tbuckley/cabot-search huggingface dataset:
Internal Medicine Certification: Scores Slip; Spirochete Survives
Authors: John F. Cary
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Norcini et al<sup>1</sup>determined that medical knowledge of recent graduates taking the internal medicine boards is declining by comparing scores on identical questions from year to year. Dr Dan<sup>2</sup>points out that the number of questions involved is small (one to three questions in a 2-day test). Both make statements that are questionable. To base the measurement of knowledge only on identical questions is unfair to the later candidates. In the 2 years since I took the boards, tissue plasminogen activator, cefixime, selegiline (L-deprenyl), pergolide mesylate, zidovudine, ganciclovir, inhaled pentamidine, esmolol, misoprostol, and lisinopril have become available. Ehrlichiosis, Lyme disease, chronic Epstein-Barr virus infection, and numerous manifestations of acquired immunodeficiency syndrome have all been first described in the recent past. Whether questions concerning these new topics were on the boards is irrelevant; today's residents learn about these diseases at the expense of others. No doubt
Further Experience With Obstructed Diaphragmatic Hernias
Authors: Gordon J. Culver
Journal: JAMA (1965)

IN A PREVIOUS communication, the mechanism of obstruction in para-esophageal hernias was described in detail.<sup>1</sup>Observations on four patients were cited to establish the validity of the following theory: When the cardia and body of the stomach are in intrathoracic location, obstruction does not occur. When the cardia descends through the diaphragmatic defect and the fundus remains in intrathoracic location, the diaphragmatic defect has to accomodate the gastric antrum and also the subcardiac portion of the stomach. The crowding of these two lumens necessarily narrows them. Also, peristalsis is initiated below the cardia and cardiac emptying is further complicated by the force of gravity. As fluids, food, and air enter the cardia, the condition is aggravated by dilatation. In the cases presented, it was shown that, occasionally, decompression of the cardia was followed by its ascent into intrathoracic location and the obstruction was relieved. Two recent cases have added
Abstract 3154: Neonatal c-kit Mutant Mice Exhibit Decreased Susceptibility to Hypoxia-Induced Pulmonary Hypertension
Authors: Karen C Young, Eneida Torres, Dorothy Hehre, Cleide Suguihara, Joshua Hare
Journal: Circulation (2009)

Background: c-kit is a tyrosine kinase receptor which is involved in the regulation of cell survival and proliferation. Given, our previous data showing increased c-kit cells in the lungs of neonat...
NHS extends never events list and introduces cost penalties
Authors: S. Mayor
Journal: BMJ (2011)

Animals learn not only about stimuli that predict reward but also about those that signal the omission of an expected reward. We used a conditioned inhibition paradigm derived from animal learning theory to train a discrimination between a visual stimulus that predicted reward (conditioned excitor) and a second stimulus that predicted the omission of reward (conditioned inhibitor). Performing the discrimination required attention to both the conditioned excitor and the inhibitor; however, dopamine neurons showed very different responses to the two classes of stimuli. Conditioned inhibitors elicited considerable depressions in 48 of 69 neurons (median of 35% below baseline) and minor activations in 29 of 69 neurons (69% above baseline), whereas reward-predicting excitors induced pure activations in all 69 neurons tested (242% above baseline), thereby demonstrating that the neurons discriminated between conditioned stimuli predicting reward versus nonreward. The discriminative responses to stimuli with differential reward-predicting but common attentional functions indicate differential neural coding of reward prediction and attention. The neuronal responses appear to reflect reward prediction errors, thus suggesting an extension of the correspondence between learning theory and activity of single dopamine neurons to the prediction of nonreward.
Abstract 836: Decursin and doxorubicin are in synergy for the induction of apoptosis via STAT3 and/or mTOR pathways in human multiple myeloma cells.
Authors: Duck-Beom Jung, Soo-Jin Jeong, Hee-Young Kwon, Ji Hoon Jung, Eunjung sohn, Eun Ah Sin, Ji-Hyun Kim, Sun-Mi Cho, Miyong Yun, Hyo-jung Lee, Sung Hoon Kim
Journal: Cancer Research (2013)

Abstract Drug resistance causes a serious limitation for the chemotherapy of multiple myeloma. Combination cancer therapy is one of attractive approaches to overcome drug resistance of cancer cells. In the present study, we investigated the synergistic effect of decursin (a major compound in Angelica gigas) and doxorubicin on the induction of apoptosis in three human multiple myeloma cells. Concurrent treatment of decursin and doxorubicin significantly exerted significant cytotoxicity, while doxorubicin or decursin alone had no cytotoxic effect at physiologically relevant concentrations in signal transducer and activator of transcription 3 (STAT3) positive cell lines such as U266 and RPMI8226 cells and also STAT3 negative cell line MM.1S cells. We further demonstrated that the loss of the viability of the cells co-treated with decursin and doxorubicin was due to the induction of apoptosis. Combination treatment of doxorubicin and decursin enhanced the activation of caspapse-9 and 3, the cleavage of poly (ADP-ribose) polymerase (PARP) and sub G1 population compared to either drug alone in three multiple myeloma cells. In addition, the combined treatment of doxorubicin and decursin downregulated the phosphorylation of the mammalian target of rapamycin (mTOR) and its downstream S6K1 and activated the phosphorylation of extracellular signal regulated kinase (ERK) in three multiple myeloma cells. Furthermore, the combined treatment of doxorubicin and decursin reduced mitochondrial membrane potential, suppressed the phosphorylation of JAK2, STAT3 and Src, activated SHP-2 and attenuated the expression of cyclind-D and survivin in STAT3 positive U266 cells. Conversely, the broadly-acting tyrosine phosphatases inhibitor pervanadate reversed STAT3 inactivation and also PARP cleavage and caspase-3 activatio induced by combine treatment of doxorubicin and decursin in U266 cells. Citation Format: Duck-Beom Jung, Soo-Jin Jeong, Hee-Young Kwon, Ji Hoon Jung, Eunjung sohn, Eun Ah Sin, Ji-Hyun Kim, Sun-Mi Cho, Miyong Yun, Hyo-jung Lee, Sung Hoon Kim. Decursin and doxorubicin are in synergy for the induction of apoptosis via STAT3 and/or mTOR pathways in human multiple myeloma cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 836. doi:10.1158/1538-7445.AM2013-836
When I use a word . . .: Say cee
Authors: J. Aronson
Journal: BMJ (2000)

Thirdly, establishing and maintaining horizontal and upwards accountability as part of clinical governance is likely to be costly.Health professionals will need time and appropriate skills, equipment, and facilities to undertake peer review and monitor the targets they set themselves.Money will be needed for financial incentives, if these are used.Additionally, if downwards accountability to local communities is taken seriously by primary care groups and trusts, this will require further expenditure on activities such as informing, training, and meeting with lay people to enable meaningful participation by the public. ConclusionsClearly, in the face of the limited resources being offered by health authorities, primary care groups and trusts will need to give priority to some elements of accountability.Horizontal accountability is important to develop early on, as it is the bedrock for effective clinical governance in primary care groups and trusts.Accountability for processes of care makes a good building block for further work, such as measuring actual outcomes of care.At the same time, it will be necessary for primary care groups and trusts to satisfy the requirements of upwards accountability to the NHS hierarchy.Thus, primary care professionals will need to concentrate on a mixture of centrally identified clinical and organisational issues, particularly those set out in the national service frameworks, and issues identified in local health improvement programmes.Downwards accountability to communities of patients is likely to be the aspect of accountability which will have the least attention paid to it in the short term.
Clinical Trial of Programmable Implantable Insulin Pump For Type I Diabetes
Authors: Jean-Louis Selam, Piero Micossi, Frederick L Dunn, David M Nathan
Journal: Diabetes Care (1992)

Objective The first step in the evolution of an artificial pancreas is the development of a reliable implantable pump for insulin delivery. Despite recent advances, significant issues remain, including small size of studies and frequent irreversible catheter obstructions. We report safety, feasibility, and efficacy results from 56 patients, representing 73 patient-yr of pump experience, entered into a multicenter trial with a new implantable programmable pump. Research Design and Methods All patients had insulin-dependent (type 1) diabetes, were 38 ± 8 yr old, and were not prone to severe hypoglycemia. The pump (Infusaid 1000) has a pulsatile mechanism powered by freon-vapor pressure. Its rate is regulated by battery-powered valves, operated via a hand-held programmer. The pump is refilled transcutaneously with 25 ml U100 insulin (Hoechst 21PH) on a monthly basis and has a second septum (side port) proximal to the catheter, which allows flushing the catheter or lavaging the pump unit. The pumps were implanted after 3 mo intensive subcutaneous insulin therapy and catheters were positioned either in the peritoneum (i.p., n = 38) or the superior vena cava (i.v., n = 18). Results All implanted pumps have functioned safely with no instance of overdelivery or stoppage. The most frequent complications were flow slow downs, presumably due to insulin precipitation within the pump, which occurred in 86% of pumps and were resolved in all but one case by lavaging the pump in situ with alkaline solution. Flow slow downs due to catheter obstruction occurred in 52% of the intravenous catheters but only 21% of the intraperitoneal catheters (P &amp;lt; 0.05) and were resolved in all but two cases by diluent flushing through the sideport. Incidence of severe hypoglycemia decreased from 0.47 before implant to 0.05 episodes/patient-yr after pump implantation (P &amp;lt; 0.001). Mean HbA1c fell from 7.4 ± 1.2% after intensive subcutaneous therapy to 7.1 ± 1.0% 12 mo after implantation. Only 2 patients withdrew from study after recurrent catheter problems, and quality-of-life questionnaires showed improvement in satisfaction with diabetes-specific quality of life when on implantable pump therapy. Conclusions Insulin therapy with implantable pumps is effective and safe for periods up to 1.7 yr with a decreased risk of severe hypoglycemia than with intensive subcutaneous insulin therapy.
Combination Therapy for Hepatitis C Infection
Authors: Liang Tj
Journal: New England Journal of Medicine (1998)

About 4 million people in the United States and probably more than 100 million people worldwide are infected with the hepatitis C virus (HCV).1 The majority have no symptoms, although they can transmit this blood-borne virus to others. People who have been infected for decades may first come to medical attention because of complications related to advanced liver disease. Ironically, the public health implications of HCV infection have only recently been widely appreciated, as a result of epidemiologic studies that pointed out the magnitude of infection and an alarming increase in morbidity and mortality due to HCV-related disease.In the . . .
Bacterial vaginosis and preterm delivery Bacteria may contribute to lung disease in neonates
Authors: A J Lyon, N McIntosh, R Ilies, P W Ross, C J F Priestly, A Nageswaran, J Dhar, A Yoong, P E Hay, R F Lamont, D Taylor-Robinson
Journal: BMJ (1994)

EDITOR, - Phillip E Hay and colleagues' report on abnormal bacterial colonisation of the genital tract and preterm labour.1 The association between infection and preterm labour has been widely reported, with the genital mycoplasmas (Ureaplasma urealyticum and Mycoplasma hominis) often being implicated.2 Many of the preterm infants need ventilation, and a considerable number develop chronic lung disease. In our unit in 1993 there were 84 survivors of <=30 weeks' gestation, of whom 41 developed chronic lung disease. The aetiology of this disease is multifactorial, with gestation and positive pressure ventilation being the most important determinants.

In a pilot study of the incidence of ureaplasma and mycoplasma infections the endotracheal secretions of all intubated neonates of <=30 weeks' gestation (n=63) were examined weekly from birth while the neonates remained intubated. Sixteen of the infants were positive for one or both organisms, with 11 yielding positive results on the first culture. Fifteen (94%) of these 16 infants with positive cultures went on to develop chronic lung disease whereas only 18 (38%) of the 47 infants for whom culture yielded negative results developed the disease (P<0.001). There were no significant differences between the two groups in gestation, birth weight, and duration of positive pressure ventilation.

These data agree with data from the United States. 3 It has been suggested not only that these organisms induce preterm labour but that their presence in the lungs causes a low grade inflammatory response, increasing the need for ventilation and hence increasing the degree of damage done by the ventilator, resulting in chronic lung disease. The presence of an inflammatory response in the development of chronic lung disease from the respiratory distress syndrome is well recognised,4and we have found an association between high levels of the cytokine interleukin-8 (as a marker of inflammatory …
GUARDING AGAINST VIOLATION OF THE HARRISON ACT
Authors: R. W. Blackmar
Journal: JAMA (1924)

<h3>To the Editor:</h3> —Probably there is no legislation of recent times of a purely public health nature from which the public should derive as much benefit, as from the Harrison Narcotic Law. We wish to call attention to a practice of many detail men who call on the physician, and who frequently request a prescription blank, as evidence of their visit. Without the slightest reflection on any detail men, we wish to condemn the practice of distributing prescription blanks in lieu of business cards, on account of the ease with which forgeries can be perpetrated. Many times the physician is asked for one of his cards by people who wish to have his name, address, and telephone numbers for future reference, and the physician gives them a blank prescription blank, which may fall into the hands of some one who may be an expert on writing narcotic prescriptions, and the
Hearts: Their Long Follow-Up
Authors: Rolf M. Gunnar
Journal: JAMA (1967)

If Dr. Paul Dudley White had published just another textbook, it would not be particularly newsworthy. However,<i>Hearts, Their Long Follow-Up</i>is not a textbook but is, instead, a fascinating narration of case histories which Dr. White has compiled with the help of Helen Donovan, his secretary for many years. Some of the patients have been followed for 40 years, and in describing their illnesses and followup, Dr. White exposes his philosophy of patient care and demonstrates the human concern of a great physician for his patients as individuals. The book is divided into chapters by disease headings, making it easy to browse through sections relevant to particular problems. It is reassuring to read of patients thought to have had fatal disease, leading happy and productive lives for 30 years. This can act as an antidote to the present rush to surgical treatment. Dr. White emphasizes moderation in diet and
A 24-Day-Old Neonate With Annular Plaques on the Scalp
Authors: Eva Hudgins, Lara Wine Lee, Leslie Castelo-Soccio
Journal: JAMA Pediatrics (2015)

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 Pediatrics 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 Pediatrics journal
Textbook of Venereal Diseases and Treponematoses
Authors: W. A. Ketterer
Journal: JAMA (1965)

This fine, second edition of a text originally published in 1950 provides timely up-to-date material in a compact, small book. The material, clearly and comprehensively presented, is appropriately interspersed with many good photographs, tables and graphs, including color plates. About half the book covers the two important and prevalent venereal diseases, syphilis and gonorrhea. Two chapters deal with nongonococcal disorders causing discharges in men and women, including Reiter's syndrome and trichomoniasis; one deals with nonvenereal treponematoses; another with chancroid, lymphogranuloma venereum, and granuloma inguinale; and one covers other conditions requiring differential diagnosis. Excellent sections on therapy discuss penicillin, reactions to penicillin, many new developments in antibiotics other than penicillin, and chemotherapeutic drugs. The final chapter embraces laboratory and minor surgical techniques used in venereal disease work. While the textbook is primarily medical, some material on preventive and public health aspects is included. The sections on diagnosis and therapy appear up-to-date.
Incidence of Cross-infection in Children's Wards
Authors: A. G. Watkins, E. Lewis-Faning
Journal: BMJ (1949)

patients with myasthenia gravis have been treated by surgical extirpation of the thymus gland.Of 120 patients who did not have thymic tumours and survived the operation, 79 (65%) have shown a complete or almost complete remission of the symptoms.These could not be accounted for as " spontaneous remissions."The operative mortality in our hands is at present 4.2%.The results are influenced by the duration of the disease before operation: the shorter the history the better the results.Early operation is indicated by the above fact, and by the 11.6% incidence of tumours, the development of which should, if possible, be anticipated.
Two cases of cystic lymphangioma of the pancreas: a rare finding in endoscopic ultrasonography
Authors: B. Applebaum, J. Cunningham
Journal: Endoscopy (2006)

Cystic lymphangioma of the pancreas is a rare, benign neoplasm classically diagnosed at surgery. We report here on two patients diagnosed using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA).
Abstract P6-06-46: Treatment decisions and five year outcomes of the oncotype Dx test: An independent assessment
Authors: R Bhargava, AM Brufsky, BC Lembersky, R Jankovic, SL Puhalla, S Oesterreich, A Lee, DJ Dabbs
Journal: Cancer Research (2013)

Abstract INTRODUCTION: Oncotype DX (ODx) was validated to provide prognostic information in ER+ lymph node negative tumors. The work of Paik et al. (JCO 2006 23:3737) has provided evidence of predictive power of ODx for chemotherapy, but there is contrary literature in this regard (Ionnadis JP Oncologist 2007, 12: 301-11; NICE Guideline March 2013 http://guidance.nice.org.uk/DT4). The specific aims of our institutional study are to determine (1) how ODx influenced treatment decisions and (2) the outcomes of patients who had ODx. METHODS: Tumor registry follow-up information was supplied for 580 patients who had ODx and follow-up (mean/median 60/63 months). RESULTS: (Table 1) Distribution of RS was 40% intermediate (232/580), 15% high RS (87/580) and 45% (261/580) low RS. Hormonal therapy was recommended to 96% (558 of 580), but refused by 3% (16 of 580) and for 1% data was unavailable. In the high RS group, chemo was recommended to 90% (79 of 87), of which 6 (8%) refused. In the intermediate RS group, chemo was recommended to 49% of the patients of which 20 (18% of recommended) refused. In the low RS group, chemo was recommended to 12% of the patients of which 8 (26% of recommended) refused. Most chemotherapy treatment decisions made at our institution were based on oncotype DX. High RS group recurrence was 9% (7 of 87) of which 2 patients died. Of these 7 patients, 3 did not receive chemotherapy (2 were recommended but refused). The recurrence rate in the intermediate RS group was 6.5% (14 of 232) of which 3 patients died. Of these 14 patients, 8 did not receive chemotherapy based on clinician's judgment. The recurrence rate in the low RS group was 1% (3 of 261) and there were no deaths due to breast cancer. Of these 3 cases, one received chemotherapy. Oncotype DX Type of Recurrence vs Recurrence ScoresType RecurrenceHigh RSIntermediate RSLow RSTotalLocoregional49114(Scores)(35,38,47,63)(19,20,20,23,24,26,26,27,29)(16) Distant2529(Scores)(31,61)(19,19,22,29,30)(2,11) Local or Distant1 1Total714324 Conclusion: (1) The oncotype DX recurrence score is prognostic when low risk and high risk categories are considered. (2)The large number (40%) of intermediate RS appears to be a prognostic limitation of the test. (3) Of patients that recurred, (50%) received chemotherapy and were somewhat equally distributed between the high RS and the intermediate RS categories. Further follow-up of this cohort should address concerns of clinical utility of the Oncotype Dx test, especially for the intermediate RS category. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-46.
BMA will review guidelines on PVS
Authors: C. Dyer
Journal: BMJ (1996)

The BMA is to review its guidelines on the persistent vegetative state after reports of patients who had been wrongly diagnosed. Dr Fleur Fisher, head of the association's ethics and science division, said that the decision had been taken before last week's report that staff at the Royal Hospital for Neurodisability in Putney, south west London, had managed to communicate with a former businessman thought to be in a persistent vegetative state for seven years.

In 1994 the health authority in the north of England that had been caring for …
Hepatic Coma and Ammonia Metabolism in Dogs
Authors: Henry Brown
Journal: JAMA (1963)

<sup>H</sup>EPATIC COMA or encephalopathy may be classified as "spontaneous" with liver failure but little rise in blood ammonia, or "exogenous" with toxic symptoms from very high ammonia levels.<sup>1</sup>The latter occurs after portal-systemic vein shunting operations and is generally attributed to the inability of the liver to detoxify ammonia through the normal pathways of the Krebs-Hensleit urea cycle. It is thought that in "spontaneous" hepatic encephalopathy, on the other hand, many enzymatic and metabolic systems simultaneously are adversely affected in the liver leading to coma refractory to treatment. This variety is therefore not characterized by the predominating influence of one biochemical defect. Clinically the gradation is not sharp and many intermediate states are observed. Both types of coma were observed in the laboratory in dogs following portacaval shunt operations in which "Eck's fistulae" were formed. In a previous report it was pointed out that the high blood ammonia