tbuckley/cabot-search huggingface dataset:
Accidental Perforation of the Uterus with an Intrauterine Contraceptive Device
Authors: B. J. E. Cooke
Journal: BMJ (1966)

secretory capacity of the stomach, but secreted significantly higher acids in the basal state as compared with their normals.These cases are thus not comparable with the two series1 2 described above.We found prominent mucosal folds in duo- denum in only 11 with spasticity and in four of the 29 adult males with severe hookworm anaemia (mean haemoglobin 4.46 g./100 ml., S.E. 0.24).Ten out of these 29 cases had complained of upper abdominal pain with some resemblance to ulcer pain.Out of these ten cases four had prominent duodenal folds, with spasticity in two.Among the cases without abdominal pain seven out of 19 showed similar changes, with duodenal bulb irritability in two of them.There was no correlation between abdominal pain and radiological appearances which could be con- sidered as suggestive of " duodenitis."In all these cases gastric acid secretion was reduced irrespective of the presence of prominent mucosal folds or the abdominal pain.We have not studied duodenal histology in these cases.However, it would be of interest to note that in a separate study we could not find any correlation between morphological changes and the radiological appearances of prominent mucosal folds with or without irritability of the jejunum, where hookworm infestation is most marked.We feel that there is no convincing proof of existence of " duodenitis " as a distinct clinical, radiological, and pathological entity, and therefore use of this term in scientific communications should be condemned and the more considered approach of Fraser and his colleagues' and your leader should be followed.-Weare, etc.,
Couple Therapy for Posttraumatic Stress Disorder—Reply
Authors: Candice M. Monson, Patricia A. Resick, Paula P. Schnurr
Journal: JAMA (2012)

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
Insulin Prevents Latent Skin Lesions by Inhibiting the Generation of Advanced Glycation End Products in Streptozotocin-Induced Diabetic Rats
Authors: Xiangfang Chen, Weidong Lin, Shuliang Lu, Yongquan Shi, Junjie Zou, Zhimin Liu, Wanqing Liao
Journal: Endocrine Pathology (2009)
Avoidance of Hypoglycemia Restores Hypoglycemia Awareness by Increasing β-Adrenergic Sensitivity in Type 1 Diabetes
Authors: Andreas Fritsche, Norbert Stefan, Hans Häring, John Gerich, Michael Stumvoll
Journal: Annals of Internal Medicine (2001)

Background: Lack of awareness of hypoglycemia is a major limiting factor in the management of type 1 diabetes. Objective: To examine whether reduction in the number of episodes of hypoglycemia restores hypoglycemia awareness by influencing β-adrenergic sensitivity in patients with type 1 diabetes. Design: Controlled interventional study. Setting: Research unit and outpatient diabetes clinic of a university hospital. Patients: 10 men with type 1 diabetes and hypoglycemia unawareness (mean age [±SD], 46 ± 16 years; mean duration of diabetes, 20 ± 10 years). Intervention: Strict avoidance of hypoglycemia. Measurements: β-Adrenergic sensitivity was measured by isoproterenol testing before and at 2 and 4 months after strict avoidance of hypoglycemia. Hypoglycemia awareness and catecholamine response were measured by performing hypoglycemic clamp (glucose level, 3 mmol/L [54 mg/dL]) before and after 4 months of avoidance of hypoglycemia. Results: After 4 months, the mean (±SE) number of episodes of hypoglycemia (glucose level < 3.9 mmol/L [70 mg/dL]) decreased from 8.4 ± 0.9 to 1.4 ± 0.3 per week (P < 0.001). Hemoglobin A1c values increased from 0.068 ± 0.003 (6.8% ± 0.3%) to 0.077 ± 0.003 (7.7% ± 0.3%) (P < 0.001). Autonomic symptom scores during hypoglycemic clamp increased from 1.8 ± 0.6 to 3.3 ± 0.7 (P = 0.004) and did not significantly differ from those of normal participants (4.7 ± 0.8) (P > 0.2). Although catecholamine responses to hypoglycemia were unchanged, the dose of isoproterenol necessary to increase heart rate by 25 beats/min (IC25) decreased from 1.96 ± 0.43 µg before treatment to 1.09 ± 0.17 µg after 4 months of treatment (P = 0.01), a value similar to that in normal participants (0.85 ± 0.20 µg) (P > 0.2). Improvements in β-adrenergic sensitivity (change in IC25 −1) were correlated with improvements in autonomic symptoms (r = 0.65; P = 0.04). Conclusions: Avoidance of hypoglycemia in patients with type 1 diabetes who have hypoglycemia unawareness seems to restore hypoglycemia awareness, primarily by increasing β-adrenergic sensitivity.
Platelet-activating factor. A potent chemotactic and chemokinetic factor for human eosinophils.
Authors: A J Wardlaw, R Moqbel, O Cromwell, A B Kay
Journal: Journal of Clinical Investigation (1986)

Platelet-activating factor (PAF-acether), an inflammatory mediator with a wide range of biological activities including neutrophil aggregation and chemotaxis, was studied for its effect on human eosinophil locomotion (chemotaxis and chemokinesis). Human eosinophils (25-95% purity) were obtained from donors with a variety of diseases associated with hypereosinophilia. PAF-acether elicited directional locomotion of eosinophils, in a time- and dose-dependent fashion, at concentrations from 10(-5) to 10(-8) M; lyso-PAF had minimal activity over the same dose range. Compared with PAF-acether, the eosinophil locomotory responsiveness of leukotriene B4 (LTB4), histamine, and the valyl- and alanyl-eosinophil chemotactic factor of anaphylaxis (ECF-A) tetrapeptides was negligible. Conversely, neutrophil responsiveness to PAF-acether (optimum 10(-6) M) was comparable in effect to LTB4 (optimum dose 10(-8) M). It was shown that PAF-acether elicited both chemotaxis and chemokinesis of eosinophils. Comparison of normal density and light density eosinophils revealed no qualitative difference in the response to PAF-acether and the other chemoattractants, although the light density cells seemed to demonstrate a greater degree of locomotion to PAF-acether and LTB4. Thus, PAF-acether appears to be a potent eosinophilotactic agent which may play a role in inflammatory reactions characterized by eosinophil infiltration.
Aviator Medical Certification after Coronary-Artery Surgery
Authors: Milton J. Sands
Journal: New England Journal of Medicine (1982)

IN several recent decisions,* the National Transportation Safety Board has issued orders to the Federal Aviation Administration for medical certification of pilots with surgically treated coronary-artery disease, thus returning them to active flight status. Because of the unresolved controversy surrounding the efficacy of bypass surgery in the treatment of patients with coronary-artery disease and the fact that resumption of active flying status in some cases represents command responsibility in passenger-carrying commercial jet aircraft, the wisdom of these decisions and their effect on the safety of the general public have generated considerable concern.This report will discuss both the basis for . . .
Developmental origins and impact of BCR-ABL1 fusion and IKZF1 deletions in monozygotic twins with Ph+ acute lymphoblastic leukemia
Authors: Giovanni Cazzaniga, Frederik W. van Delft, Luca Lo Nigro, Anthony M. Ford, Joannah Score, Ilaria Iacobucci, Elena Mirabile, Mary Taj, Susan M. Colman, Andrea Biondi, Mel Greaves
Journal: Blood (2011)
Outpatient Electronic Health Records and the Clinical Care and Outcomes of Patients With Diabetes Mellitus
Authors: Mary Reed, Jie Huang, Ilana Graetz, Richard Brand, John Hsu, Bruce Fireman, Marc Jaffe
Journal: Annals of Internal Medicine (2012)

Chinese translation Background: Physicians can receive federal payments for meaningful use of complete certified electronic health records (EHRs). Evidence is limited on how EHR use affects clinical care and outcomes. Objective: To examine the association between use of a commercially available certified EHR and clinical care processes and disease control in patients with diabetes. Design: Quasi-experimental design with outpatient EHR implementation sequentially across 17 medical centers. Multivariate analyses adjusted for patient characteristics, medical center, time trends, and facility-level clustering. Setting: Kaiser Permanente Northern California, an integrated delivery system. Patients: 169 711 patients with diabetes mellitus. Intervention: Use of a commercially available certified EHR. Measurements: Drug treatment intensification and hemoglobin A1c (HbA1c) and low-density lipoprotein cholesterol (LDL-C) testing and values. Results: Use of an EHR was associated with statistically significant improvements in treatment intensification after HbA1c values of 9% or greater (odds ratio, 1.10 [95% CI, 1.05 to 1.15]) or LDL-C values of 2.6 to 3.3 mmol/L (100 to 129 mg/dL) (odds ratio, 1.06 [CI, 1.00 to 1.12]); increases in 1-year retesting for HbA1c and LDL-C levels among all patients, with the most dramatic change among patients with the worst disease control (HbA1c levels ≥9% or LDL-C levels ≥3.4 mmol/L [≥130 mg/dL]); and decreased 90-day retesting among patients with HbA1c levels less than 7% or LDL-C levels less than 2.6 mmol/L (<100 mg/dL). The EHR was also associated with statistically significant reductions in HbA1c and LDL-C levels, with the largest reductions among patients with the worst control (0.06-mmol/L [2.19-mg/dL] reduction among patients with baseline LDL-C levels ≥3.4 mmol/L [≥130 mg/dL]; P < 0.001). Limitation: The EHR was implemented in a setting with strong baseline performance on cardiovascular care quality measures. Conclusion: Use of a commercially available certified EHR was associated with improved drug treatment intensification, monitoring, and physiologic control among patients with diabetes, with greater improvements among patients with worse control and less testing in patients already meeting guideline-recommended glycemic and lipid targets. Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases.
Previous Exposure to Trauma and PTSD Effects of Subsequent Trauma: Results From the Detroit Area Survey of Trauma
Authors: Naomi Breslau, Howard D. Chilcoat, Ronald C. Kessler, Glenn C. Davis
Journal: American Journal of Psychiatry (1999)

OBJECTIVE: With the exception of a few reports of higher rates of childhood trauma in Vietnam veterans with posttraumatic stress disorder (PTSD), little is known about the influence of previous exposure to trauma on the PTSD effects of subsequent trauma. The authors examine interrelated questions about the effects of previous exposure to trauma. METHOD: A representative sample of 2,181 individuals in southeast Michigan were interviewed by telephone to record lifetime history of traumatic events specified in DSM-IV as potentially leading to PTSD. PTSD was assessed with respect to a randomly selected index trauma from the list of events reported by each respondent. RESULTS: History of any previous exposure to traumatic events was associated with a greater risk of PTSD from the index trauma. Multiple previous events had a stronger effect than a single previous event. The effect of previous assaultive violence persisted over time with little change. When they examined several features of the previous exposure to trauma, the authors found that subjects who experienced multiple events involving assaultive violence in childhood were more likely to experience PTSD from trauma in adulthood. Furthermore, previous events involving assaultive violence—single or multiple, in childhood or later on—were associated with a higher risk of PTSD in adulthood. CONCLUSIONS: Previous exposure to trauma signals a greater risk of PTSD from subsequent trauma. Although these results are consistent with a sensitization hypothesis, like the results from previous research on PTSD, they do not address the mechanism of increased responsivity to trauma. Long-term observational studies can further elucidate these observations.
Place of Death and Its Predictors for Local Patients Registered at a Comprehensive Cancer Center
Authors: Eduardo Bruera, Nancy Russell, Catherine Sweeney, Michael Fisch, J. Lynn Palmer
Journal: Journal of Clinical Oncology (2002)

PURPOSE: To help with planning of a palliative care program, we reviewed the place of death of patients who were registered at our comprehensive cancer center and explored factors that predicted death in the hospital versus death at home. PATIENTS AND METHODS: A retrospective study was undertaken of local patients who were registered at the University of Texas M.D. Anderson Cancer Center and died during the 1997/1998 fiscal year. Data from the institutional tumor registry and from the State of Texas Bureau of Vital Statistics file were collected and analyzed. The main outcome measures were place of death, patient characteristics associated with place of death, and time from registration at the institution to death. RESULTS: Of 1,793 local patients, 251 (14%) died at M.D. Anderson Cancer Center; the remaining 86% died elsewhere. A total of 617 (34%) died at home, and 929 (52%) died in an acute hospital setting (including M.D. Anderson). A total of 1,040 (58%) died within 2 years of registration. The risk of hospital death versus home death increased for patients with cancer at a hematologic site (odds ratio [OR], 4.4; 95% confidence interval [CI], 2.8 to 6.8) and black ethnicity (OR, 1.9; 95% CI, 1.4 to 2.6) and decreased for patients who paid with Medicare (OR, 0.71; 95% CI, 0.57 to 0.90). CONCLUSION: Most patients died in an acute care hospital setting and within 2 years of registration. Our data show some predictors of hospital death for cancer patients and suggest that better hospital palliative care services and integrated palliative care systems that bridge community and acute hospitals are needed.
Abstract 895: NFκB and IκBKB polymorphisms and colorectal cancer survival in the Seattle Colon Cancer Family Registry
Authors: Anna E. Coghill, Polly A. Newcomb, Elizabeth M. Poole, Dave Duggan, Karen W. Makar, Cornelia M. Ulrich
Journal: Cancer Research (2010)

Abstract Introduction: IκBKB and NFκB are regulatory enzymes that interact with the prostaglandin synthesis pathway, which plays a key role in inflammation and colorectal carcinogenesis. Transcriptional targets of the nuclear factor NFκB have been linked to cellular proliferation, angiogenesis, and metastasis. IκBKB binds NFκB within the cytoplasm and can prevent its nuclear localization. The role of variability in these genes in relation to colorectal cancer (CRC) survival has not been investigated; we therefore examined polymorphisms in both IκBKB and NFκB in relation to CRC survival. Methods: CRC cases were ascertained from 1997-2002 from the Seattle Colon Cancer Family Registry and were matched through linkages to the National Death Index records to obtain date and cause of death. A subgroup of CRC cases was genotyped for selected tagSNPs (9 in IκBKB; 44 in NFκB), including non-synonymous candidate polymorphisms (IκBKB: rs17875749, rs2272736; NFκB: rs4648072, rs4648099). Cox proportional hazards regression models were used to estimate hazard ratios investigating the relationship between polymorphisms in IκBKB and NFκB and CRC-specific mortality. Results: We observed statistically significant inverse associations between four SNPs in IκBKB (rs11986055, rs2272733, rs6474387, and rs9694958) and the risk of CRC mortality after diagnosis. The observed survival benefit ranged from 86% reduced CRC mortality risk for rs11986055 (HR AA vs. AC or CC: 0.14, 95% CI 0.02-1.03) to 59% reduced CRC mortality risk for rs2272733 (HR GG vs. GA or AA: 0.41, 95% CI 0.20-0.82). The functional significance of these SNPs is unknown; none of these SNPs were in high linkage disequilibrium, with all r2 values &amp;lt; 0.7. No SNPs investigated in NFκB were significantly associated with colorectal cancer survival. Conclusion: These data suggest that certain polymorphisms in IκBKB may be associated with mortality from colorectal cancer after diagnosis.Associations between IκBKB polymorphisms and CRC survival Hazard Ratio95% CIp-valueAliveDeaadrs11986055 A&amp;gt;C AA1.00Ref. 20279AC or CC0.140.02-1.030.05241rs2272733 G&amp;gt;A GG1.00Ref. 17571GA or AA0.410.20-0.820.01519rs6474387 C&amp;gt;T CC1.00Ref. 18875CT or TT0.400.16-1.000.05365rs9694958 A&amp;gt;G AA1.00Ref. 18874AG or GG0.370.16-0.860.02386All models reported above adjusted for age, sex, and stage of disease at diagnosis Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 895.
Life and Death in the US Army
Authors: David W. Levine
Journal: JAMA (1991)

<h3>To the Editor.—</h3> The article by Rothberg et al<sup>1</sup>is timely and provocative. As US troops in the Persian Gulf wind down the war, it is timely to pay attention to the lives of our often forgotten soldiers. The irony of the study's finding that soldiers, especially black men, are safer from violence in the army than in the civilian world is provocative. The authors recognize several limitations in their study. Before the army starts urging people to enlist to "be as healthy as you can be," additional research is needed to explain the differences in standardized mortality ratios (SMR) between civilian and military populations. The authors speculate that several factors unique to military life account for the reduced SMR of soldiers compared with the general population. However, the case for a military-specific healthy worker effect may not be that strong. The US Army white male SMR of 64
A personal choice
Authors: Jason Karlawish
Journal: The Lancet (1997)

I am a physician, specifically a geriatrician. The Greek roots of the word physician mean that to be one is to be “a scientist of nature”. My goal is to restore my elderly patients to their natural state. But I am suspicious that “naturalness” is the condition that justifies what I do and who I am. I am suspicious because I cannot accept that ageing should happen because it is natural, any more than I can accept that tooth decay should happen because it is natural. Suspicious too because as a gay man I cannot accept the claim that the way I live is “unnatural” and therefore wrong. In short, I am in a bind: as I experience an ever-increasing incorporation into the natural order, my patients experience less. As the naturalness of homosexuality waxes, the naturalness of ageing wanes. Patient-triggered ventilation of the newbornThe introduction of assisted ventilation has been credited with striking improvements in the survival of very-low-birthweight infants.1 However, improvements in survival have been overshadowed by the emergence of diseases such as bronchopulmonary dysplasia.2 Since the mid-1960s, ventilators in neonatal intensive-care units have been of the type that produces intermittent mandatory ventilation (IMV)—ie, a fixed number of breaths independent of the infant's own respiratory effort. A concern about IMV is the possibility that the infant's spontaneous breaths are out of phase with mechanically delivered ventilator breaths. Full-Text PDF Wakley Prize, 1997Hares, tortoises, ears, middle-age, stress, synapses, cockroaches, the phrenic nerve, love, frailty, angels, and ghosts. We even had the statistics of pleasure. 78 essays from 26 countries, including Croatia, Mauritius, Cuba, and Ethiopia. We whittled these entries down to 20 and invited Nick White (just off an aeroplane in Thailand) to draw up a short list. His selection matched ours and we easily agreed on a winner, together with four runners-up, whose essays we will publish next year. Full-Text PDF
Occupational and Environmental Medicine
Authors: Linda Rosenstock, Kathleen M. Rest, John A. Benson, Joseph M. Cannella, Jordan Cohen, Mark R. Cullen, Frank Davidoff, Philip J. Landrigan, Richard C. Reynolds, Linda Hawes Clever, Gary B. Ellis, Bernard D. Goldstein
Journal: New England Journal of Medicine (1991)

ENVIRONMENTAL and occupational diseases encompass a wide range of human illness and are important causes of disability and death in modern American society.1 , 2 They include lung cancer and mesothelioma in persons exposed to asbestos, leukemia in persons exposed to benzene, asthma and chronic bronchitis in persons exposed to organic dusts, lung cancer in persons exposed to radon, chronic disorders of the nervous system in workers exposed to solvents, kidney failure and hypertension in persons chronically exposed to lead, heart disease in persons exposed to carbon disulfide, impairment of reproductive function in persons exposed to certain solvents and pesticides, and chronic . . .
Academic medicine: time for reinvention: Research needs researching
Authors: J. Grant
Journal: BMJ (2004)

Editor—We agree with Bell that advocating funding for clinical research needs to become evidence based.1

With colleagues we recently explored the relations between basic research, clinical research, and clinical practice.2,3 In the first report we tried to replicate Comroe and Dripps's seminal study as reported in Science in 1976,4 tracing back from current clinical practice to the knowledge behind the advance.2 Comroe and Dripps concluded that 40% of all research articles judged to be essential for later clinical advance were not clinically oriented at the time of the study and that 62% of key articles reported basic research. Their paper has often been used (albeit at times implicitly) in support of the increased funding for basic biomedical research in the United Kingdom and elsewhere over the past two decades.

We found we were unable to repeat the study method, thus confirming earlier doubts about it5 and raising questions about its reliability, validity, and applicability, at least for current circumstances.

In recognising the difficulties in tracing backwards from clinical practice, we undertook a preliminary study that tries to work forwards by tracing the impact of a range of research conducted 20 years ago.3 In this study we explored several methods that could help to identify the benefits from previous research and thus potentially be used to develop an evidence base to support funding decisions for research and development.

Our work has only begun to scratch the surface of this important but complex issue. Nevertheless, we think that research funding agencies should accept the need for a firm evidence basis for their policies and therefore support researching research, as Smith put it in 1987.5