tbuckley/cabot-search huggingface dataset:
Do-Not-Resuscitate Decisions in a Community Hospital
Authors: Helene Levens Lipton
Journal: JAMA (1986)

To investigate intensity of care after do-not-resuscitate (DNR) designation, the implications of DNR decisions were analyzed in a 450-bed community hospital. All 333 patients who received written DNR orders in a six-month period were studied. These 333 patients constituted 3% of all discharges, but 70% of patients who died in hospital. Treatment goals for care provided after DNR designation were not documented in 60% of the patients' medical records. Intensity of care, as measured by hospital charges, decreased significantly after DNR designation. Although many types of care were provided after DNR, most were noninvasive. These findings suggest that although many DNR policies consider DNR status fully compatible with aggressive care, in actual clinical practice the DNR order usually leads to less intensive care. Results further suggest that the DNR decision should properly become part of a comprehensive patient care plan individualizing treatment goals for patients.A study was conducted to examine the intensity of care given to 333 patients in a 450-bed community hospital subsequent to their designation as do-not-resuscitate (DNR) patients. Treatment plans were not provided for 60% of the DNR patients; intensity of care, as measured by hospital charges, decreased; and type of care varied greatly, in a manner unrelated to age and not strictly consistent with prognosis. The findings suggest that clinical practice does not accord with the policy that DNR status ought to be compatible with aggressive care. The authors propose that perhaps DNR decisions should be considered as part of a general patient care plan that shifts from "therapeutic" or "aggressive" care to "supportive" or "conservative" care, ideally agreed on by patient, family, and physician.
A Phase II, Randomized, Double-Blind, Multicenter, Based on Standard Therapy, Placebo-Controlled Study of the Efficacy and Safety of Recombinant Human Neuregulin-1 in Patients With Chronic Heart Failure
Authors: Runlin Gao, Jian Zhang, Liuquan Cheng, Xuesi Wu, Wei Dong, Xinchun Yang, Tianchang Li, Xifu Liu, Yabei Xu, Xinyan Li, Mingdong Zhou
Journal: Journal of the American College of Cardiology (2010)
Racial Disparities in Rates of Pressure Ulcers in Nursing Homes and Site of Care
Authors: Nancy Bergstrom, Susan D. Horn
Journal: JAMA (2011)

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
Effect of paracetamol on gastric mucosa.
Authors: R J Ivey, G R Silvoso, W J Krause
Journal: BMJ (1978)

The effect of paracetamol on the gastric mucosa was examined in seven healthy volunteers. The dose used (2 g instilled in 100 ml isotonic saline) was equivalent to about six tablets taken with water. Biopsy specimens were taken before and 10 and 60 minutes after instillation. The mean incidence of damaged surface cells in the control period was 1.7%. Ten minutes after instillation 3.5% of the surface cells were damaged. This increase was not significant. Light microscopy showed focal cell disruption and infiltration of red blood cells. Scanning electronmicroscopy showed minimal loss of normal cell apices. No erosions were seen on microscopy. Biopsy specimens taken 60 minutes after paracetamol showed similar changes. These findings differ appreciably from the extensive cell damage and microscopic erosions caused by therapeutic doses of 600 mg (two tablets) of aspirin. We conclude that large "analgesic" doses of paracetamol cause minimal ultrastructural changes in normal human gastric mucosa. The continued use of paracetamol in place of aspirin appears to be justified when there is a possibility of gastric mucosal injury.
Pyogenic Granuloma of the Esophagus Treated by Endoscopic Removal
Authors: N. Okada, T. Matsumoto, K. Kurahara, K. Kanamoto, T. Fukuda, Y. Okada, M. Lida
Journal: Endoscopy (2003)

A 56-year-old man was referred to our institution with symptoms of chest discomfort, which had persisted for a month. The physical examination was unremarkable, and laboratory data revealed no abnormalities. A barium meal examination showed a round radiolucent area in the middle third of the esophagus (Figure [1]). Upper endoscopy revealed a sessile, protruding lesion, which was brownish-red with a white coating on the top (Figure [2]). In view of the patient's symptoms and the risk of bleeding, endoscopic mucosal resection of the tumor was carried out, without any complications. Histologically, the tumor was located in the proper mucosal layer, covered by normal squamous epithelium (Figure [3]). The resected margin was free of tumor cells. High-power magnification showed that the tumor was composed of various-sized capillaries proliferating in a lobular fashion, accompanied by an edematous stroma. On the basis of these findings, the tumor was diagnosed as a pyogenic granuloma. A follow-up endoscopic examination 6 months later revealed a scarred ulcer, with no evidence of recurrence. In the field of dermatology and oral surgery, pyogenic granuloma is a common neoplasm, which is considered to be benign in nature. However, the tumor is known to recur frequently after resection [1] [2]. The occurrence of pyogenic granuloma in the gastrointestinal tract is extremely rare, and only nine such cases have been reported in the literature [3] [4] [5]. Pyogenic granulomas of the gastrointestinal tract have been treated using surgical resection or endoscopic snare polypectomy, due to bleeding or an increase in size. Recurrences of gastrointestinal pyogenic granuloma have not previously been described in detail, and the tumor in this case was removed completely using endoscopic mucosal resection, with no sign of recurrence at 6 months. This procedure may make it possible to resect pyogenic granuloma completely, as confirmed in this case.
Measurement of Pulmonary Edema in Valvular Heart Disease
Authors: MICHAEL MCCREDIE
Journal: Circulation (1967)

Pulmonary extravascular fluid volume (PEV) has been estimated by using a double isotope technique in nine normal subjects and 45 patients with valvular heart disease. The method was reproducible, the standard deviation being±15.2 ml/m 2 , or 11.2% of the mean. Groups of patients with aortic and mitral valve disease had significantly higher values of PEV than normal persons; some patients with pulmonary stenosis had subnormal values. There was a relationship between PEV and the severity of dyspnea; all patients with an abnormally high PEV were class II or worse. Of the 18 patients with abnormally high PEV, only seven had radiological evidence of chronic pulmonary edema. PEV was independent of blood flow but was clearly related to the level of pulmonary intravascular pressure. PEV was only significantly elevated if left atrial mean pressure exceeded 12 mm Hg and was invariably raised if it exceeded 25 mm Hg. No relationship of PEV to pulmonary vascular resistance was evident in this study.
Of Lice and Men
Authors: Melanie M. Pickett, Melissa A. Muszynski, Scott A. Norton
Journal: JAMA Dermatology (2014)

Lice have annoyed hominids for millions of years, since long before Pediculushumanusbranched,onceormultiple times, into its capitisand corporis ecotypes. Although head louse infestations receive a particularly bad reputation frommedia andmothers, this condition in reality is morepesky thanpestilent.Head licecarrynegligible riskofdisease transmission and therefore have minimal morbidity. Popular media, however, portray head lice as an affliction of the unclean anduncouth. Televisionoftendepicts pediculosis as a disgrace invitedby lapsedpersonal hygiene and fully deserving of society’s scorn. For example, in an episode of The Office (American version, episode 9.10), the protagonist, Pam, conceals that she contracted head lice from her3-year-olddaughter.Anensuingoutbreakofheadlice inherofficefinds blamedeflectedontoaninnocentcharacterwhoissuspectbecauseofpast hygienic transgressions.Athirdcharacter,whenaskedtorefrain fromvilifying her louse-ridden coworkers, declares, “I have not yet begun to shame,” thus capturing the stigma engendered by themedia. An episode of South Park (episode 11.3) also addresses the stigma of pediculosis, but ends, as usual, with a quasi-lesson for viewers. Like The Office, this episode is a whodunit, seeking to identify which character introduced head lice into the classroom. At the episode’s conclusion, all discover that every child is infested with head lice, a more appropriatecharacterizationof theegaliteet fraterniteofpediculosisamong school-aged children. These showsperpetuate thenotion thatpediculosis is shameful and promulgateahostofmisinformation.Thecommunicablenatureofhead lice is exaggerated in both episodes, seen when an Office character dons a Hazmat suit to protect himself from contagion and South Park’s children pummel their infested classmate with soap. Although viewers may not take the comedic portrayal of head lice seriously,myths about head lice appear on “fact-based” shows, too. For example, on the forensic crime series, CSI (episode 9.3), investigators presumethat anunidentifiedcorpse is thatof ahomelessmanpartlybecause of lice found throughout his hair. Television also perpetuates myths about treating head lice. For example,usingmayonnaisetocurehead lice inTheOffice,whileperhapsnot harmful, is an ineffective remedy. Pam’s admission that shewas “up all night disinfecting every sheet, towel, toy, item of clothing, in the entire house”encouragessanitationmeasuresfarbeyondrecommendedactions. In contrast to television’s frequentportrayal ofhead lice as a scourge of theGreatUnwashed,many children’s books are correct and informative. A search of current children’s literature finds many picture books designed to educate children and families about head lice and to dispel its stigma. Similar attempts by broadcast media to correct false beliefs about this condition could mollify popular sentiments toward this benign and nearly universal condition.
Depression and Psychosomatic Illness
Authors: Wilfred Dorfman
Journal: Psychotherapy and Psychosomatics (1974)

Current concepts of depression recognize that it may have many roots including genetic, constitutional, biochemical, neurophysiological, sociocultural and psychodynamic factors. Depression can be overt and quite evident; yet in many instances it can be masked, hidden by more noticeable somatic symptoms and even somatic disease. Concepts of psychosomatic illness have undergone considerable change in that the 'specificity' theories which prevailed 30 years ago have been superseded by the current belief that all illness is psychosomatic and not limited to a few chosen ones. Depression is often intertwined and interwoven with psychosomatic illness since it can be the trigger that precipitates a somatic illness. It can also be the result.
Cord-Blood Vitamin D Levels and Risk of Recurrent Wheezing, Effect of Sleep-Disordered Breathing on Blood Pressure in Children, and Long-Term Impact of Bronchopulmonary Dysplasia
Authors: Rizwana Popatia, Vidya Pai, Stephanie O. Zandieh
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Recent studies have suggested a strong inverse correlation between maternal intake of vitamin D during pregnancy and the risk of recurrent wheezing in children (2). However, the relationship between cord-blood levels of 25(OH)D and childhood wheezing is unknown. To address this issue, the New Zealand Asthma Cohort did a prospective trial in which the cord-blood levels of 25(OH)D in 922 apparently healthy children were examined and correlated with outcomes, which included parental history of respiratory infection at 3 months of age, wheezing at 15 months of age and annually thereafter till 5 years, and incident asthma diagnosed by 5 years of age. Effects of various potential confounders were assessed using multivariate logistic regression models, thereby increasing the validity of findings. Eighty-nine percent of the children completed the study. The median cord-blood level of 25(OH)Dwas 44 nmol/L.After adjusting for the birth season, 25(OH)D had an inverse association with risk of respiratory infection at 3 months of age (odds ratio, 1 for.75 nmol/L, 1.39 for 25–74 nmol/L, and 2.16 for ,25 nmol/L, with 95% confidence interval). Similarly, 25(OH)D had an inverse linear association with risk of wheezing at 15 months, 3 years, and 5 years of age (all P , 0.05). Every 10-nmol/L increase in cord-blood 25(OH)D lowered cumulative risk of wheeze by the age of 5 years (odds ratio, 0.95). In all models, cord-blood 25(OH)D levels were not associated with either atopic or nonatopic asthma (all P . 0.2). These results were unchanged after adjustment for more than 12 potential confounders. In light of growing literature on the role of vitamin D in innate immunity, this study indicates that improvement in vitamin D status in pregnant women may provide a simple, safe, and inexpensive way to reduce the respiratory infections that often trigger wheezing in early childhood (3). Indistinctiveness of the primary outcomes is the potential limitation of the study, as it was based on parental survey rather than actual medical examination. Further randomized controlled trials are needed to evaluate the outcome of vitamin D supplementation during pregnancy and early childhood on respiratory outcomes and follow-up in late childhood and adulthood to better define this relationship.
Preparation and physicochemical characterization of biodegradable nerve guides containing the nerve growth agent sabeluzole
Authors: Geert Verreck, Iksoo Chun, Yufu Li, Ram Kataria, Qiang Zhang, Joel Rosenblatt, Annelies Decorte, Koen Heymans, Jef Adriaensen, Monique Bruining, Marie Van Remoortere, Herman Borghys, Theo Meert, Jef Peeters, Marcus E. Brewster
Journal: Biomaterials (2004)
Transitional Care From Pediatric to Adult Surgery
Authors: Jessica A. Naiditch, David H. Rothstein
Journal: JAMA Surgery (2014)

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 Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Drug Treatment of Depression
Authors: MONTE L. SCHEINBAUM
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 November 1978Drug Treatment of DepressionMONTE L. SCHEINBAUM, PH.D., M.D.MONTE L. SCHEINBAUM, PH.D., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-89-5-724_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dr. Leo Hollister ("Treatment of Depression with Drugs," Ann Intern Med 89:78-84, 1978) states in his discussion of secondary amine versus tertiary amine tricyclic antidepressants that "Protriptyline and doxepin fit neither chemical classification." This is incorrect since the chemical structure of protriptyline is that of a secondary amine, and doxepin, whose side-chain nitrogen is fully substituted, is clearly a tertiary amine. Selectivity and potency of biogenic amine blockade are pharmacologic properties of tricyclic compounds that may not necessarily be inferred from the chemical classification and may not necessarily be responsible for their antidepressant actions....References1. TRAFFORDJONESEVANSSHARPSHARPSTONECOOK JRRPPJ: Haemoperfusion with R-004 Amberlite resin for treating acute poisoning. Br Med J 2:1453-1456, 1977 CrossrefMedlineGoogle Scholar2. WINCHESTERGELFANDKNEPSHIELDSCHREINER JMJG: Dialysis and hemoperfusion of poisons and drugs—update. Trans Am Soc Artif Intern Organs 23:762-808, 1977 CrossrefMedlineGoogle Scholar3. MERRILL J: Treatment of drug intoxication by hemoperfusion. N Engl J Med 284:911-912, 1971 CrossrefMedlineGoogle Scholar4. BARBOURLASETTEKOFFLER BAA: Fixed-bed charcoal hemoperfusion for the treatment of drug overdose. Kidney Int 10(suppl):S333-S337, 1976 Google Scholar5. ROSENBAUMKRAMERRAJA JMR: Resin hemoperfusion for acute drug intoxication. Arch Intern Med 136:263-266, 1976 CrossrefMedlineGoogle Scholar1. CROMEDAWLINGBRAITHWAITEMASTERSWALKEY PSRJR: Effect of activated charcoal on absorption of nortriptyline. Lancet 2:1203-1205, 1977 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MONTE L. SCHEINBAUM, PH.D., M.D.Affiliations: Pennwalt Corporation Rochester, NY 14603 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1978Volume 89, Issue 5_Part_1Page: 724-725KeywordsAntidepressantsDrugsTricyclic antidepressants ePublished: 1 December 2008 Issue Published: 1 November 1978 PDF downloadLoading ...
Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial
Authors: S. Kinra, K V Rameshwar Sarma, None Ghafoorunissa, V. V. R. Mendu, R. Ravikumar, V. Mohan, I. B Wilkinson, J. R Cockcroft, G. Davey Smith, Y. Ben-Shlomo
Journal: BMJ (2008)

<b>Objective</b> To determine whether integration of nutritional supplementation with other public health programmes in early life reduces the risk of cardiovascular disease in undernourished populations. <b>Design</b> Approximately 15 years' follow-up of participants born within an earlier controlled, community trial of nutritional supplementation integrated with other public health programmes. <b>Setting</b> 29 villages (15 intervention, 14 control) near Hyderabad city, south India. <b>Participants</b> 1165 adolescents aged 13-18 years. <b>Intervention</b> Balanced protein-calorie supplementation (2.51 MJ, 20 g protein) offered daily to pregnant women and preschool children aged under 6 years, coupled with integrated delivery of vertical public health programmes. <b>Main outcome measures</b> Height, adiposity, blood pressures, lipids, insulin resistance (homoeostasis model assessment (HOMA) score), and arterial stiffness (augmentation index). <b>Results</b> The participants from the intervention villages were 14 mm (95% confidence interval 4 to 23; P=0.007) taller than controls but had similar body composition. The participants from the intervention villages had more favourable measures of insulin resistance and arterial stiffness: 20% (3% to 39%; P=0.02) lower HOMA score and 3.3% (1% to 5.7%; P=0.008) lower augmentation index. No strong evidence existed for differences in blood pressures and serum lipids. <b>Conclusions</b> In this undernourished population, integrated delivery of supplemental nutrition with other public health programmes in pregnancy and early childhood was associated with a more favourable profile of cardiovascular disease risk factors in adolescence. This pragmatic study provides the most robust evidence to date on this important hypothesis for which classic trials are unlikely. Improved maternal and child nutrition may have a role in reducing the burden of cardiovascular disease in low income and middle income countries.
MECHANISMS OF OLFACTORY DISCRIMINATION: Converging Evidence for Common Principles Across Phyla
Authors: John G. Hildebrand, Gordon M. Shepherd
Journal: Annual Review of Neuroscience (1997)

▪ Abstract Olfaction begins with the transduction of the information carried by odor molecules into electrical signals in sensory neurons. The activation of different subsets of sensory neurons to different degrees is the basis for neural encoding and further processing of the odor information by higher centers in the olfactory pathway. Recent evidence has converged on a set of transduction mechanisms, involving G-protein-coupled second-messenger systems, and neural processing mechanisms, involving modules called glomeruli, that appear to be adapted for the requirements of different species. The evidence is highlighted in this review by focusing on studies in selected vertebrates and in insects and crustaceans among invertebrates. The findings support the hypothesis that olfactory transduction and neural processing in the peripheral olfactory pathway involve basic mechanisms that are universal across most species in most phyla.
CHILLS FOLLOWING TRANSFUSION OF BLOOD
Authors: RICHARD LEWISOHN
Journal: JAMA (1923)

Transfusion of blood, when used with proper precautions, is a comparatively safe procedure; but when used indiscriminately and without proper consideration of technic and indications, blood transfusion can be followed by most serious complications, even by death.  The safety with which blood transfusion can be used in a variety of diseases is based mainly on Landsteiner's discovery of the blood groups. Landsteiner,1in 1900, demonstrated that human beings and certain animals can be classified in three different groups. A fourth group was added by Jansky2in 1907. This work of Landsteiner is the foundation underlying the modern development of blood transfusion.  As compared with the preliminary testing of donor and recipient, the technic of blood transfusion, i. e., the method to be applied in a given case, is of minor importance. Any method (syringe, stopcock, paraffinized glass cylinders, sodium citrate) is applicable, provided it is possible to measure