tbuckley/cabot-search huggingface dataset:
On Call Before Christmas
Authors: John G. Sandness
Journal: JAMA (1993)

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
The impact of new drugs on management of glaucoma in Scotland: observational study
Authors: D N Bateman, R Clark, A Azuara-Blanco, M Bain, J Forrest
Journal: BMJ (2001)

studies suggest that the beliefs and values of people in lower socioeconomic groups, such as their tolerance and acceptance of the behavioural and social aspects of the disorder 18 and their sense of low control or powerlessness, 29 may help to explain the observed socioeconomic inequalities.A "contact" study found that low social class at birth increased the duration of untreated psychosis. 30If, as we suspect, people with schizophrenia from lower social classes are not presenting to family doctors, those with the least financial resources and opportunities for employment may be the most exposed to the adverse effects of untreated psychosis.This delay may, at least partially, explain why people from lower social class have a less favourable outcome. 13Efforts to reduce the duration of untreated psychosis through earlier detection should be particularly focused on people in lower social classes.In addition, researchers should be careful to adjust for social class at birth if using age at first presentation as a measure of age at onset of schizophrenia.We thank the St John of God Order and the Stanley Foundation for their support and staff of the General Register Office, Dublin, for help in locating birth registration records.
Occupational Health Medical Officers in the Hospital Service
Authors: D. N. FitzGerald
Journal: BMJ (1975)

the leadership was proved to be wrong.When we, the General Medical Services Commnittee negotiators, met her she was very reasonable and gave us assurances.However, we would have been pilloried, and rightly so, if we had accepted them without warning her that the collection of resignations was likely.Under stress politicians unite but our pro- fession fragments.Dr.
SYNTAX score II predicted mortality after PCI or CABG in complex CAD better than SYNTAX score
Authors: Richard G. Bach
Journal: Annals of Internal Medicine (2013)

Source Citation Farooq V, van Klaveren D, Steyerberg EW, et al. Anatomical and clinical characteristics to guide decision making between coronary artery bypass surgery and percutaneous coronary intervention for individual patients: development and validation of SYNTAX score II. Lancet. 2013;381:639-50. 23439103
Robotic Versus Laparoscopic Adrenalectomy: A Systematic Review and Meta-analysis
Authors: Luis Felipe Brandao, Riccardo Autorino, Humberto Laydner, Georges-Pascal Haber, Idir Ouzaid, Marco De Sio, Sisto Perdonà, Robert J. Stein, Francesco Porpiglia, Jihad H. Kaouk
Journal: European Urology (2013)
A mutation in the dystrophin gene selectively affecting dystrophin expression in the heart.
Authors: F Muntoni, L Wilson, G Marrosu, M G Marrosu, C Cianchetti, L Mestroni, A Ganau, V Dubowitz, C Sewry
Journal: Journal of Clinical Investigation (1995)

We have previously shown in a large X-linked pedigree that a deletion removing the dystrophin muscle promoter, the first muscle exon and part of intron 1 caused a severe dilated cardiomyopathy with no associated muscle weakness. Dystrophin expression was present in the muscle of affected males and transcription studies indicated that this dystrophin originated from the brain and Purkinje cell isoforms, upregulated in this skeletal muscle. We have now studied dystrophin transcription and expression in the heart of one member of this family. In contrast to the skeletal muscle, dystrophin transcription and expression were absent in the heart, with the exception of the distal Dp71 dystrophin isoform, normally present in the heart. The 43- and 50-kD dystrophin-associated proteins were severely reduced in the heart, despite the presence of Dp71, but not in skeletal muscle. The absence of dystrophin and the down-regulation of the dystrophin-associated proteins in the heart accounted for the severe cardiomyopathy in this family. The mutation present in these males selectively affects dystrophin expression in the heart; this could be secondary to the removal of cardiac-specific regulatory sequences. This family may represent the first example of a mutation specifically affecting the cardiac expression of a gene, present physiologically in both the skeletal and cardiac muscles.
UK doctor who worked in US after being struck off by GMC has licence withdrawn
Authors: C. Dyer
Journal: BMJ (2014)

A British anaesthetist who reinvented himself as a minimally invasive spinal surgeon in the United States after his 2001 conviction in the United Kingdom for gross negligence manslaughter has had his licence to practise in New Jersey revoked for posing a danger to the public.

Richard Kaul has been stripped of his licence by the state board of medical examiners and ordered to pay $300 000 (£179 000; €219 000) in civil penalties …
Letter: Assessment of preoperative cases.
Authors: W N Rollason
Journal: BMJ (1976)

proximal jejunum to absorb glucose.The trapping of available carbohydrate within intact cell walls and alterations of the physical characteristics of the intraluminal contents by unabsorbable carbohydrates may both result in reduced availability of glucose for absorption in the proximal small bowel while increasing its availability in the distal small bowel.The adaptation of the proximal jejunum may then be reversed, resulting in a flatter glucose tolerance curve.It is possible that some diabetic patients might benefit from treatment with wheat bran or other dietary fibres and unavailable carbohydrates.
Limitations of measurement of transdiaphragmatic pressure in detecting diaphragmatic weakness.
Authors: A De Troyer, M Estenne
Journal: Thorax (1981)

Intrathoracic (oesophageal), intra-abdominal (gastric), and transdiaphragmatic (Pdi) pressures were studied in 20 untrained, healthy subjects during a full inspiration and repeated maximal static inspiratory efforts. The pattern of pressure generation during these two types of respiratory manoeuvre was highly reproducible in each subject. By contrast, it varied over a wide range among individuals. In particular a substantial number of subjects naturally had a strong recruitment of their intercostal and accessory muscles and thus, low Pdi values, during both slowly performed and forceful inspiratory manoeuvres. These observations make it clear that Pdi values, as usually obtained, are commonly open to misinterpretation. For this approach to ensure a reliable assessment of diaphragmatic function and detect diaphragm weakness adequately, it appears essential either to monitor the abdominothoracic configuration or to standardise the pattern of respiratory muscle contraction.
REFLEX APNEA AND CARDIAC INHIBITION IN OPERATIONS ON THE RESPIRATORY TRACT.
Authors: W. G. B. HARLAND
Journal: JAMA (1904)

form of intoxication.Its symptoms are not so pro¬ nounced or so easy of recognition as in the acute form, but the eyes, digestive apparatus and nervous system un¬ doubtedly suffer.15.The use of ethyl or grain alcohol in the arts, as in the manufacture of varnishes, as a burn¬ ing fluid, for "stiffening" hats, lacquering brass, etc., is without danger to life or eyesight.By adding to it a small percentage of naphthalin, for example, the fluid would be undrinkable.A combination of ethylic alcohol with 10 per cent, of wood spirit would answer the same purpose.Such a mixture is the "methylated spirit" of Great Britain, where not a sin¬ gle case of acute poisoning or amaurosis from methyl alcohol is recorded, in spite of the extensive commercial use of methylated preparations in the British Isles.16.The treatment of methyl alcohol intoxication con¬ sists chiefly in getting rid of the poison from the stom¬ ach and intestines by means of the stomach-pump and rectal injections; stimulants, especially ethyl alcohol, strychnia and coffee ; heat to the body and extremities. 17.The treatment of the amaurosis is unsatisfactory.In the early stages pilocarpin and potassium iodid ; later, strychnia hypodermically and by the mouth.
Gene Therapy for Leber's Congenital Amaurosis is Safe and Effective Through 1.5 Years After Vector Administration
Authors: Francesca Simonelli, Albert M Maguire, Francesco Testa, Eric A Pierce, Federico Mingozzi, Jeannette L Bennicelli, Settimio Rossi, Kathleen Marshall, Sandro Banfi, Enrico M Surace, Junwei Sun, T Michael Redmond, Xiaosong Zhu, Kenneth S Shindler, Gui-Shuang Ying, Carmela Ziviello, Carmela Acerra, J Fraser Wright, Jennifer Wellman McDonnell, Katherine A High, Jean Bennett, Alberto Auricchio
Journal: Molecular Therapy (2009)

The safety and efficacy of gene therapy for inherited retinal diseases is being tested in humans affected with Leber's congenital amaurosis (LCA), an autosomal recessive blinding disease. Three independent studies have provided evidence that the subretinal administration of adeno-associated viral (AAV) vectors encoding RPE65 in patients affected with LCA2 due to mutations in the RPE65 gene, is safe and, in some cases, results in efficacy. We evaluated the long-term safety and efficacy (global effects on retinal/visual function) resulting from subretinal administration of AAV2-hRPE65v2. Both the safety and the efficacy noted at early timepoints persist through at least 1.5 years after injection in the three LCA2 patients enrolled in the low dose cohort of our trial. A transient rise in neutralizing antibodies to AAV capsid was observed but there was no humoral response to RPE65 protein. The persistence of functional amelioration suggests that AAV-mediated gene transfer to the human retina does not elicit immunological responses which cause significant loss of transduced cells. The persistence of physiologic effect supports the possibility that gene therapy may influence LCA2 disease progression. The safety of the intervention and the stability of the improvement in visual and retinal function in these subjects support the use of AAV-mediated gene augmentation therapy for treatment of inherited retinal diseases.
Lifelong Left Ventricular Remodeling of Hypertrophic Cardiomyopathy Caused by a Founder Frameshift Deletion Mutation in the Cardiac Myosin-Binding Protein C Gene Among Japanese
Authors: Toru Kubo, Hiroaki Kitaoka, Makoto Okawa, Yoshihisa Matsumura, Nobuhiko Hitomi, Naohito Yamasaki, Takashi Furuno, Jun Takata, Masanori Nishinaga, Akinori Kimura, Yoshinori L. Doi
Journal: Journal of the American College of Cardiology (2005)
Finger counting: The missing tool?
Authors: Michael Andres, Samuel Di Luca, Mauro Pesenti
Journal: Behavioral and Brain Sciences (2008)

Abstract Rips et al. claim that the principles underlying the structure of natural numbers cannot be inferred from interactions with the physical world. However, in their target article they failed to consider an important source of interaction: finger counting. Here, we show that finger counting satisfies all the conditions required for allowing the concept of numbers to emerge from sensorimotor experience through a bottom-up process.
Nursing Homes: A Review
Authors: BERNARD A. STOTSKY
Journal: American Journal of Psychiatry (1966)

Recent developments, such as the passage of Medicare, have drawn attention to the need for evaluating existing posthospital extended care services, of which nursing homes are presently a major part. The author traces the evolution of the nursing home and reviews the literature describing nursing home services in the areas of general medical care, rehabilitation, psychiatric therapy, and psychiatric evaluation. The future of nursing homes, he concludes, depends in large part upon their ability to broaden and professionalize their functions beyond the provision of basic custodial care.
An unexpected finding after a fall from a horse
Authors: S. Raby, D. Greaves, J. Padayatty, B. Huntly
Journal: BMJ (2013)

A 37 year old jockey was admitted with left sided abdominal pain and fullness one week after a fall from a horse. Before this he had been fit and well. On examination, he was tender in the left upper outer quadrant of his abdomen and his blood pressure was 90/55 mm Hg. A computed tomography scan showed an area of active bleeding in the parenchyma of the spleen and a large subcapsular haematoma. Blood tests showed a white blood cell count of 259×109/L (reference range 4-11) with the following differential: blasts 3%, promyelocytes 11%, myelocytes 28%, metamyelocytes 19%, neutrophils 21%, basophils 10%, lymphocytes 4%, and eosinophils 4%. His haemoglobin was 109 g/L (130-180), mean cell volume was 80 fL (76-96), and platelets were 201×109/L (150-400). Lactate dehydrogenase was 563 IU/L (70-250; 1 mmol/L=9.01 mg/dL) and uric acid was 600 µmol/L (300-470; 1 µmol/L=0.03 mg/dL). He underwent emergency splenectomy. Macroscopically, the spleen was greatly enlarged, at 22×13×10 cm, and microscopically it showed a dense infiltrate of left shifted immature myeloid cells. ### 1 What are the possible causes of a raised white blood cell count? #### Short answer A white blood cell count greater than 50×109/L is caused by a primary haematological disease or, less commonly at such a high value, a leukemoid reaction. A leukemoid reaction may be lymphoid or myeloid in nature and is a physiological response of the bone marrow to a strong stimulus, such as infection, drugs, or an underlying solid cancer. #### Long answer Causes of leucocytosis (>11×109/L) can be classified according to cell lineage (box 1). #### Box 1 Causes of leucocytosis (>11×109/L) ##### Neutrophilia
When Competent Patients Make Irrational Choices
Authors: D W Brock, S A Wartman
Journal: New England Journal of Medicine (1990)

In recent years, physicians and patients have tended to move toward shared decision making. Although it sounds reasonable on the surface that patients and physicians should collaborate in making decisions about medical care, surprisingly little attention has been given to the complex and troubling issues that can arise. In particular, what does shared decision making imply for a physician's responsibilities when an apparently competent patient's choice appears to be irrational? A discussion of this issue requires a taxonomy of the different sources and forms of irrational decision making. We believe such a taxonomy should include the bias toward the present . . .
Interactions Between Vascular Wall and Perivascular Adipose Tissue Reveal Novel Roles for Adiponectin in the Regulation of Endothelial Nitric Oxide Synthase Function in Human Vessels
Authors: Marios Margaritis, Alexios S. Antonopoulos, Janet Digby, Regent Lee, Svetlana Reilly, Patricia Coutinho, Cheerag Shirodaria, Rana Sayeed, Mario Petrou, Ravi De Silva, Shapour Jalilzadeh, Michael Demosthenous, Constantinos Bakogiannis, Dimitris Tousoulis, Christodoulos Stefanadis, Robin P. Choudhury, Barbara Casadei, Keith M. Channon, Charalambos Antoniades
Journal: Circulation (2013)

Background— Adiponectin is an adipokine with potentially important roles in human cardiovascular disease states. We studied the role of adiponectin in the cross-talk between adipose tissue and vascular redox state in patients with atherosclerosis. Methods and Results— The study included 677 patients undergoing coronary artery bypass graft surgery. Endothelial function was evaluated by flow-mediated dilation of the brachial artery in vivo and by vasomotor studies in saphenous vein segments ex vivo. Vascular superoxide (O 2 − ) and endothelial nitric oxide synthase (eNOS) uncoupling were quantified in saphenous vein and internal mammary artery segments. Local adiponectin gene expression and ex vivo release were quantified in perivascular (saphenous vein and internal mammary artery) subcutaneous and mesothoracic adipose tissue from 248 patients. Circulating adiponectin was independently associated with nitric oxide bioavailability and O 2 − production/eNOS uncoupling in both arteries and veins. These findings were supported by a similar association between functional polymorphisms in the adiponectin gene and vascular redox state. In contrast, local adiponectin gene expression/release in perivascular adipose tissue was positively correlated with O 2 − and eNOS uncoupling in the underlying vessels. In ex vivo experiments with human saphenous veins and internal mammary arteries, adiponectin induced Akt-mediated eNOS phosphorylation and increased tetrahydrobiopterin bioavailability, improving eNOS coupling. In ex vivo experiments with human saphenous veins/internal mammary arteries and adipose tissue, we demonstrated that peroxidation products produced in the vascular wall (ie, 4-hydroxynonenal) upregulate adiponectin gene expression in perivascular adipose tissue via a peroxisome proliferator-activated receptor-γ–dependent mechanism. Conclusions— We demonstrate for the first time that adiponectin improves the redox state in human vessels by restoring eNOS coupling, and we identify a novel role of vascular oxidative stress in the regulation of adiponectin expression in human perivascular adipose tissue.
Word of warning to junior ophthalmologists
Authors: B Hopkisson
Journal: BMJ (1995)

EDITOR,—I recently spent several humbling and depressing hours trying to shortlist half a dozen applicants for a career registrar post in ophthalmology. There were 30 applications for the one post, which is only the 11th such post to be advertised in the BMJ during the first eight months of 1994.

Twenty four applicants had an FRCS or FRCOphth; four also had an MRCP; three had an MSc; one had an MD; one had an MRCGP; many were multiple prize winners; and most had multiple publications. Any one of the applicants would have had no problem in obtaining a registrar …
Dehydroepiandrosterone for Adrenal Insufficiency
Authors: Wolfgang Oelkers
Journal: New England Journal of Medicine (1999)

The human adrenal cortex secretes not only the essential hormones cortisol and aldosterone, but also dehydroepiandrosterone and large amounts of dehydroepiandrosterone sulfate. The serum concentration of dehydroepiandrosterone sulfate is 20 times that of serum cortisol, and the concentration of dehydroepiandrosterone is 1/20 that of cortisol. The very high concentration of dehydroepiandrosterone sulfate reflects its high rate of secretion and low rate of metabolic clearance. Dehydroepiandrosterone and its sulfate are interconvertible. The sulfate is mainly formed from dehydroepiandrosterone in the zona reticularis of the adrenal gland and in the liver by a sulfotransferase, and many organs that are targets of androgens . . .
Erythropoietin therapy after allogeneic hematopoietic cell transplantation: a prospective, randomized trial
Authors: Aurélie Jaspers, Frédéric Baron, Évelyne Willems, Laurence Seidel, Kaoutar Hafraoui, Gaetan Vanstraelen, Christophe Bonnet, Yves Beguin
Journal: Blood (2014)
Meta-analysis of rat lung tumors from lifetime inhalation of diesel exhaust.
Authors: P A Valberg, E A Crouch
Journal: Environmental Health Perspectives (1999)

Estimating the carcinogenic potential of exposure to diesel-engine exhaust particulates (DEPs) is problematic. In rats, high concentrations of DEPs (> 1,000 microg/m(3)) inhaled over a lifetime result in excess lung tumors. However, data for rats exposed to DEP at concentrations not associated with lung overload are consistent with no tumorigenic effect. Individual rat studies have only a limited number of exposure groups; therefore, we combined the tumor data from eight chronic inhalation studies in a meta-analysis. Statistical analysis identified a threshold of response between 200 and 600 microg/m(3) average continuous lifetime exposure, consistent with biological-effect thresholds reported by other investigators. Our exposure-response analysis of all rats with < 600 microg/m(3) average continuous lifetime exposure found no tumorigenic effect of DEP in these rats. When we evaluated all rat studies, accounted for a threshold and for inhomogeneity between experiments, and expressed the results in terms of human unit risk (UR), we found a negative maximum-likelihood human UR of -32 (times) 10(-6) per microgram per cubic meter (microg/m(3)), but this was not statistically significantly different from zero. Extrapolating the rat upper 95th percentile confidence limit to humans gave an upper-bound human UR of 9.3 (times) 10(-6) per microg/m(3)]. This upper-bound human UR, derived from all of the data points (including 1,087 animals below the estimated threshold and 1,433 in the control groups), falls entirely below the range of estimates derived from lung-overloaded rats or from epidemiology of railroad workers. Our meta-analysis of the low-exposure data in rats does not support a lung cancer risk for DEP exposure at nonoverload conditions. Average ambient concentrations of DEP (0-3 microg/m(3)) are < 1% of the concentration associated here with a threshold of tumor response in the rat bioassay.
Priorities in Parkinson's disease research
Authors: Wassilios G. Meissner, Mark Frasier, Thomas Gasser, Christopher G. Goetz, Andres Lozano, Paola Piccini, José A. Obeso, Olivier Rascol, Anthony Schapira, Valerie Voon, David M. Weiner, François Tison, Erwan Bezard
Journal: Nature Reviews Drug Discovery (2011)
The Sorcerer's Apprentice: Medical Miracles and Other Disasters
Authors: Pamela Kay DeClaire
Journal: JAMA (1989)

Hats off to Sallie Tisdale on this outstanding book that examines the cold, hard, and sometimes frightening issues of bioethics. Tisdale describes medical ethics as  concept doomed to futility. It is too small to contain the problem it hopes to solve.... It is the reaction of last resort, the thumb in a dike.  Tisdale is able to beautifully articulate the moral dilemmas faced by health care givers each day, but she particularly focuses on those dilemmas faced by individual nurses. Her descriptions of situations, patients' reactions to their illnesses, and interactions between patients and medical personnel are painfully accurate.  Each chapter centers on one or two patients and involved care givers. In a very moving and emotional way, Tisdale narrates the patients' struggle and agony with their illnesses, the grief, the loss of control, and cumulative medical and health care experiences. She explores the areas of a kidney dialysis