tbuckley/cabot-search huggingface dataset:
A HELPFUL SIGN IN THE DIAGNOSIS OF APPENDICITIS
Authors: A. L. Soresi
Journal: JAMA (1924)

The sign here described as of value in diagnosing appendicitis, although found most reliable, does not exclude the necessity of a thorough examination. Briefly, one should not palpate the abdomen around McBurney's point. The patient flexes the thighs. The hand is applied to the region of the hepatic flexure of the colon. While the patient breathes as deeply as possible, the hand is pressed very gently under the costal margin. The patient is told to cough, and is then asked whether any pain is felt; the answer may be yes or no. When it is "yes," the patient, on being asked where the pain is felt, without hesitation will indicate McBurney's point when a true appendicitis is present. In acute cases it will be unnecessary to ask the patient whether pain is felt. The patient will eagerly and spontaneously say: "It hurts me here," indicating McBurney's point. When the case
Epidural Pneumatosis and Diffuse Soft Tissue Free Air As a Complication of Diabetic Ketoacidosis
Authors: William B. Hall, Robert M. Aris
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

A 23-year-old male with type 1 diabetes presented to the emergency department with insulin nonadherence, vomiting, and sharp neck pain.Laboratory values were consistent with diabetic ketoacidosis (DKA).The physical exam revealed diffuse crepitance around the neck and chest wall.A chest X-ray (Figure 1) showed subcutaneous emphysema (black arrow) and pneumomediastinum (white arrow).A chest computed tomographic scan (Figure 2) revealed extensive pneumomediastinum (thin white arrow) and soft tissue emphysema involving the chest wall, paraspinal musculature, soft tissues (thick black arrow), and epidural pneumatosis (thin black arrow).Rarely reported in the English-language medical literature (1-4), diffuse soft tissue free air associated with DKA is typically benign and likely caused by alveolar rupture from forceful vomiting or Kussmaul respiration (1).Epidural pneumatosis occurs when free air tracks through fascial planes in the brachial plexus, axillary arteries, intercostal nerves, or intervertebral foramina.Our patient's history of emesis raised concern for esophageal perforation, but water-soluble contrast swallow evaluation was normal.The patient fully recovered with conservative management.
Medicare Reform — Now Is the Time
Authors: G R Wilensky
Journal: New England Journal of Medicine (2001)

Reforming Medicare, which serves persons who are 65 years of age or older and many persons with disabilities, is a popular topic whenever the program's solvency is perceived to be at stake. Given that the latest report of the Medicare trustees predicts that the hospital insurance trust fund will be solvent until 2029 (although trust-fund payments will exceed trust-fund income by 2016),1 should Medicare reform still be regarded as requiring the near-term attention of the public and Congress? I believe that now — by which I mean this presidential term, if not this session of Congress — is precisely the . . .
In-111 7E11-C5.3 ANTI PROSTATE ANTIBODY
Authors: D A Podoloff, R J Babalan, J Sayer, V A Bhadkamkar, L Steelhammer
Journal: Clinical Nuclear Medicine (1993)

Podoloff, D A M.D.; Babalan, R J M.D.; Sayer, J M.D.; Bhadkamkar, V A; Steelhammer, L R.N. U.T. M.D. Author Information
Impaired Glucose Tolerance and Diabetes Mellitus in Elderly Subjects
Authors: Erik Agner, Birger Thorsteinsson, Marie Erikson
Journal: Diabetes Care (1982)

In a 10-yr prospective population study 406 subjects who were 70 yr old received an oral glucose tolerance test. Of these subjects 169 were retested at 80. Three sets of diagnostic criteria were evaluated, of which the WHO criteria are recommended for screening studies in this age group. The prevalences of diabetes mellitus (DM) and impaired glucose tolerance (IGT) according to the latter criteria were 10% vand 26% at 70 and 12% and 35% at 80 in men and women. Excess 10-yr mortality was seen in both sexes when DM existed at 70, and in men also when IGT existed at this age. The excess mortality in men could solely—and in women partly—be explained by cardiovascular diseases. The 10-yr incidence of DM was 20% if IGT existed at 70, but only 4% when normal glucose tolerance was present at 70.
Long-term Diazepam Therapy
Authors: Eve Bargmann, Sidney M. Wolfe
Journal: JAMA (1984)

<h3>To the Editor.—</h3> In their report on long-term diazepam use, Rickels et al<sup>1</sup>leave at least two important questions unanswered. First, none of their 14 patients experiencing diazepam withdrawal symptoms had seizures or psychosis, and they conclude that the withdrawal was neither life threatening nor incapacitating. This is hardly surprising, since in 11 of these 14 patients, diazepam therapy was reinstituted when withdrawal symptoms appeared and was then gradually withdrawn. Psychosis during benzodiazepine withdrawal has been reported four to seven days after discontinuation of treatment with the drug<sup>2,3</sup>; seizures have been reported after two to five days.<sup>4,5</sup>How long did Rickels' patients receive placebo before diazepam treatment was resumed? Second, they suggest that the gradual return of anxiety symptoms in patients who no longer took diazepam proves the long-term efficacy of diazepam. To prove efficacy, they would need to show that patients receiving diazepam for 22 weeks
Noise in the Operating Room
Authors: Richard A. Shapiro, Theodore Berland
Journal: New England Journal of Medicine (1972)

MODERN surgery discovered the dangers of air pollution and water pollution about a century ago and, as a result, has practiced aseptic, antipollution technics since. However, in our pollution-aware age, surgery has fallen behind in its recognition of what has been called "The Third Pollution." This is noise, defined as unwanted, noxious, or harmful sound.We surveyed noise levels and noise sources in a typical operating room during a common procedure. The room was one in the Surgical Suite at Michael Reese Hospital and Medical Center, Chicago, built in the early 1960's. The procedure was a combination cholecystectomy and tubal . . .
Syphilis Exposure in Patients with Uveitis
Authors: Gaetano R. Barile, Thomas E. Flynn
Journal: Ophthalmology (1997)

Purpose: The purpose of the study is to determine the frequency of syphilis exposure in patients with uveitis, identify patient characteristics associated with serologic fluorescent treponemal antibody assays (FTA-ABS) reactivity, and examine the clinical implications of syphilis exposure in patients with uveitis. Methods: A retrospective review of the records of 552 consecutive patients examined in the referral uveitis clinic of an urban eye hospital between January 1989 and January 1994 was performed. Results: Forty-four (8%) of 552 consecutive patients with uveitis had serologic evidence of syphilis exposure on the basis of a strongly reactive serum FTA-ABS. Syphilis was presumed to be the sole cause of uveitis in 24 patients (4.3%) over the 5-year period. The racial demographic profile of those patients with serologic evidence of syphilis was consistent with the reported distribution of syphilis cases, but there were relatively few identifiable risk factors for sexually transmitted disease (including only three patients who were positive with human immunodeficiency virus). The choice of antibiotic treatment of these patients was variable and sometimes suboptimal. Conclusions: This study implicates syphilis exposure as a more common etiology of uveitis than did previous reports, advocates routine serum FTA-ABS testing of patients with uveitis, and indicates a need for a more aggressive role of the ophthalmologist in antibiotic treatment of patients with uveitis and syphilis exposure. Purpose: The purpose of the study is to determine the frequency of syphilis exposure in patients with uveitis, identify patient characteristics associated with serologic fluorescent treponemal antibody assays (FTA-ABS) reactivity, and examine the clinical implications of syphilis exposure in patients with uveitis. Methods: A retrospective review of the records of 552 consecutive patients examined in the referral uveitis clinic of an urban eye hospital between January 1989 and January 1994 was performed. Results: Forty-four (8%) of 552 consecutive patients with uveitis had serologic evidence of syphilis exposure on the basis of a strongly reactive serum FTA-ABS. Syphilis was presumed to be the sole cause of uveitis in 24 patients (4.3%) over the 5-year period. The racial demographic profile of those patients with serologic evidence of syphilis was consistent with the reported distribution of syphilis cases, but there were relatively few identifiable risk factors for sexually transmitted disease (including only three patients who were positive with human immunodeficiency virus). The choice of antibiotic treatment of these patients was variable and sometimes suboptimal. Conclusions: This study implicates syphilis exposure as a more common etiology of uveitis than did previous reports, advocates routine serum FTA-ABS testing of patients with uveitis, and indicates a need for a more aggressive role of the ophthalmologist in antibiotic treatment of patients with uveitis and syphilis exposure.
A Case of Tuberculous Rheumatism: Grocco-Poncet Type
Authors: E. Montuschi
Journal: Annals of the Rheumatic Diseases (1944)

The conception that rheumatoid (atrophic) arthritis and acute polyarthritis simulating rheumatic fever may in certain cases have a tuberculous aetiology with an allergic or bacillaemic pathogenesis, was born in Florence with the teachings of Pietro Grocco (1892), who held the chair of clinical medicine at the University.* Because of this, many papers on tuberculous rheumatism were published in Italy at the beginning of the century.A second crop of papers in the 1930's can be traced to the fact that Cesare Frugoni, a disciple of the Florentine school, became Professor of Medicine in Rome at that time.In 1932 Frugoni and Peserico, reviewing the subject of tuberculous rheumatism, proposed that the condition should be named " Grocco- Poncet" rheumatism.They expressed doubts of the claims of Reitter and Loewenstein (1933) that a tuberculous bacillaemia is commonly found in this condition, and also rejected the claims of the French authors that the condition itself is very common.The Roman school of medicine adheres to the view (Klinge, 1929) that rheumatism is a specific reaction of mesenchymal tissue to non-specific noxae, and believes that tuberculosis is one of the agents capable of producing the clinical and pathological changes characteristic of rheumatism.The observation of
Comparison between subjective and ultrasound assessments of fetal movement.
Authors: A Gettinger, A B Roberts, S Campbell
Journal: BMJ (1978)

Forty pregnant women participated in a study to compare subjective with ultrasound assessments of fetal movements. A real-time ultrasound scanner was used. Movements were recorded for 45 minutes in all cases. There was a significant positive correlation between the number of movements recorded by the two methods, but the 95% confidence limits were wide and no correlation was found in those patients who recorded fewer than 20 movements in the study period. Thus "false-positive" information may be obtained from purely subjective data, and in patients reporting low "kick counts" fetal activity should be assessed from real-time ultrasound recordings.
Diagnosis of abdominal tuberculosis by T-cell-based assays on peripheral blood and peritoneal fluid mononuclear cells
Authors: Sung-Han Kim, Oh-Hyun Cho, Su Jin Park, Byong Duk Ye, Heungsup Sung, Mi-Na Kim, Sang-Oh Lee, Sang-Ho Choi, Jun Hee Woo, Yang Soo Kim
Journal: Journal of Infection (2009)
Beneficial effect of intravenous diltiazem in the acute management of paroxysmal supraventricular tachyarrhythmias.
Authors: A Betriu, B R Chaitman, M G Bourassa, G Brévers, J M Scholl, P Bruneau, P Gagné, M Chabot
Journal: Circulation (1983)

We tested the effectiveness and safety of i.v. diltiazem in the management of paroxysmal supraventricular tachyarrhythmias in 39 patients, 21 with organic heart disease and seven in heart failure. Fifteen patients presented with supraventricular tachycardia, 12 with atrial fibrillation and 12 with atrial flutter. End points were conversion to sinus rhythm or slowing of the ventricular rate to 100 beats/min or less. Diltiazem was given as an i.v. bolus of either 150 or 300 micrograms/kg over 2 minutes. A second injection was administered to patients who received the lower dose and failed to reach either end point within 30 minutes. The overall success rate was 82% (32 of 39 patients). Time to end point was 5 minutes or less in 20 patients. Conversion to sinus rhythm occurred in 13 of 15 patients (87%) with supraventricular tachycardia and in two of 12 patients with atrial fibrillation. Treatment side effects included a slow ventricular rate in one patient who had a sick sinus syndrome and hypotension in two patients that rapidly responded to fluid administration. We conclude that i.v. diltiazem is effective and well tolerated and advocate its use in the management of paroxysmal supraventricular tachyarrhythmias.
Impact of hyperthermic preconditioning on postischemic hepatic microcirculatory disturbances in an isolated perfusion model of the rat liver
Authors: Hiroaki Terajima, Georg Enders, Axel Thiaener, Claus Hammer, Tadashi Kondo, Joachim Thiery, Yuzo Yamamoto, Yoshio Yamaoka, Konrad Messmer
Journal: Hepatology (2000)

Sublethal hyperthermia and the following recovery from this heat exposure, referred to as hyperthermic preconditioning, elicits a transient state of tolerance to oxidative insults through an intracellular protective response: stress response. The impact of hyperthermic preconditioning on hepatic microcirculatory disturbance, which is one of the determinants of ischemia/reperfusion-induced injury of the liver, was investigated by using intravital fluorescence microscopy. Thirty minutes of ischemia and a subsequent 120 minutes of reperfusion was induced in an in situ isolated perfusion model of Sprague-Dawley rats. Heat stress was given by whole-body hyperthermia, and a subsequent recovery was allowed for 18 or 48 hours, respectively. Postischemic decrease in sinusoidal perfusion rate and sinusoidal diameter, leukocyte stagnation in sinusoids, and leukocyte adhesion in postsinusoidal venules were significantly attenuated in both hyperthermia-pretreated groups. A recovery of bile production, a reduction of liver enzyme release, and an attenuation of tissue edema and histological damage were also observed. A marked expression of heat shock protein (HSP) 70 and heme oxygenase (HO-1)/HSP32 was correlatively observed in the liver tissue coincident with the induction of these protective effects. Hyperthermic preconditioning provides a continuous long-term and constant inhibitory effect (up to 48 hours after heat exposure) on postischemic injury of the liver through the attenuation of microcirculatory disturbances. These beneficial effects might be associated with a concomitant increase in HSP70 and HO-1/HSP32 expression.
New Findings in the Genetics of Alcoholism
Authors: Marc A. Schuckit
Journal: JAMA (1999)

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
A seek-and-hide game between Cd1-restricted T cells and herpesviruses
Authors: Nagendra R. Hegde, David C. Johnson
Journal: Journal of Clinical Investigation (2005)

T and NK cells collaborate to control viral infections, discerning minute differences between infected and uninfected cells. At the same time, viruses have evolved to escape this discovery. In this issue of the JCI, Ganem and colleagues show that Kaposi sarcoma–associated herpesvirus (KSHV) inhibits CD1d presentation to T cells. This novel immune evasion strategy highlights the importance of CD1d-restricted T cells in controlling viral infection and raises an interesting question: how do T cells recognize viruses in the context of CD1 molecules that bind lipids? In the case of herpesviruses, alterations in endosomal trafficking might trigger redistribution of CD1/lipid complexes to cell surfaces, thereby promoting recognition by CD1d-restricted T cells.
Anticoagulant drugs in the elderly
Authors: H G M Shetty
Journal: BMJ (1988)

the relative risk of vertical transmission of herpes simplex virus.Medicolegally it would be difficult to defend a case of neonatal herpes in which antenatal maternal virological screening had not been performed on a woman with a history of genital herpes.Although systemic administration of acyclovir does not produce teratogenic effects in animal studies, experience in humans is limited.Oral acyclovir is offered to women with primary genital herpes during pregnancy with a warning of the possibility of unknown risks.The use of acyclovir in late pregnancy for women with an episode of recurrent herpes virus infection remains contro- versial.
GW25-e3448 Mitochondrial Transfer from Induced Pluripootent Stem Cells to Ischemic Myocardial Cells Protects against Acute Myocardial Infarct in Rats
Authors: Xu Jia, Jiang Ren, Zhan Wei, Xu Xue, Cai Ruibin, Zheng Ziyu, Zhan Hong, Ye Zi, Xiong Yan
Journal: Journal of the American College of Cardiology (2014)
Politician accuses drug companies of overplaying dangers of H1N1
Authors: R. Watson
Journal: BMJ (2010)

Drug companies are being accused of unnecessarily raising fears over the H1N1 swine flu virus so as to increase profits by boosting sales of their new vaccines.

The allegations, made in the parliamentary assembly of the Strasbourg based Council of Europe, are surfacing as several countries, notably the United Kingdom, France, and Germany, are looking to dispose of excess supplies of the unwanted vaccines ( BMJ 2010;340:c170, 11 Jan, doi:10.1136/bmj.c170).

Wolfgang Wodarg, a German Social Democrat MP and chairman of the assembly’s health subcommittee, is, with the support of a cross party group of Council of Europe parliamentarians, pressing for a pan-European investigation into the role of the companies in the current pandemic.

“We have twice had …
Prophylaxis after Sexual Exposure to HIV
Authors: Amy J. Behrman
Journal: Annals of Internal Medicine (1998)

Letters15 October 1998Prophylaxis after Sexual Exposure to HIVAmy J. Behrman, MDAmy J. Behrman, MDUniversity of Pennsylvania; Philadelphia, PA 19104Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Drs. Katz and Gerberding [1] argue effectively for prophylaxis after sexual exposures to HIV. As a physician who treats many occupational HIV exposures, I offer a few comments.Many patients seeking prophylaxis after sexual exposures are likely to present to emergency departments for care because populations with sexually transmitted diseases often use this facility for episodic care. Because sexual exposures often occur after normal office hours, a public health campaign emphasizing rapid postexposure treatment and attempts to provide treatment within hours rather than days (as is recommended after occupational exposures [2, 3]) would increase use of emergency ...References1. Katz MH, Gerberding JL. The care of persons with recent sexual exposure to HIV. Ann Intern Med. 1998; 128:306-12. Google Scholar2. Update: Provisional Public Health Service recommendations for chemoprophylaxis after occupational exposure to HIV. MMWR Morb Mortal Wkly Rep. 1996; 45:468-72. Google Scholar3. Gerberding JL. Prophylaxis for occupational exposure to HIV. Ann Intern Med. 1996; 125:497-501. Google Scholar Author, Article, and Disclosure InformationAuthors: Amy J. Behrman, MDAffiliations: University of Pennsylvania; Philadelphia, PA 19104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1998Volume 129, Issue 8Page: 671KeywordsEmergency departmentHealth care providersHIVPatientsPopulation statisticsPrevention, policy, and public healthProphylaxisRisk assessmentsSexually transmitted diseasesTreatment guidelines ePublished: 15 August 2000 Issue Published: 15 October 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Dutch consider obligatory testing of surgeons for hepatitis B
Authors: T. Sheldon
Journal: BMJ (1999)

Pressure is mounting in the Netherlands for regular testing plus obligatory vaccination against viruses such as hepatitis B for medical and nursing staff working in areas where there is a risk of blood contact.

The calls follow an investigation into how up to 28 patients were infected with hepatitis B by a surgeon over four years at the Saint Joseph Hospital near Eindhoven. One patient subsequently passed the virus to his partner, who later died, probably …
Aminoacidurias Due to Inherited Disorders of Metabolism
Authors: George W. Frimpter
Journal: New England Journal of Medicine (1973)

Branched-Chain Amino AcidsMaple-Syrup-Urine DiseaseThis designation derives from a supposedly characteristic odor to the urine of children who fail to dispose of the keto acid derivates of valine, isoleucine and leucine. These patients become ill in early infancy with vomiting and hypertonicity and later depression of the reflexes, convulsions and death. Over 30 cases have been described.81 The accumulation of keto acids and their corresponding branched-chain amino acids is due to a deficiency of oxidative metabolism. Alloisoleucine is also found in the urine and is due to reamination of α-keto-β-methylvaleric acid.82 Dancis and his co-workers developed an assay for . . .
Salvage therapy with azacitidine increases regulatory T cells in peripheral blood of patients with AML or MDS and early relapse after allogeneic blood stem cell transplantation
Authors: T Schroeder, J Fröbel, R-P Cadeddu, A Czibere, A Dienst, U Platzbecker, G Bug, L Uharek, R Fenk, U Germing, N Kröger, R Haas, G Kobbe
Journal: Leukemia (2013)