tbuckley/cabot-search huggingface dataset:
One in four trainee doctors have concerns about their NHS career, study shows
Authors: Sally Hargreaves
Journal: BMJ (2007)

Doctors from more than a third of accident and emergency departments in hospitals in England said they were not reaching the government's target of dealing with patients within four hours.The main reason for this finding, from a survey published this week, was a shortage of available hospital beds, making it difficult for patients to be admitted.Only 49% of the nearly 500 members of the British Association for Emergency Medicine-all consultants and middle grade doctors-responding to the survey reported that their departments met the emergency access target for 98% of all patients to be seen, treated, admitted, or discharged within four hours.Although only 49% considered that their department actually met the emergency access target, 67% said that the figures reported by their department indicated that the target had been met.Respondents' comments on what had happened in their departments included, "Middle managers revising figures before being submitted," "Minor injury unit figures used to help achieve department's 96.9% target," and "Patients often 'moved' on the computer tracking but still kept in department to meet targets."Forty one per cent said that their depart- Lack of beds leads to missed government targetsment did not reach this target."Not enough available in-patient beds" was the main reason given for departments not meeting the emergency access target, and 88% of respondents reported it as a major contributory factor.Don MacKechnie, chairman of the BMA's emergency subcommittee and a consultant in emergency medicine at Pennine Acute Hospitals NHS Trust, said that financial problems in the NHS had meant that the availability of hospital beds for patients needing admission from accident and emergency departments was an important problem.He said, "In certain trusts, financial recovery measures have included closing beds previously used as 'safety valves' before, such as beds in rehabilitation wards.This has a knock-on effect to A&E [accident and emergency departments], with recovering patients that might have previously been moved remaining in acute beds."Mr MacKechnie said it was important that emergency access targets were seen as having broader application than simply affecting accident and emergency departments."Sometimes, other specialties forget that this is not just an A&E target.It is an emergency access target, with a responsibility from all specialties in an acute trust to ensure that the four hour target can be met."He said this meant ensuring that sufficient beds were available to admit patients from emergency departments and ensuring that doctors on call in each specialty are free to see patients in accident and emergency departments within the target of one hour after being referred.
Value of Gastric Biopsy in the Study of Chronic Gastritis and Pernicious Anaemia
Authors: I. J. Wood
Journal: BMJ (1951)

MEDICAL JOURN~AL during these trials; that this dosage was effective in clearing most: trophozoites of P. falciparum from the blood of the observed group by D + 4 day, but that occasional parasites persisted; that P. malariae para- sites, although persisting in the blood for more than seven days after treatment, do eventually disappear; that the effect of a single dose of B.W. 50-63, as assessed by parasite density indices, spleen rates, and average enlarged spleens, appears to persist for one month but to be lost during the next month.During the preliminary trials no unexplained absence occurred among the 22 children treated with 25 mg.B.W. 50-63, and no complaint of headache, nausea, or vomit- ing was made by any of these children.
Angiopoietin-2 Impairs Revascularization After Limb Ischemia
Authors: Yvonne Reiss, Jasmin Droste, Matthias Heil, Silvia Tribulova, Mirko H.H. Schmidt, Wolfgang Schaper, Daniel J. Dumont, Karl H. Plate
Journal: Circulation Research (2007)

Angiopoietins play important roles in the formation of neovessels and complex vascular networks. Angiopoietin (Ang)-1 and Ang-2 belong to a family of growth factors that display opposing effects on the activation of Tie2 (tyrosine kinase with immunoglobulin and epidermal growth factor homology domain 2). Endothelial Ang-2 expression is associated with vessel destabilization and regulates a balance between vascular regression and growth. To elucidate, in particular, the role of Ang-2 after arterial artery occlusion in the mouse limb, we applied a transgenic animal model with targeted Ang-2 expression in endothelial cells. We show here that restoration of blood flow in Ang-2:Tie1 transgenic mice is dramatically impaired when Ang-2 expression is induced in the vasculature. The defective restoration of perfusion in Ang-2 transgenic mice is evidenced by reduced collateral artery growth, which typically occurs to compensate for flow deficits after occlusion of the large conductance artery. Furthermore, reduced movement capacities and higher incidents of necrosis are consequently observed in the transgenic limbs as compared with controls. Mechanistically, the observed effects are attributed to defective smooth muscle cell recruitment in Ang-2 transgenic mice. Moreover, distinct Ang-2 levels in the genetically modified animals clearly correlated with the magnitude of reduced perfusion. In conclusion, our studies define Ang-2 as an important molecule for the progression of collateral artery growth and angiogenesis during ischemia and suggest precise Ang-2 dosage activities to accomplish blood vessel growth.
Antibiotics and Breast Cancer—What's the Meaning of This?
Authors: Roberta B. Ness
Journal: JAMA (2004)

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
Cutaneous polyarteritis nodosa associated with precore mutant hepatitis B infection
Authors: M.B.Y. Tang, K.V.S. Liew, P.P.L. Ng, S.H. Tan, S.K. Ng
Journal: British Journal of Dermatology (2003)

Journal Article Cutaneous polyarteritis nodosa associated with precore mutant hepatitis B infection Get access M.B.Y. Tang, M.B.Y. Tang National Skin Centre, 1 Mandalay Road, Singapore 308205, Singapore, and Gastroenterology Unit, Department of General Medicine, Tan Tock Seng Hospital, Singapore E‐mail: marktang@nsc.gov.sg Search for other works by this author on: Oxford Academic Google Scholar K.V.S. Liew, K.V.S. Liew National Skin Centre, 1 Mandalay Road, Singapore 308205, Singapore, and Gastroenterology Unit, Department of General Medicine, Tan Tock Seng Hospital, Singapore E‐mail: marktang@nsc.gov.sg Search for other works by this author on: Oxford Academic Google Scholar P.P.L. Ng, P.P.L. Ng National Skin Centre, 1 Mandalay Road, Singapore 308205, Singapore, and Gastroenterology Unit, Department of General Medicine, Tan Tock Seng Hospital, Singapore E‐mail: marktang@nsc.gov.sg Search for other works by this author on: Oxford Academic Google Scholar S.H. Tan, S.H. Tan National Skin Centre, 1 Mandalay Road, Singapore 308205, Singapore, and Gastroenterology Unit, Department of General Medicine, Tan Tock Seng Hospital, Singapore E‐mail: marktang@nsc.gov.sg Search for other works by this author on: Oxford Academic Google Scholar S.K. Ng S.K. Ng National Skin Centre, 1 Mandalay Road, Singapore 308205, Singapore, and Gastroenterology Unit, Department of General Medicine, Tan Tock Seng Hospital, Singapore E‐mail: marktang@nsc.gov.sg Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 149, Issue 4, 1 October 2003, Pages 914–915, https://doi.org/10.1046/j.1365-2133.2003.05538.x Published: 01 October 2003
"Cold" cures and monoamine-oxidase inhibitors.
Authors: A. M. Mason, R. M. Buckle
Journal: BMJ (1969)

MEDICALJOUR 845 drapes;(2) high relative humidity in the room;(3) preoperative dehydration; (4) atropine and other anticholinergic drugs.Heatstroke is a highly fatal disease unless promptly treated.But it is also a prevent- able disease.Surgeons and anaesthetists should consider what can be done to alter the conditions in the operating-room and the condition of the patient.As a single impor- tant way to prevent fatal heatstroke in the operating-room, I suggest monitoring of body temperature during operation.This is easily done, and, because the patient is unconscious, can provide the only clue to diagnosis in time.-I am, etc.,
Iliotibial tract friction syndrome in athletes--an uncommon exertion syndrome on the lateral side of the knee.
Authors: S. Orava
Journal: British Journal of Sports Medicine (1978)

An uncommon exertion pain on the lateral side of the knee is described in 88 patients, in four of whom it was bilateral. The disorder is a result of the friction of the iliotibial tract over the lateral femoral epicondyle. The syndrome is the iliotibial tract friction syndrome of ITFS. All the patients in the material were active athletes or middle-aged joggers in regular training. The cases were seen over four years and four months. The mean age of them was approximately 25 years, and there were only nine women in the series. Th pain appeared usually after running and was localised on the outer femoral condyle, and often radiated downwards along the iliotibial tract. Conservative treatment and changes in training habits cured most cases. The disorder has not often been described in the literature, and seems to appear only in physically very active people, such as athletes or military recruits.
Patient-reported outcome measures (PROMs): how should I interpret reports of measurement properties? A practical guide for clinicians and researchers who are not biostatisticians
Authors: Megan Davidson, Jennifer Keating
Journal: British Journal of Sports Medicine (2012)

This paper will help clinicians and researchers to understand studies on the validity, responsiveness and reliability of patient-reported outcome measures (PROMs) and to interpret the scores and change scores derived from these and other types of outcome measures. Validity studies provide a method for assessing whether the underlying construct of interest is adequately assessed. Responsiveness studies explore the longitudinal validity of a test and provide evidence that an instrument can detect change in the construct of interest. Reliability is commonly assessed with correlation indices, which indicate the stability of repeated measurements and the ‘noise’ or error in the measurement. Proposed indicators for clinical interpretation of test scores are the minimum clinically important difference, the standard error of measurement and the minimum detectable change. Studies of the Victorian Institute of Sports Assessment questionnaire for patellar tendinopathy and other PROMs are used to illustrate concepts.
Pathogenic factors of glucose intolerance in obese Japanese adolescents with type 2 diabetes
Authors: Koji Kobayashi, Shin Amemiya, Kosuke Higashida, Toshihide Ishihara, Emi Sawanobori, Kisho Kobayashi, Mie Mochizuki, Nobuyuki Kikuchi, Kunpie Tokuyama, Shinpei Nakazawa
Journal: Metabolism (2000)
Effect of delays in primary care referral on survival of women with epithelial ovarian cancer: retrospective audit
Authors: J. M J Kirwan
Journal: BMJ (2002)

<h3>Abstract</h3> <b>Objective:</b> To examine referral pathways from primary care for patients with epithelial ovarian cancer and to identify factors related to survival at 18 months. <b>Design:</b> Retrospective review of patient notes. <b>Setting:</b> General practices and receiving hospitals within Mersey region. <b>Subjects:</b> 135 patients with epithelial ovarian cancer identified from an audit in the Mersey area between 1992 and 1994. <b>Main outcome measures:</b> Delays between onset of symptoms and treatment attributable to patient, general practitioner, and hospital. <b>Results:</b> 105 (78%) women first presented to their general practitioner within four weeks of the onset of symptoms. 99 (73%) women were referred to hospital by their general practitioners within four weeks of presentation, and 95 (70%) were seen in hospital within two weeks of referral. Multivariate analysis with survival as the dependent variable identified age (odds ratio 0.96, 95% confidence interval 0.93 to 0.99) cancer stage III or more (0.15, 0.05 to 0.43), and non-specific symptoms (0.36, 0.14 to 0.89) as significant variables. <b>Conclusion:</b> Most patients attended their general practitioner within four weeks and were referred within two weeks. No evidence was found that delays in referral or diagnosis adversely affected survival at 18 months. Stage of disease at surgery was the most important adverse factor. An effective screening programme is the most likely method to improve survival. <h3>What is already known on this topic</h3> Epithelial ovarian cancer is the most common gynaecological cancer in the United Kingdom 75% of patients present with advanced incurable disease, and five year survival is 30% The Department of Health recommends that everyone suspected of having ovarian cancer should be seen within two weeks of referral by their general practitioner <h3>What this study adds</h3> 78% of patients have had symptoms for less than 4 weeks when they present to general practice and are referred to hospital within four weeks of presentation 70% of patients are seen in hospital within two weeks of the referral Delay by patients and general practitioners does not affect survival beyond 18 months
Childhood Vaccination and Nontargeted Infectious Disease Hospitalization
Authors: Anders Hviid
Journal: JAMA (2005)

ContextIt has been hypothesized that multiple-antigen vaccines, such as measles-mumps-rubella vaccine, or aggregated vaccine exposure could lead to immune dysfunction, resulting in nontargeted infectious diseases as a result of an "overload" mechanism.ObjectiveTo evaluate the relationship between routinely administered childhood vaccines (Haemophilus influenzae type b; diphtheria-tetanus-inactivated poliovirus; diphtheria-tetanus-acellular pertussis-inactivated poliovirus; whole-cell pertussis; measles-mumps-rubella; oral poliovirus) and hospitalization for nontargeted infectious diseases.Design, Setting, and ParticipantsPopulation-based cohort comprising all children born in Denmark from 1990 through 2001 (N = 805 206). Longitudinal information was collected on type and number of vaccine doses received and hospitalization with infectious diseases, specifically acute upper respiratory tract infection, viral and bacterial pneumonia, septicemia, viral central nervous system infection, bacterial meningitis, and diarrhea.Main Outcome MeasuresRate ratios for each type of infectious disease according to vaccination status.ResultsDuring 2 900 463 person-years of follow-up, 84 317 cases of infectious disease hospitalization were identified. Out of 42 possible associations (6 vaccines and 7 infectious disease categories), the only adverse association was for Haemophilus influenzae type b vaccine and acute upper respiratory tract infection (rate ratio, 1.05; 95% confidence interval, 1.01-1.08 comparing vaccinated participants with unvaccinated participants). This one adverse association of 42 possible outcomes was within the limits of what would be expected by chance alone and the effect was not temporal or dose-response. When considering aggregated vaccine exposure, we found no adverse associations between an increasing number of vaccinations and infectious diseases.ConclusionThese results do not support the hypotheses that multiple-antigen vaccines or aggregated vaccine exposure increase the risk of nontargeted infectious disease hospitalization.
Nubile Maidens and the Premarital Law
Authors: John C. Magill
Journal: JAMA (1964)

<h3>To the Editor:—</h3> Unlike those charmed by astute formulations of social engineers, I do not readily see how a massive speculum assault upon premarital introiti, reenforced by the power of positive law, will greatly diminish—as your editorial, "Premarital Laws" (<i>JAMA</i><b>187</b>:948 [March 21] 1964), suggests—the "economic and biological waste from abortions, illegitimacy, and divorce." If sexual sophistication is the primary consideration of a law ostensibly promulgated to control venereal diseases, nubile maidens might best be compelled to seek the premarital services of an experienced paramour. Preferentially, in their crude unwillingness to comply with our coercive, legalized, humanitarian insistence upon assaulting them, they may not acknowledge our verbalized largess of a "legal right to a physical examination." The editorial and the communication, "The Premarital Law," by Dr. Sylvester Trythall in the same issue (p 900) both give a resolute consideration to the high national divorce rate. This, I suppose, is
Atorvastatin Restores Endothelial Function in Normocholesterolemic Smokers Independent of Changes in Low-Density Lipoprotein
Authors: Joshua A. Beckman, James K. Liao, Shauna Hurley, Leslie A. Garrett, Daoshan Chui, Debi Mitra, Mark A. Creager
Journal: Circulation Research (2004)

Cigarette smoking impairs endothelial function. Hydroxymethylglutaryl (HMG) CoA reductase inhibitors (statins) may favorably affect endothelial function via nonlipid mechanisms. We tested the hypothesis that statins would improve endothelial function independent of changes in lipids in cigarette smokers. Twenty normocholesterolemic cigarette smokers and 20 matched healthy control subjects were randomized to atorvastatin 40 mg daily or placebo for 4 weeks, washed out for 4 weeks, and then crossed-over to the other treatment. Baseline low-density lipoprotein (LDL) levels were similar in smokers and healthy subjects, 103±22 versus 95±27 mg/dL, respectively ( P =NS) and were reduced similarly in smokers and control subjects by atorvastatin, to 55±30 and 58±20 mg/dL, respectively ( P =NS). Vascular ultrasonography was used to determine brachial artery, flow-mediated, endothelium-dependent, and nitroglycerin-mediated, endothelium-independent vasodilation. To elucidate potential molecular mechanisms that may account for changes in endothelial function, skin biopsy specimens were assayed for eNOS mRNA, eNOS activity, and nitrotyrosine. Endothelium-dependent vasodilation was less in smokers than nonsmoking control subjects during placebo treatment, 8.0±0.6% versus 12.1±1.1%, ( P =0.003). Atorvastatin increased endothelium-dependent vasodilation in smokers to 10.5±1.3% ( P =0.017 versus placebo) but did not change endothelium-dependent vasodilation in control subjects (to 11.0±0.8%, P =NS). Endothelium-independent vasodilation did not differ between groups during placebo treatment and was not significantly affected by atorvastatin. Multivariate analysis did not demonstrate any association between baseline lipid levels or the change in lipid levels and endothelium-dependent vasodilation. Cutaneous nitrotyrosine levels and skin microvessel eNOS mRNA, but not ENOS activity, were increased in smokers compared with controls but unaffected by atorvastatin treatment. Atorvastatin restores endothelium-dependent vasodilation in normocholesterolemic cigarette smokers independent of changes in lipids. These results are consistent with a lipid-independent vascular benefit of statins but could not be explained by changes in eNOS message and tissue oxidative stress. These findings implicate a potential role for statin therapy to restore endothelial function and thereby investigate vascular disease in cigarette smokers.
Obesity and the Evolution of Man
Authors: Ashley Montagu
Journal: JAMA (1966)

Anyone who is familiar with the appearance of L monkeys and apes in zoos will have noted that occasionally some of these creatures tend to be obese. The orang-utan in captivity often tends to become strikingly obese—rather more so than any other ape. Chimpanzees may become well filled out in captivity, but seldom obese. Under natural conditions, there are two factors that militate against the development of obesity in nonhuman primates. The first is that, with the exception of man, all primates are predominantly herbivorous, and it is difficult to become obese on a plant diet. The second is that these creatures are very active, and thus get a great deal of exercise. These two factors, under natural conditions, tend to keep all primates adequately well-upholstered but not overstuffed. In captivity, confined within a limited space, monkeys and gibbons manage to maintain some activity, as the chimpanzee also sometimes does.
Predictability of VO2 max from submaximal cycle ergometer and bench stepping tests.
Authors: M A Fitchett
Journal: British Journal of Sports Medicine (1985)

The predictability of the maximal oxygen uptake (VO2 max) was studied using progressive and steady state protocols for cycle ergometry and bench stepping. The subjects were 12 healthy men, 23-58 years old. Prediction of VO2 max was made by extrapolation of the heart rate and O2 uptake at several sub-maximal work-loads using the least squares regression technique. The four sub-maximal procedures underestimated the measured VO2 max by between 0.13-0.55 l.min-1. The differences between the measured and predicted values were statistically significant for the tests involving the steady state protocol. The correlation coefficients between the predicted VO2 max for each of the submaximal tests, and the measured VO2 max, were significant at the .05 level. The results indicate that for a group of male subjects VO2 max can be predicted using the progressive protocol on either the cycle ergometer or stepping bench. Individual predictions are liable to considerable error.
THE USE OF SODIUM CITRATE AS A MODIFIER OF COW'S MILK.FROM A CHEMICAL AND PHYSICAL POINT OF VIEW.
Authors: JOSEPH W. ENGLAND
Journal: JAMA (1906)

The use of sodium citrate with cow's milk, first recommended by Wright (1893) and later by Poynton (1904), Variot (1904), Vanderslice (1905) and Shaw (1906), has attracted considerable attention, the claim being made that it furnishes an exceedingly valuable method for the treatment of proteid-indigestion and the vomiting of chronic gastric catarrh. It is entirely apart from the purpose of this paper to discuss the therapeutic aspects of the subject, the purpose being only to consider the chemical and physical facts in relation thereto. The chemical ground has been taken by the earlier investigators that the addition of sodium citrate to milk resulted, on contact with the gastric juice, in the decomposition of the calcium-casein of the milk, with the precipitation of insoluble calcium citrate, and the separation of the casein in a more flocculent form than ordinarily obtains. But Shaw's experiments have clearly demonstrated that such is not the