were euthanised 28–30 days after surgery and blood and tissue removed for quantification of neointimal size and determination of endothelial function using isolated vessel tension studies. The ability of the endothelium to prevent platelet aggregation was determined by challenging a vessel ring with carbachol when incorporated into a whole blood sample in which platelet aggregation was induced with collagen. Results: Balloon injury in non-treated rabbits resulted in the development of marked intimal hyperplasia (18.8[3.6]% of the area within the internal elastic lamina) while endothelial function remained intact. Maximum responses to carbachol and calcimycin were, respectively, a 66.6[14.7]% and 46.9[12.9]% relaxation of 5HT-induced tone, compared to 58.0[3.2]% and 39.8[9.4]% in non-injured vessels. Maximum contractile responses to 5HT and KCl were unaffected by injury. l-Arginine therapy alone had no effect on the vasodilator function of the endothelium, but reduced the endothelium-dependent inhibition of platelet aggregation (68.4[7.8] vs 109[10]% of the maximum extent of platelet aggregation in non-treated and 2-week l-arginine-treated non-injured vessels, respectively). l-Arginine significantly reduced the extent of neointimal formation (7.2[3.9]% of the area within the IEL; P<0.05 vs. non-treated group). However, l-arginine significantly attenuated the relaxant responses to both carbachol (26.5[10.4]% and 31.4[9.4]% for 2- and 4-week l-arginine groups) and calcimycin (38.7[15.4]% and 16.4[10.7]%) in the injured artery (P<0.05 compared to non-treated controls). Conclusions:l-Arginine reduces neointimal formation following balloon catheter injury in heritable hypercholesterolaemic rabbits, which is consistent with previous findings in normocholesterolaemic models. However, in the presence of hypercholesterolaemia, l-arginine has a detrimental effect on endothelial function following injury. This may be a consequence of the presence of lipids in the vascular wall on nitric oxide synthase activity.
Stop denigrating service
Authors: R H Salter
Journal: BMJ (1995)

A cornerstone of William Osler's approach to medical education was to learn by active participation in patient care. Students learnt most by being taught in outpatient clinics and on ward rounds. British postgraduate medical education was based on this philosophy.

Nowadays undergraduate and postgraduate medical education is in a state of turmoil—both the curriculum and the teaching and learning methods are being criticised. Most people involved accept that excessive service demands detract from the educational value of hospital based junior posts. In fact the barrage of adverse …
Intestinal Perforation Due to Retained Wireless Capsule Endoscope
Authors: P. Gonzalez Carro, J. Picazo Yuste, S. Fernández Díez, F. Pérez Roldán, O. Roncero García-Escribano
Journal: Endoscopy (2005)

To date, there have been no documented cases of intestinal perforation occurring as a result of long-term retention of a wireless capsule endoscope in the absence of intestinal strictures.
4-[18F]-Tetraphenylphosphonium as a PET Tracer for Myocardial Mitochondrial Membrane Potential
Authors: Gagandeep S. Gurm, Stephan B. Danik, Timothy M. Shoup, Steven Weise, Kazue Takahashi, Shawna Laferrier, David R. Elmaleh, Henry Gewirtz
Journal: JACC. Cardiovascular imaging (2012)
Introductory Address Delivered in the Section of Medicine
Authors: D. Embleton
Journal: BMJ (1870)

THIS being the first meeting of the British Medical Association in the North of England, I take the opportunity of heartily welcoming this Section to Newcastle-upon-Tyne.We have been long, perhaps, in cast- ing in our lot with the Association: it may be that there exists among us a tinge of that caution the full development of which is best seen north of the Tweed; but, once convinced of the advisability of joining the body, we have rapidly entered into the main spirit of it, and the development of the Northern Branch has been rapid, steady, and * Chaucer's " Doctour of physike" must have been a graduate of some university.+ When the late Professor Whewell said " Medicine, in its original and comprehensive sense, as one of the great divisions of human culture, must be considered as taking in the whole of physical science," he probably referred to the revival rather than to the origin of medicine.
Role of somatostatin-14 and its analogues in the management of gastrointestinal fistulae: clinical data
Authors: U Hesse, D Ysebaert, B de Hemptinne
Journal: Gut (2001)

Summary: Somatostatin-14 and its analogue octreotide both exert inhibitory effects on gastrointestinal secretions and may therefore be beneficial in the treatment of gastrointestinal fistulae. There are no studies that have compared these two drugs directly and hence this paper aims to review studies that are available for each drug. There are only six controlled studies that have examined the effects of somatostatin-14 and octreotide on fistula output reduction, three for each drug. All studies compared conservative therapy and the drug in combination with conservative therapy. Of the somatostatin-14 studies, two showed a significant effect on output (p&lt;0.05) and the other demonstrated an output reduction on day 1 that was twice that in the control group (NS). Of the octreotide studies, one showed a significant effect (p&lt;0.01) and the other two showed no effect of the drug on output. No study with either drug has demonstrated an increase in the number of patients that have achieved closure. However, a positive effect on the time to achieve closure has been found. Of the five controlled studies with somatostatin-14, all showed a significant reduction in time to closure. Of the two controlled studies with octreotide, one showed a significant reduction (p=0.002) and the other showed no difference. Due to the limited number of trials, a definitive evaluation of the efficacies of somatostatin-14 and octreotide in the treatment of gastrointestinal fistulae is not possible. However, currently available information seems to suggest a considerable benefit of somatostatin-14 when administered in association with standard conservative treatment, but this needs to be confirmed in a large prospective controlled study.
Compensatory carotid artery dilatation in early atherosclerosis.
Authors: W Steinke, T Els, M Hennerici
Journal: Circulation (1994)

BACKGROUND From pathological studies of coronary arteries, it has been recognized that progressive plaque development may be compensated for by an increase of the arterial diameter. However, the dynamics of this process have not been investigated, and it is not known whether compensatory dilatation is a general pathomechanism in human arteries. METHODS AND RESULTS Using a high-resolution duplex scanner and subsequent three-dimensional plaque reconstruction, we prospectively studied the effect of carotid plaque development on the vascular geometry in 32 patients at 6- to 12-month intervals. Plaque progression in 41% (n = 26) of studies was associated with an increase of the vessel diameter between 0.4 and 1.2 mm in 76% (n = 20). Among 36 unchanged plaque developments, enlargement of the arterial diameter was assessed in only 28% (n = 10) (P &lt; .001). CONCLUSIONS Our data suggest that increasing plaque volume is significantly associated with enlargement of carotid artery segments, which compensates for arterial narrowing in early stages of the disease.
Surgery at 100
Authors: Rebecca Voelker
Journal: JAMA (2000)

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
Role of cysteinyl leukotrienes in adenosine 5`-monophosphate induced bronchoconstriction in asthma
Authors: S Rorke
Journal: Thorax (2002)

Background: Adenosine induced bronchoconstriction in patients with asthma is thought to be mediated by the synthesis and release of autacoids from airway mast cells. In vitro, adenosine induced constriction of asthmatic bronchi is blocked by a combination of specific histamine and cysteinyl leukotriene receptor antagonists, but the relative contribution of these mediators in vivo is unclear. We hypothesised that adenosine induced bronchoconstriction in asthmatic patients may be blocked by pretreatment with the orally active selective cysteinyl leukotriene-1 (<i>CysLT</i><sub>1</sub>) receptor antagonist, montelukast. Methods: In a randomised, double blind, crossover study, oral montelukast (10 mg) or placebo was administered once daily on two consecutive days to 18 patients with mild to moderate persistent atopic asthma. Incremental doses of adenosine 5`-monophosphate (AMP) from 0.39 to 400 mg/ml were inhaled by dosimeter and the dose producing a 20% fall in FEV<sub>1</sub> (PC<sub>20</sub>AMP) after AMP inhalation was recorded. Leukotriene E<sub>4</sub> (LTE<sub>4</sub>) urinary concentrations were measured by enzyme immunoassay 4 hours after AMP challenge. Results: Montelukast pretreatment provided highly significant protection against adenosine induced bronchoconstriction, with geometric mean PC<sub>20</sub>AMP values of 52.6 mg/ml (95% CI 35.2 to 78.7) after placebo and 123.9 mg/ml (95% CI 83.0 to 185.0) after montelukast (p=0.006). The geometric mean of the montelukast/placebo PC<sub>20</sub>AMP ratio was 2.4 (95% CI 1.3 to 4.2). Montelukast had no significant effect on 4 hour urinary excretion of LTE<sub>4</sub> compared with placebo. Conclusions: Selective <i>CysLT</i><sub>1</sub> receptor antagonism with montelukast provides highly significant protection against AMP induced bronchoconstriction in patients with atopic asthma, implying that cysteinyl leukotrienes are generated from airway mast cells through preferential activation of their A<sub>2B</sub> receptors.
Investigating lexical entries and rules: A typological perspective
Authors: Greville G. Corbett
Journal: Behavioral and Brain Sciences (1999)

Research into entries and rules based on English is hampered by the fact that crucial factors coincide. Clahsen avoids this problem and demonstrates his claims by working on German. Seen against the background of the immense variety of the world's languages, this successful move is potentially the first of many possible ones: Several languages offer promising configurations of the factors relevant to Clahsen, and others present new challenges.
THE IMPACT OF INTEGRATION OF A COMPUTED TOMOGRAPHY ANNULUS AREA SIZING ALGORITHM ON CLINICAL OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT: A PROSPECTS. MULTICENTER, CONTROLLED TRIAL
Authors: Ronald K. Binder, John Webb, Marina Urena, Nicolaj Hansson, Josep Rodes–Cabau, Bjarne L. Norgaard, Philippe Pibarot, Marco Barbanti, Eric Larose, Melanie Freeman, Eric Dumont, Christopher Thompson, Sergio Pasian, Giang Nguyen, Rekha Raju, Stefan Toggweiler, Alexander B. Willson, David Wood, Jonathon Leipsic
Journal: Journal of the American College of Cardiology (2013)
Doctors' faith in the GMC falls, while the public's rises
Authors: Madeleine Brettingham
Journal: BMJ (2006)

Doctors' trust in the UK General Medical Council is falling, while public confidence in medical regulation is at its highest point in years, says a new survey that shows a shift in the GMC's public profile.

A year ago, 39% of doctors and about one half of patients lacked confidence in the way that medicine was regulated. In 2006, two thirds of patients say that they are happy with the system whereas nearly one half of doctors have lost trust in it. The poll was of more than 400 doctors and almost 1000 members of the public.

The GMC's latest …
A PLEA FOR A MORE FUNDAMENTAL METHOD IN MEDICAL TEACHING
Authors: ROBERT W. LOVETT
Journal: JAMA (1918)

The recognition of the specialties of medicine made by the Surgeon-General of the United States Army in the early months of the present war represents a step of importance in the progress of medicine, and will obviously promote the efficient care of the wounded. It must to a greater or less extent have an effect on the future of medicine, and it is not unlikely that it may modify medical education, especially as some of the medical schools have in the past few months had experience in the intensive training of groups of military surgeons in the special branches, an experience which in my case has modified extensively my views as to the best methods of teaching. The experience mentioned has consisted in being associated with four such intensive courses, three at the Harvard Graduate School of Medicine and one at the Army Medical School in Washington. These courses were
Extracellular action of adenosine and the antagonism by aminophylline on the atrioventricular conduction of isolated perfused guinea pig and rat hearts.
Authors: L Belardinelli, R A Fenton, A West, J Linden, J S Althaus, R M Berne
Journal: Circulation Research (1982)

Adenosine is known to cause atrioventricular block by slowing conduction through the atrioventricular node, thereby lengthening the atria to His (A-H) interval.To test the hypothesis that the increase in atrioventricular conduction delay produced by adenosine is mediated at an extracellular site, the efficacy of nucleoside transport inhibitors in preventing cellular adenosine uptake was correlated with their ability to potentiate the atrioventricular block and prolong the A-H interval.The antagonism of aminophylline and adenosine also was examined.Since methylxanthines are known to inhibit cyclic nucleotide phosphodiesterase, to release catecholamines from nerve terminals, and to block adenosine receptors, it was determined whether the ability of aminophylline to reverse the adenosine-induced prolongation of the atrial-His interval and atrioventricular block was associated with an increase in myocardial cyclic AMP and/or release of norepinephrine.The atrial-His conduction time and adenosine uptake and release were determined in isolated perfused guinea pig and rat hearts.The nucleoside transport inhibitors dipyridamole, nitrobenzylthioinosine, and diazepam caused a dose-dependent decrease in the uptake of 14 Cadenosine.Nitrobenzylthioinosine was the most and diazepam the least effective in blocking adenosine uptake.Dipyridamole (5 X 10~6 M) inhibited uptake by 97% and increased adenosine levels in the perfusate.These effects were strongly correlated with a potentiation of adenosineinduced atrial-His prolongation (r = 0.99).The oligonucleotide, adenyl (3'-5')9-adenosine, an agent restricted to the extracellular space as a result of its large molecular size, was found to be 1.8 times more potent per mole than free adenosine.2'-Deoxyadenosine and N 6 -methyladenosine, respectively, were found to have either no effect or an effect similar to that of free adenosine on the atrial-His interval.Aminophylline (1 X 1CT 5 to 3 X 10~5 M) in the presence or absence of propranolol antagonized in a dose-dependent and competitive manner the prolongation of the atrial-His interval and atrioventricular block caused by adenosine.In concentrations up to 10~4 M, aminophylline did not cause any accumulation of myocardial cyclic AMP, nor did it increase the release of norepinephrine.We conclude (1) that the effect of adenosine on atrioventricular conduction results from binding to an extracellular receptor that resembles the R site described for other actions of adenosine in different tissues, and (2) that the reversal of adenosine-induced increases in atrioventricular conduction delay by aminophylline is not due to phosphodiesterase inhibition and/or release of norepinephrine from nerve terminals.(
Relationship between plasma level of cardiotrophin-1 and left ventricular mass index in patients with dilated cardiomyopathy
Authors: Takayoshi Tsutamoto, Atsuyuki Wada, Keiko Maeda, Naoko Mabuchi, Masaru Hayashi, Takashi Tsutsui, Masato Ohnishi, Masanori Fujii, Takehiro Matsumoto, Takashi Yamamoto, Xinwen Wang, Shigeru Asai, Tetsuo Tsuji, Hitoshi Tanaka, Yoshihiko Saito, Koichiro Kuwahara, Kazuwa Nakao, Masahiko Kinoshita
Journal: Journal of the American College of Cardiology (2001)
Comparison of the clinical features and clinical course of antimitochondrial antibody-positive and -negative primary biliary cirrhosis
Authors: P Invernizzi, A Crosignani, P M Battezzati, G Covini, G De Valle, A Larghi, M Zuin, M Podda
Journal: Hepatology (1997)

Reports from North America and Northern Europe have suggested that antimitochondrial antibody (AMA) negative primary biliary cirrhosis (PBC) is a distinct chronic cholestatic liver disease with high prevalence of serum non-organ-specific autoantibodies other than AMA. To evaluate if such a peculiar serum immunoreactivity is associated with clinically relevant characteristics, we reviewed our experience with 297 Italian patients who have had a clinical and histological diagnosis of PBC and were regularly followed-up at our Center from June 1974 to June 1994. AMA-negative and AMA-positive patients were compared in terms of biochemical and clinical features, and clinical outcome of the disease. At presentation, 30 of 297 patients (10%) tested negative for AMA by indirect immunofluorescence. Six of them tested positive for antimitochondrial M2 antibodies (AMA-M2) by immunoblotting analysis, therefore, diagnosis of AMA-negative PBC was made in 24 patients (8%). At the initial visit, AMA-negative and AMA-positive patients were similar in terms of biochemical and clinical features. Antinuclear and anti-smooth-muscle antibodies (ANA and ASMA) were more frequently positive in the AMA-negative patients (71% vs. 31%, and 37% vs. 9%; both P = .0002). Incidence of complications of cirrhosis and development of liver failure resulting in death or referral for liver transplantation did not differ significantly between the two populations. In conclusion, data from this historical cohort study suggest that the distinct serological features of AMA-negative PBC are not associated with substantial differences in the clinical spectrum or course of the disease.
South Africa sidelines its health minister on AIDS issues
Authors: Pat Sidley
Journal: BMJ (2006)

The South African government has effectively sidelined its controversial health minister, Manto Tshabalala-Msimang, as the country's public face of policy on HIV and AIDS.

Dr Tshabalala-Msimang has denied that she has in any way been sidelined or silenced, claiming that she can and does say what she wants as the minister responsible for health.

However, the cabinet seems to have given the task of developing policy on AIDS to the deputy president, Phumzile Mlambo-Ngcuka. A cabinet statement issued after a meeting at which President Thabo Mbeki was reportedly not present confirmed the deputy's role in the drawing up and presenting of AIDS policies.

President Mbeki's absence …
THE RÔLE OF THE CIVILIAN PHYSICIAN IN THE TRAINING OF CITIZEN SOLDIERS
Authors: M. W. IRELAND
Journal: JAMA (1923)

The scientific advances of the last century have served to render the science and art of medicine an essential and inherent part of the military art, and no feasible plan for national defense can be devised and carried to a successful conclusion without the cooperation of the medical profession. The individual soldier constitutes the basic unit of any fighting force, and his ability to perform the duties that he may be called on to undertake in the defense of his country is fundamentally dependent on his physical fitness. Of all men, only the physician possesses the knowledge that will enable him to select from the great mass of the national man power those individuals who are physically fit for military service, and to eliminate the incompetents whose presence would tend to prevent the successful outcome of military operations. However, the responsibilities of the medical profession do not terminate with the
Cigarette Smoking and Body Weight
Authors: Nancy A. Rigotti
Journal: New England Journal of Medicine (1989)

IT has been 25 years since the Surgeon General's Advisory Committee on Smoking and Health released its landmark report summarizing what was then known about the health consequences of cigarette smoking. That widely publicized document directed the attention of Americans to the dangers of smoking and launched public health efforts to reduce tobacco use. In the ensuing quarter century, remarkable progress has been made against this deadly habit, with dramatic changes in public knowledge, attitudes, and behavior. Among adults, the prevalence of smoking fell from 40 percent in 1965 to 29 percent in 1987.1 Nearly half the adults alive who . . .