tbuckley/cabot-search huggingface dataset:
"Zip injury" to the penis.
Authors: A Srivastava
Journal: BMJ (1977)

two separate analyses2 3 we concluded that from 1956 to 1973 age-specific mortality from ischaemic heart disease increased in both sexes, but the increase was greater in women than in men, except in age groups above 55 years, and in young men this increase was less marked during the 1960s than it was in earlier years.The reasons for the different conclusions arise from the inclusion by Clayton et al of deaths due to hypertensive disease in their analyses of ischaemic heart disease trends.It is not, however, clear why they did this.With the introduction of effective treatment for hypertension there are reasonable grounds for believing that the reduction in mortality from hypertensive disease in recent years is real and not simply due to transfer of cases from hypertensive categories into ischaemic heart disease categories.4If such transfer did occur one would expect it to have affected men and women to the same extent, but this did not happen.If deaths attributable to hypertensive disease are excluded from analyses of ischaemic heart disease trends the conclusions of Clayton et al are consistent with ours and together they indicate the need to explain the recent increase in ischaemic heart disease among women.
Health status measurement: sensitivity of the self-reported Chronic Respiratory Questionnaire (CRQ-SR) in pulmonary rehabilitation
Authors: J E A Williams
Journal: Thorax (2003)

<b>Background:</b> A self-reported CRQ (CRQ-SR) has recently been developed and found to be a reproducible and reliable measure of health status. This study explores both the sensitivity of the CRQ-SR and relative sensitivity compared with the conventional interviewer led CRQ (CRQ-IL) in patients undergoing pulmonary rehabilitation. <b>Methods:</b> Eighty patients with stable chronic obstructive pulmonary disease who had been referred for pulmonary rehabilitation completed the CRQ-SR at initial assessment and at the end of the 7 week programme. A further 35 patients completed both the CRQ-SR and the CRQ-IL, administered 1 week apart, before starting rehabilitation and again at the end of the programme. <b>Results:</b> There were large statistically and clinically significant changes in mean score per dimension following rehabilitation in all dimensions of the CRQ-SR (dyspnoea mean difference 0.87 (95% CI 0.61 to 1.14); fatigue 0.76 (0.53 to 1.0); emotion 0.60 (0.35 to 0.86); mastery 0.76 (0.52 to 1.0); p&lt;0.001). Similar results were found in the comparison of the sensitivity of the CRQ-SR and the CRQ-IL, with large changes in mean score per dimension following rehabilitation for both versions of the questionnaire (p&lt;0.005). No significant differences were seen in the magnitude of change between the two formats of the questionnaire (p&gt;0.05). <b>Conclusion:</b> The self-reported CRQ is as sensitive to change as the interviewer led CRQ in patients undergoing pulmonary rehabilitation but has the advantage of being less time consuming to administer.
Divergent Effects of Physical Training and Nitroglycerin in Coronary Heart Disease.
Authors: J-M. R. Detry
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Divergent Effects of Physical Training and Nitroglycerin in Coronary Heart Disease.J-M. R. Detry, M.D., R. A. Bruce, M.D., F.A.C.P.J-M. R. Detry, M.D.Search for more papers by this author, R. A. Bruce, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-819_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMaximal oxygen intake (VO2) and ECG responses to multistage treadmill test were determined before and after 3 months of physical training in 14 patients with coronary heart disease. Responses to 0.4 mg nitroglycerin sublingually were measured before training in 11 of these patients. The ST-segment responses were measured by computer averaging 100 beat samples.After training maximal VO2increased by 20.8% (P< 0.001), mainly by a greater maximal A-VO2difference. At submaximal exercise heart rate, blood pressure, and pressure-rate product were lower after training and the ST segment less depressed (P< 0.05). At maximal exercise, however, heart rate... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Seattle, Wash. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEarly exercise training in patients older than age 65 years compared with that in younger patients after acute myocardial infarction or coronary artery bypass graftingCirculatory and Symptomatic Effects of Physical Training in Patients with Coronary-Artery Disease and Angina Pectoris 1 May 1971Volume 74, Issue 5Page: 819-819KeywordsBlood pressureComputersCoronary heart diseaseExerciseHeart rateOxygenOxygen consumption per unit time Issue Published: 1 May 1971 PDF downloadLoading ...
Therapy for Mild Hypertension
Authors: Norman M. Kaplan
Journal: JAMA (1983)

PUBLICATION in this journal of the results of the Multiple Risk Factor Intervention Trial (MRFIT)<sup>1</sup>should bring about a reassessment of the current widespread and routine use of drug treatment for most people with mild hypertension, defined as a diastolic BP between 90 and 104 mm Hg. Such patients make up about 75% of the hypertensive population, a total of at least 30 million Americans. Most American practitioners are now responding to the admonishments of hypertension experts and pharmaceutical advertisements that the "HDFP (Hypertension Detection and Follow-up Program) findings justify early and aggressive management of mild hypertension." Even before the HDFP<sup>2</sup>or any other data in support of the value of such therapy for mild hypertension were available, 92% of the physicians in New York State who responded to a questionnaire indicated they routinely gave antihypertensive drug therapy to patients with diastolic BPs between 90 and 104 mm
Partnerships with children
Authors: M. Dixon-Woods, B. Young, D. Heney
Journal: BMJ (1999)

Earlier this year a 15 year old girl had her decision to refuse a heart transplant overruled by the High Court,1 highlighting the issue of partnership with children. The case is the latest of several2 that have shown how children's participation in decision making and recognising their autonomy and rationality 3 4 can conflict with the need to protect them from making decisions that are not in their long term interests.5

Court cases dramatically show the problems of involving children in decision making, but they tend to deal with extreme and unusual examples and have led to uncertainty and anxiety about routinely involving children in decision making. Away from the courts a movement is growing to promote children's rights. Proponents have argued from a position of moral obligation and have called for a code of practice which would emphasise children's rights to information, to express views, and to give or withhold consent provided the child is considered competent by a doctor.6 Professional bodies and others concerned with children's wellbeing seem to have accepted many of these principles,7–10 which are based on ethical and moral principles of autonomy, free will, choice, and compassion and have the laudable aim of allowing children's opinions to be voiced, heard, and acted on wherever possible.

However, the evidence suggests that partnership with children enjoys only limited success. Children are given little voice in medical consultations 8 11 and are rarely consulted as partners in the evaluation and planning of health services.12 13 The …
"Bulls-eye" Image of Gallbladder Volvulus
Authors: GENE J. WANG, MICHAEL COLLN, JAN CROSSETT, RICHARD A. HOLMES
Journal: Clinical Nuclear Medicine (1987)

A 79-year-old female was admitted with RLQ abdominal pain for 24 hours. The pain gradually localized in the RUQ prior to admission. Peritoneal signs were noted. Liver function tests were normal. DISIDA hepatobiliary scan revealed a patent common bile duct without visualization of the gallbladder. A photopenic area was observed in the right lower portion of the liver. Delayed 5-1/2 hour images showed a focal accumulatipn of radioactivity medial to the photopenic area that was believed to be nonfilling of the gallbladder with accumulation of activity in the cystic duct. Follow-up ultrasonogram revealed an enlarged gallbladder (10.8 cm longitudinal diameter). Surgery was performed the following day and volvulus of gallbladder near the cystic duct was corrected by cholecystectomy.
Abstract 2341: Intracardiac Echo for Registration of Rotational Angiography Based Left Atrial Reconstructions: A Novel Approach Integrating Two Intraprocedural 3D Imaging Techniques in Atrial Fibrillation Ablation
Authors: Georg Nolker, Klaus J Gutleben, Guido Ritscher, Anil Sinha, Nassir Marrouche, Johannes Heintze, Juergen Vogt, Dieter Horstkotte, Johannes Brachmann
Journal: Circulation (2009)
&lt;emph type="ital"&gt;The Virgin of Chancellor Rolin&lt;/emph&gt;
Authors: Thomas B. Cole
Journal: JAMA (2009)

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
Pneumomediastinum and diabetic hyperpnoea.
Authors: N. W. Grieve, D. R. Bird, A. J. Collyer, G. A. Meredith
Journal: BMJ (1969)

came less.Subsequently she developed a very marked sensitivity rash, and this treatment was therefore stopped after two weeks.Oral erythromycin was then used, but only for 24 hours because of severe vomiting and diarrhoea.Oral lincomycin, 1.5 g. six hourly, was then given and effected complete remission of the fever; she has remained apyrexial since.After lincomycin therapy had been started complement fixation tests for Coxiella burneti revealed 1 :128 (phase I) and 1:4096 (phase II).Subsequent tests showed a rise of phase I titres to 1:2048.When the diagnosis of rickettsial endocarditis seemed in this way to be established, and two weeks after the institution of lincomycin, tetracycline 2 g. daily was added in the light of published data up to that time.The patient has continued
Invasive cancer of the cervix in women with mild dyskaryosis followed up cytologically
Authors: W P Soutter, A Fletcher
Journal: BMJ (1994)

Mildly dyskaryotic smears are common, and women with such results are often followed up with further cervical smear tests. An important consideration in evaluating this practice would be the annual incidence of invasive cervical cancer. A reanalysis of five previous studies of the cytological follow up of women with mildly abnormal smear test results was undertaken to calculate this incidence. The annual incidence of invasive cancer in these women ranged from 0 to 420 per 100,000 women years. The large studies providing the most precise estimates had annual rates of 143 to 420 per 100,000 women years. This is 16 to 47 times greater than in women aged 15-34 years in England and Wales. The average rate was 208 per 100,000 women years. Women with mild dyskaryosis are at high risk of developing invasive cervical cancer despite cytological follow up. A full appraisal of the costs and benefits of colposcopy in this situation is urgently required.
Emerging therapies targeting the ubiquitin proteasome system in cancer
Authors: Nathaniel M. Weathington, Rama K. Mallampalli
Journal: Journal of Clinical Investigation (2014)

The ubiquitin proteasome system (UPS) is an essential metabolic constituent of cellular physiology that tightly regulates cellular protein concentrations with specificity and precision to optimize cellular function. Inhibition of the proteasome has proven very effective in the treatment of multiple myeloma, and this approach is being tested for utility in other malignancies. New pharmaceuticals targeting the proteasome itself or specific proximal pathways of the UPS are in development as antiproliferatives or immunomodulatory agents. In this article, we discuss the biology of UPS-targeting drugs, their use as therapy for neoplasia, and the state of clinical and preclinical development for emerging therapeutics.
Monitoring the Physical Health of Cancer Survivors: A Survivorship-Focused Medical History
Authors: Patricia A. Ganz
Journal: Journal of Clinical Oncology (2006)

Cancer survivors frequently visit their primary-care physicians, as well as oncology specialists, for follow-up care. There is a need to monitor these survivors for the late physical effects of cancer, yet few health care providers have received training in how to do this. This article provides guidance on how to take a cancer survivor-directed medical history to facilitate the elicitation of relevant exposures, family history, and symptoms that may be related to the late effects of cancer therapy.
Chewing Gum Causing a Very High FDG Uptake of the Tongue on PET Scan
Authors: Satheesh K. Kathula, Joseph Mantil
Journal: Clinical Nuclear Medicine (2007)

A patient with nonsmall cell lung carcinoma had a PET scan done for restaging, which showed very high FDG uptake in the tongue (SUV of 24). Physical examination of the tongue was normal. CT scan did not reveal any abnormality in the tongue. On questioning, the patient recollected that he was chewing gum before injection of FDG. A repeat PET scan 9 days later showed no tongue uptake. It is important to tell the patients not to chew gum for at least 4 hours before the PET study.
The rights of patients in research
Authors: H. Goodare, R. Smith
Journal: BMJ (1995)

Clinical trials cannot be done without patients, and the whole purpose of conducting trials is to benefit patients. These two indisputable statements should mean that patients should be at the front of researchers' minds when they design, conduct, and report medical research. But they rarely are. Too often patients are forgotten in the complex business of conducting research. We argue that patients should help to decide which research is conducted, help to plan the research and interpret the data, and hear the results before anybody else.

The patients certainly seemed to have been forgotten in the notorious case of the “trial” of the complementary treatment offered to women with breast cancer by the Bristol Cancer Help Centre.1 The women who had willingly participated in the research knew nothing of the results until they heard on the television news on the evening of 5 September 1990 that those of them who had been to the centre were twice as likely to die and three times as likely to relapse as women who had not been to the centre.

As far as the women were concerned, the study was still in progress and they had received only four of the five annual questionnaires they wereexpecting to be asked to complete as part of the five year study. Nobody had sought their permission to publish interim results, and no one had written to thank them for their cooperation (as recommended by the Royal College of Physicians2) or to communicate even in broad outline the conclusions of the study. Instead, the results were published in the Lancet (dated 8 September) and released prematurely to the media with a fanfare of publicity. (The BMJ contributed by publishing a news story entitled “Death from complementary medicine.”3) The result was desolation for the women …
TCT-650 The high sensitive C-reactive protein (hs-CRP) level represents the disease burden and the age but not vulnerability of coronary atherosclerosis: a study of volumetric plaque composition by 3-vessel virtual histology-intravascular ultrasound
Authors: Se-Jun Park, So-Yeon Choi, You-Hong Lee, Yong-Woo Choi, Jeoung-sook Shin, Kyoung-Woo Seo, Jin-Sun Park, Hyoung-Mo Yang, Hong-Seok Lim, Byoung-Joo Choi, Gyo-Seung Hwang, Seung-Jea Tahk
Journal: Journal of the American College of Cardiology (2013)
Factors Associated With Caregivers' Choice of Infant Sleep Position, 1994-1998
Authors: Marian Willinger, Chia-Wen Ko, Howard J. Hoffman, Ronald C. Kessler, Michael J. Corwin
Journal: JAMA (2000)

ContextThe success and simplicity of the 1994 national "Back to Sleep" campaign to reduce sudden infant death syndrome provides an opportunity to study which elements determine whether a behavior will change in the desired direction in response to a public health intervention.Objective To examine sociodemographic characteristics, motivation, and message exposure to ascertain which factors influenced a caregiver's choice of infant sleep position after implementation of the campaign.Design Annual nationally representative telephone surveys conducted between 1994 and 1998.Setting The 48 contiguous United States.Participants Nighttime caregivers of infants born within the 7 months prior to interview between 1994 and 1998.Approximately 1000 interviews were conducted each year. Main Outcome MeasuresThe position the infant was usually placed in for sleep, sleep position recommendations received from specific sources, and reasons reported for position choice.Results Between 1994 and 1998, prone placement declined from 44% to 17% among white infants and from 53% to 32% among black infants.Supine placement increased from 27% to 58% among white infants and from 17% to 31% among black infants.During this period, reports of supine recommendations from at least 1 source doubled from 38% to 79%.From 1995 to 1998, 86% of caregivers who placed the infant prone reported receiving only nonprone recommendations.Infant comfort was given as a reason for prone placement by 82% of these caregivers.In multivariate analysis, physician recommendation of "supine not prone" had the strongest influence and was associated with decreased prone placement (odds ratio [OR], 0.25 [95% confidence interval {CI}, 0.16-0.39])and increased supine placement (OR, 3.37 [95% CI, 2.38-4.76]).Recommendations from all 4 sources (the physician, neonatal nurse, reading materials, and radio/television) further increased the probability of supine placement (OR, 6.01 [95% CI, 4.57-7.90]).Other factors independently associated with increased prone and decreased supine placement included maternal black race, parity of more than 1, and living in a southern or mid-Atlantic state.Conclusions According to our study, as of 1998, approximately one fifth of infants were still placed prone, and only half were placed supine.Recommendations of supine placement during infancy by physicians at well-baby checks and by neonatal nursery staff and print and broadcast media have increased the proportion of infants placed supine.Caregiver beliefs regarding perceived advantages of prone sleeping should be addressed to attain further reduction in prone placement.
Regulation of contractile proteins in diabetic heart
Authors: A Malhotra
Journal: Cardiovascular Research (1997)

Diabetes is one of the most prevalent chronic conditions that has a high association with death from cardiovascular disease(s). An impaired cardiac function independent of vascular disease suggests the existence of a primary myocardial defect in diabetes mellitus. We and others have documented that myocardial performance is impaired in the hearts of chronically diabetic rats and rabbits. Abnormalities in the contractile proteins and regulatory proteins could be responsible for the mechanical defects in streptozotocin (STZ)-diabetic hearts. The major focus of research on contractile proteins in the diabetic state has been on myosin ATPase and its isoenzymes. However, in the contractile protein system, this could be only one of the mechanisms that might be a controlling factor in myofilament contraction in diabetes. To define the role of cardiac contractile as well as regulatory proteins (troponin-tropomyosin) as a whole in the regulation of actomyosin system in diabetic cardiomyopathy, individual proteins of the cardiac system were reconstituted under controlled conditions. Enzymatic data confirmed a diminished calcium sensitivity in the regulation of the cardiac actomyosin system when regulatory protein(s) complex was recombined from diabetic hearts. This diminished calcium sensitivity along with shifts in cardiac myosin heavy chain (V1→V3) could contribute to the impaired cardiac function in the hearts of chronic diabetic rats. It has also been reported that sarcomeric proteins such as myosin light chain-2 (MLC-2) and troponin I (TnI) could be involved in regulating muscle contraction and in calcium sensitivity. Since phosphorylation of cardiac TnI is associated with altered maximum enzymatic activity and calcium force relationship in isolated muscle preparations, TnI phosphorylation could contribute to depressed myocardial contractility in experimental diabetes. While we have yet to understand the exact function of each component in cardiac muscle and their behavior in concert where all of them act in tandem, we have focussed on the role of contractile proteins and their regulation in diabetes in this review. We have also included a brief discussion on other relevant intracellular components. In summary, there is substantial evidence to suggest that there are independent processes associated with diabetes which effect cardiac performance in experimental animals and in man. The focus of this review has been the explication of a biochemical defect which underlies cardiac contractile dysfunction in experimental models of diabetes.
United States Citizens Studying Medicine Abroad
Authors: Davis G. Johnson, August G. Swanson, Paul Jolly, Judith Teich, Samuel P. Asper
Journal: New England Journal of Medicine (1986)

To acquire information about the characteristics of U.S. citizens who had recently studied medicine abroad, the Educational Commission for Foreign Medical Graduates (ECFMG) and the Association of American Medical Colleges merged independently collected data on a study group of 10,460 U.S. citizens who attended 359 medical schools in 75 foreign countries and who took their first ECFMG examination between 1978 and 1982. The study group was markedly heterogeneous: 21 percent were not U.S. citizens at birth, 32 percent did not have English as a native language, and 12 percent had two or more years of undergraduate college education in Puerto Rico. Sixty-seven percent resided in New York, New Jersey, California, Florida, or Puerto Rico, and 74 percent studied medicine in Mexico or the Caribbean. Forty-six percent passed the ECFMG examination on their first attempt, and 22 percent passed a subsequent examination. Only 45 percent had applied to a U.S. medical school, and 65 percent had taken the Medical College Admission Test. The means of the college grade-point averages, known for 39 percent of the study group, and of the scores on the admission test, known for 65 percent, were lower than those of both accepted and unaccepted applicants to U.S. medical schools in the 1976 and 1978 entering classes. The finding that 55 percent of the study group did not apply to a U.S. medical school does not support the widely held belief that most, if not all, U.S. citizens who attend foreign medical schools do so only after several unsuccessful attempts to gain admission to a U.S. school.