tbuckley/cabot-search huggingface dataset:
Reenvisioning Medical Education for the New Millennium
Authors: Charlene Breedlove, Hannah Hedrick
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
The MONICA project comes of age
Authors: R Bonita
Journal: BMJ (1994)

Coronary heart disease accounts for an estimated five million deaths a year worldwide. Not only is it the leading cause of death in Western industrialised countries; it is an increasingly important problem in developing countries.1 The potential for prevention has long been recognised because of the widespread geographical differences in the incidence of the disease and the dramatic improvements in mortality that have occurred in many countries since the late 1960s.2 Still to be resolved are the reasons for the decline in mortality from both coronary heart disease and stroke in many countries and the continuing increase in countries of eastern and central Europe.

In the late 1970s it was realised that more data were needed to explain why death rates were changing than were provided in routine death certificates.3 Validated data from death certificates and complementary data on non-fatal myocardial infarctions, stroke, acute coronary care, and standard risk factors were essential. On the basis of the experience gained from the registers of ischaemic heart disease and stroke of the 1970s,4 the MONICA project was conceived in the early 1980s to MONItor the trends in and determinants of cardiovascular diseases. It was …
Effects of exercise training on in vivo insulin action in individual tissues of the rat.
Authors: D E James, E W Kraegen, D J Chisholm
Journal: Journal of Clinical Investigation (1985)

It has previously been suggested that exercise training leads to increased whole body insulin sensitivity. However, the specific tissues and metabolic pathways involved have not been examined in vivo. By combining the euglycemic clamp with administration of glucose tracers, [3H]2-deoxyglucose (2DG), [14C]glucose, and [3H]glucose, in vivo insulin action at the whole body level and within individual tissues has been assessed in exercise-trained (ET, running 1 h/d for 7 wk) and sedentary control rats at four insulin doses. Whole body insulin sensitivity was significantly increased in ET. In addition, the skeletal muscles, soleus, red and white gastrocnemius, extensor digitorum longus (EDL), and diaphragm all showed increased sensitivity of insulin-stimulated 2DG uptake with training. With the exception of EDL, no significant difference in insulin-mediated glycogen synthesis between control and ET could be found. Therefore, the increased insulin-induced 2DG uptake observed in muscle following training is apparently directed towards glucose oxidation. In ET animals, adipose tissue exhibited a significant increase in insulin-mediated 2DG uptake and [14C]glucose incorporation into free fatty acids but there was no difference from control in any parameters measured in lung or liver. EDL and white gastrocnemius, which are not primarily involved during exercise of this type, also demonstrated increased insulin sensitivity following training. In conclusion, exercise training results in a marked increase in whole body insulin sensitivity related mainly to increased glucose oxidation in skeletal muscle. This effect may be mediated by systemic as well as local factors and is likely to be of therapeutic value in pathological conditions exhibiting insulin resistance.
Prescribing at the interface between hospitals and general practitioners.
Authors: R. Jones, M. D. Rawlins
Journal: BMJ (1992)

high as 60% in revisions of revisions.2'Use of modern cementing techniques does not seem to reduce the failure rate.22Despite great advances in improving the lifespan of the primary hip replacement the capacity to correct a loose, aseptic, failed replacement is still poor,5 with rerevision within four years not being abnormal.'8A strong case can therefore be made for some surgeons to specialise in revision hip surgery and build on their familiarity with advanced bone grafting techniques, bone banking, custom made compo- nents, and sophisticated microbiological advice.Such special- ist facilities are not widely available in all countries.As the number of primary total hip replacements per- formed rises so will the number of revision procedures.Proper surgical technique may reduce the chance of failure but cannot entirely eliminate it.Pressure to increase the number of joint replacements performed must not be allowed to diminish surgical standards, otherwise this revision epidemic runs the risk of bringing orthopaedic surgery to its knees.
Sexual Rehabilitation of the Urologic Cancer Patient
Authors: Harry W. Schoenberg
Journal: JAMA (1981)

<i>Sexual Rehabilitation of the Urologic Cancer Patient</i>is an excellent in-depth survey of all aspects of this often overlooked subject. The material in this work is not for physicians alone but for all health professionals who, in the course of their work, encounter urologic cancer patients and their spouses and families. The wide range of experience, expertise, and professional points of view among the contributors indicates the complexity of this problem and the value of a multidisciplinary approach to it. There is a clarity of style throughout the book that makes reading easy. In addition, certain sections need special mention as being of particular interest to urologists. "Mechanisms of Human Erection, Emission, and Ejaculation: Current Clinical Concepts" by Benson et al presents what is known about these important human functions. These are complicated and often poorly understood areas where knowledge is incomplete and new data are presently appearing. In the
Recent Progress in Cancer Family Syndrome.
Authors: Henry T. Lynch
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Recent Progress in Cancer Family Syndrome.Henry T. Lynch, M.D., Anne J. Krush, M.S.Henry T. Lynch, M.D.Search for more papers by this author, Anne J. Krush, M.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-800_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe cancer family syndrome is characterized by increased incidence of adenocarcinoma, primarily of the colon and endometrium; increased frequency of multiple primary malignant neoplasms (20% or more); early age of onset; and autosomal dominant inheritance. Investigation of this syndrome was carried out on seven large kindreds in order to determine its clinical manifestations, possible incidence in the population, and to demonstrate the practical application of genetic information as an aid to earlier cancer diagnosis. Medical genetic information was compiled by means of physicians' and hospital records, questionnaires, and field trips for personal examination of family members. In addition, gastroenterologists and... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Henry T. Lynch, M.D.; Anne J. Krush, M.S.Affiliations: Omaha, Neb. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 800-800KeywordsCancer geneticsClinical geneticsColonEndometriumGastroenterology and hepatologyGenetic determinismHereditary nonpolyposis colorectal cancerMedical geneticsPopulation geneticsQuestionnaires ePublished: 1 December 2008 Issue Published: 1 May 1970 PDF downloadLoading ...
THE FATE OF PEPTIDES PINOCYTOSED BY MACROPHAGES IN VITRO
Authors: Barbara A. Ehrenreich, Zanvil A. Cohn
Journal: The Journal of Experimental Medicine (1969)

A series of small peptides, such as might arise in the course of intralysosomal protein digestion, were screened for the ability to escape, intact, from mouse peritoneal macrophage lysosomes. Inability to penetrate lysosomal membranes was inferred from a peptide's induction of lysosomal swelling, or vacuolization, in cultured macrophages. Two of the peptides tested, (D-Glu)2 and (D-Ala)3, induced vacuolization. Neither peptide was susceptible to hydrolysis by enzymes in macrophages or in the serum-containing culture medium. Their morphological effect was inhibited by parafluorophenylalanine, an inhibitor of pinocytosis. Once formed by either peptide, the vacuoles persisted for several hours in peptide-free medium. Quantitative studies of radioactively labeled (D-Glu)2 confirmed the morphological evidence that (D-Glu)2 is taken up by pinocytosis and stored, intact, in macrophage lysosomes. The majority of the peptides which failed to induce vacuolization—(L-Ala)2, L-Ser·L-Ala, L-Val·L-Ala, L-Ala·L-Thr, Gly·D, L-Phe, L-Ala·D-His, (L-Ala)3, (L-Glu)2, and D-Leu·L-Tyr—were found to be susceptible to hydrolysis by cellular or serum peptidases. Their failure to induce vacuolization was attributed to their hydrolysis to subunits capable of penetrating lysosomal membranes. Some of the peptides which had failed to induce vacuolization—(D-Ala)2, D-Ser·D-Ala, D-Val·D-Ala, Gly-D-Asn, D-Ala·D-Thr, and D-Arg·D-Val—were found to be indigestible. Except for the cytotoxic peptide D-Arg·D-Val, peptides in this category all had lower molecular weights and volumes than (Glu)2 or (Ala)3. It is inferred that these peptides are small enough to escape from macrophage lysosomes, while (Glu)2 and (Ala)3 are too large to escape intact. The implications of this inference for the mechanism of intracellular digestion of pinocytosed proteins are discussed.
Imported malaria in Britain
Authors: C Walton
Journal: BMJ (1985)

fever, myalgia, anorexia, and weight loss but in our case the finding was incidental.Interstitial nephritis has also been reported in a patient with glomerulonephritis who was concurrently taking cimetidine.3Determining the cause of deteriorating renal function may therefore be difficult, and, on present evidence, ranitidine should be used in preference to cimetidine in people with impaired renal function who need an H. antagonist, although there is one reported case of the use of steroids to control the cimetidine induced interstitial nephritis.4In our case, as in another,5 substitution of ranitidine for cimetidine permitted recovery of renal function.N ALI
Sleeplessness and Smoking
Authors: Joseph R. Thurn
Journal: JAMA (1988)

<h3>To the Editor.—</h3> The May 27,1988, issue of<i>JAMA</i>contains two articles concerning the findings of sleep researchers dealing with chronobiology, circadian rhythms, and work shifts.<sup>1,2</sup>The photographs are of interest. The first depicts a person who finds herself "staring at the clock" instead of sleeping. The nightstand is otherwise uncluttered. The second photograph, which asks if short-acting drugs are sometimes an appropriate choice to induce sleep for shift workers, contains some changes. The clock is no longer visible. Am open book and a prescription bottle are visible. Unfortunately, another addition is depicted that is hardly appropriate. Perhaps the pack of cigarettes, the matches, and the ashtray were included to indicate anxiety over the inability to sleep. The addition suggests that smoking is a normal response to stress and the inability to sleep. That smoking is a major health hazard and cause of fires and results in significant morbidity,
Mark Howard Beers
Authors: C. Richmond
Journal: BMJ (2009)

Highlighted the dangers of prescribing for elderly people

Mark Beers published and publicised his cautionary research on drug interactions in older people. He showed that many were the victims of inappropriate and excessive prescribing, and he drew up guidelines that are widely used in the United States and occasionally in Britain. His work led to the eponymous Beers criteria for prescribing for elderly people—although, said former colleague Professor Richard Besdine, he was far too self effacing to have used the term himself. Beers, a geriatrician, was attracted to the specialty for the intellectual challenge of working with patients with multiple illnesses.

He was born in New York; his father was a brigadier in the US Air Force and his mother a nurse. He attended Polypred School, Brooklyn, and was refused entry into several premedical university courses because he had type 1 diabetes, diagnosed when he was 9. He graduated in science from Tufts University in Boston and did his medical training at the University of Vermont. He did postgraduate training at Harvard, where he was …
Bias alone could account for benefit attributed to flu vaccine, study finds
Authors: J. Lenzer
Journal: BMJ (2008)

The reduction in mortality seen among elderly people who have been given the flu vaccine could have more to do with a “healthy user” effect than any protective value of the vaccine itself, a study has found. 

The researchers, from the University of Alberta in Edmonton, Canada, prospectively obtained clinical, laboratory, and functional status data and identified 1813 adults with community acquired pneumonia who were admitted to six hospitals in Alberta ( American Journal of Respiratory and Critical Care Medicine 2008;178:527-33, doi:10.1164/rccm.200802-282OC). Of these adults, 354 vaccine recipients met the inclusion criteria and were matched with 354 controls. 

The outcome of in-hospital mortality was examined during the months before and after the flu season, when no benefit of the flu jab would be expected. 

The researchers replicated a 51% mortality difference between the …
Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey
Authors: F. C. Warren, G. Abel, G. Lyratzopoulos, M. N. Elliott, S. Richards, H. E. Barry, M. Roland, J. L. Campbell
Journal: BMJ (2015)

Objective To investigate the experience of users of out of hours general practitioner services in England, UK. Design Population based cross sectional postal questionnaire survey. Setting General Practice Patient Survey 2012-13. Main outcome measures Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users' experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users' experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. Results The overall response rate was 35%; 971 232/2 750 000 patients returned surveys. Data from 902 170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of −3.13 (95% confidence interval −4.96 to −1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care −3.62, −4.36 to −2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care −4.73, −5.29 to −4.17). Conclusions Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and patients who are unable to take time away from work might be warranted.
Glucocorticoid induction of Kv1.5 K+ channel gene expression in ventricle of rat heart.
Authors: K Takimoto, E S Levitan
Journal: Circulation Research (1994)

Multiple voltage-gated K+ channels contribute to the repolarization phases of the cardiac action potential and are targets of several antiarrhythmic drugs. The Kv1.5 K+ channel gene is expressed in the heart, and heterologous expression of this gene generates a slowly inactivating K+ current. Previously, we found that glucocorticoids specifically upregulate pituitary Kv1.5 gene expression. To test whether these steroids might also induce Kv1.5 gene expression in the heart, cardiac channel mRNA and protein were measured by RNase protection assay and by immunoblotting with antibody specific for the extracellular domain of Kv1.5 polypeptide. Kv1.5 mRNA and immunoreactive protein appeared to be more abundant in rat ventricle than atrium. Reduction of endogenous glucocorticoids by adrenalectomy decreased ventricular Kv1.5 mRNA approximately 8-fold, which was estimated by using cyclophilin mRNA as an internal control. Kv1.5 immunoreactive protein also decreased approximately 6-fold. Injection of dexamethasone into adrenalectomized rats acted within a day to increase ventricular Kv1.5 mRNA and immunoreactive protein approximately 50-fold and approximately 20-fold, respectively. In contrast, atrial Kv1.5 mRNA expression was unaffected by either adrenalectomy or injection of the glucocorticoid agonist. Furthermore, dexamethasone-induced upregulation was specific for Kv1.5, since whole-heart Kv1.4 and Kv2.1 mRNA levels, as well as ventricular Kv2.1 mRNA expression, were unchanged. Thus, dexamethasone specifically upregulates Kv1.5 K+ channel gene expression in rat ventricle but not atrium. Glucocorticoids may affect excitability of ventricular myocytes and the efficacy of clinically useful drugs by changing the expression of the Kv1.5 K+ channel.
Women and Lung Cancer
Authors: Alfred I. Neugut, Judith S. Jacobson
Journal: JAMA (2006)

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
Toleration of Poor Teaching
Authors: Bruce Dearing
Journal: JAMA (1983)

<h3>To the Editor.—</h3> I note with amused bafflement the implicit message of Samuel M. Chen's essay in A PIECE OF MY MIND (1982;248:1541). Dr Chen underlines once more the familiar but curious tolerance by medical students of inept, unengaged, and unengaging teaching of a sort that would be sharply challenged and openly resented by students in less hierarchically organized disciplines and programs. The boring professor who droned monotonously through his required course in history of medicine is remembered with affection and approval because he generously (or indifferently) chose not to use his awesome professional power to punish a student who had had the temerity to speak the truth about the short-comings of the course. It would be more reasonable to be concerned about improvement of teaching or altering a system in which a student must expect harsh retribution if he calls attention to demonstrable inadequacy in the instruction to which