tbuckley/cabot-search huggingface dataset:
The Neglect of Nutrition in Medical Education
Authors: Nathaniel P. Morris
Journal: JAMA Internal Medicine (2014)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Internal Medicine journal
Synovial accumulation of technetium labelled liposomes in rheumatoid arthritis.
Authors: B D Williams, M M O'Sullivan, G S Saggu, K E Williams, L A Williams, J R Morgan
Journal: Annals of the Rheumatic Diseases (1987)

Technetium labelled, negatively charged, unilamellar liposomes were given by intravenous injection to patients with rheumatoid arthritis and the joints scanned 20-22 hours later. Positive scintigraphy was obtained in all six patients with active disease, and, with the exception of the small interphalangeal joints, all clinically involved joints could be visualised.
Indications for Anticoagulant Therapy
Authors: P. A. Owren
Journal: New England Journal of Medicine (1963)

THE place of anticoagulant therapy in the various types and phases of occlusive vascular disease, venous and arterial, has been debated ever since its introduction into clinical practice more than fifteen years ago. The widely divergent opinions and seemingly conflicting results of therapeutic trials that have appeared are unmistakable symptoms of defective knowledge, concerning not only the basic pathologic processes, which it is the aim of therapy to prevent, but also the management of therapy and the selection of the patients who are likely to benefit most. As a background for evaluating the various results in an attempt to establish . . .
Diffuse recidivant alveolar hemorrhage in a patient with hepatitis C virus-related mixed cryoglobulinemia
Authors: V. Gómez-Tello, J. J. Oñoro-Cañaveral, R. M. Casa Monje, R. B. Gómez-Casero, J. L. Moreno Hurtrez, M. García-Montes, L. C. Armas
Journal: Intensive Care Medicine (1999)
THE TREATMENT OF DIABETES
Authors: J. Hume
Journal: BMJ (1916)

JouaXand teriiiinal peritonitis all point to tllis.The case, however, presents imany problems of interest.It started wtlh tonsillitis probably of streptococcal origin, and at that timne tlhere -:as no albuiminuria.Tlle question arises, then, Did the tonsillitis pass on to a septicaemia, and cause a strepto- coccal interstitial neplhritis, or did the toxin circulating in the blood from thle focus in the throat cause tlle kidney trouble, leading to a general lowering of resistance, which allowed the streptococcus to get a footing in the general circulation ?In other words, was this nephritis of pyaemic or toxic origin ?Personally I am inclined to the former view.I admit that no organism -was denionstrable in the section:s, and the fact of its growing from the kidney pulp can be explained by a general blooI infection.I support my case eintirely on the microscopical abscesses in the interstitial tissue of the kidney, and on the clinical course of the case.My thanks armdue to Captain McLeod, R.A.M.C., who did the bacteriological work, and to Dr. Amecielle, of the Frenclh medical service, wlho got the tissues sectioned for me, and gave mne his valuable opinion on tllem.
The pros and cons of generic drugs
Authors: D. Kamerow
Journal: BMJ (2011)

Yes, they save money. But are they good for us?

It is a tough time for Big Pharma. The pipeline of new blockbuster drugs has largely dried up. Many are losing their patent protection, allowing competition from generic versions to emerge. For almost every major disease category—infections, diabetes, hypertension, heart failure, lipid disorders, acid reflux, and more—cheap and effective generic drugs are now available.

Furthermore, the US economy is being bankrupted by healthcare costs. Even though drugs are not even close to the largest part of the healthcare budget—around 10% by most accounts1—switching to generic prescription drugs to save money seems an easy and visible way to help deal with the crisis.

A recent article by Ranit Mishori in the Washington Post extolled the benefits of generics, urging patients and doctors alike to embrace them.2 There is no doubt about the savings. On www.drugstore.com I can buy 90 generic simvastatin 20 mg tablets for $74 (£46; €53); the same amount of brand name Zocor costs $486. Ninety lisinopril 20 mg tablets are $34, while Prinivil …
Chronic Obstructive Disease of Small Airways
Authors: PETER T. MACKLEM
Journal: Annals of Internal Medicine (1971)

The clinical, radiological, pathophysiological, and morphological features of seven patients with chronic airways obstruction characterized by chronic cough and expectoration are described. All had a reticular pattern on their chest roentgenogram. None had severe or extensive emphysema. Hypercapnia was chronic in four and transient in two. The lungs were not hyperinflated, but residual volume was increased. Pulmonary function tests showed airways obstruction. Mucous plugging, narrowing, and peribronchial fibrosis were variably present. The only morphological abnormality common to all was inflammation of small bronchi and bronchioles. These morphologic lesions may be principally responsible for the functional and possibly the roentgenographic abnormalities in these patients. Similar abnormalities are seen in small airways of patients dying from chronic bronchitis and emphysema and may be responsible for many of the functional derangements in these disorders.
Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomised comparison of two tube designs.
Authors: M Z Panos, H Reilly, A Moran, T Reilly, P J Wallis, R Wears, I M Chesner
Journal: Gut (1994)

The indications for percutaneous endoscopic gastrostomy (PEG) and patient outcome, were examined prospectively in the setting of a general hospital. In the course of 26 months, 76 patients underwent PEG (median age 62 years (range 18-99)) and were followed up for 6887 patient days. The median (range) duration of PEG feeding was 93 (3-785) days. The procedure was carried out for neurological indications in 76% of cases (stroke 51%) and 53% of patients were severely malnourished (body mass index &lt; 17 kg/m2) at the time of referral. In 12 (16%) patients swallowing recovered and the PEG was removed after a median (range) of 55 days (20-150). Three (4%) deaths were related to PEG (one oesophageal perforation, one haemorrhage, and one aspiration pneumonia). One patient developed peritonism and ileus, which resolved with conservative treatment. Minor complications included local sepsis 3%, tube blockage 12%, and tube connector leak 5%. During seven days of observation, demands on nursing time for routine care of the PEG were the same as for nasogastric tube feeding, median (range) 21 (4-42) v 16 (4-40) min/day respectively, but in about half the latter cases the tube had to be replaced at least once. Over 15 months, 29 patients were randomised to receive a 1.9 mm inner, 2.9 mm (9F) outer diameter Fresenius and 27 a 3.0 mm inner, 4.0 mm (12F) outer diameter Bower polyurethane tube and were followed for 2920 and 2388 patient days respectively. There was no difference in the insertion time (median (range) 20 (10-45) v 24 (10-45) min respectively) or number of patients with complications (three v eight patients NS), although there were more minor mechanical problems (three v 12, p &lt; 0.01) with the 12F tube. The internal anchoring device of the 12F tube allowed its non-endoscopic removal, a method applicable too 16% of cases. No tubes were removed because of blockage.
Trusting researchers to use open trial registers such as PROSPERO responsibly
Authors: A. Booth, L. Stewart
Journal: BMJ (2013)

Waugh is correct1—we cannot completely prevent unscrupulous use of content with an open register. However, there is no evidence that people are using PROSPERO records to plunder others’ ideas and scoop publication. But there are examples of unnecessary duplication being avoided, including the National Institute for Health Research Health Technology Assessment programme being able to allocate resources to an alternative review.

For pragmatic reasons we have to …
Electrophysiological effects of alinidine (ST 567) on sinoatrial node fibres in the rabbit heart
Authors: T. OPTHOF, J. J DUIVENVOORDEN, A. C G VANGINNEKEN, H. J JONGSMA, L. N BOUMAN
Journal: Cardiovascular Research (1986)

In a study of the electrophysiological effects of alinidine a concentration of 0.7-14.3 mumol X litre-1 decreased the rate of diastolic depolarisation and prolonged especially the terminal part of the action potential in the rabbit sinoatrial node. It did not induce pacemaker shifts since the effects were not restricted to the primary pacemaker or the central nodal area but were evident in the more peripheral nodal region. The substitution of chlorine ions by other anions did not prevent the decrease in the rate of diastolic depolarisation due to alinidine but did prevent the effect on the action potential duration. The decreased chronotropic action of alinidine in low chlorine Tyrode solution was, however, caused by a shift of pacemaker dominance towards an atrial pacemaker. This pacemaker shift concealed the response of the primary pacemaker to alinidine in low chlorine Tyrode. Blockade of the pacemaker current of if by caesium prevented neither the alinidine effect on the diastolic depolarisation completely nor its effect on the action potential duration, but blockade of if probably was one of the determinants of the action of alinidine. It cannot be excluded that alinidine interferes with still another current than if. Alinidine decreased the chronotropic responses to adrenaline and to acetylcholine and also prevented pacemaker shifts due to these substances.
Automated Quantitative Analysis of Activator Protein-2α Subcellular Expression in Melanoma Tissue Microarrays Correlates with Survival Prediction
Authors: Aaron J. Berger, Darren W. Davis, Carmen Tellez, Victor G. Prieto, Jeffrey E. Gershenwald, Marcella M. Johnson, David L. Rimm, Menashe Bar-Eli
Journal: Cancer Research (2005)

Abstract The activator protein-2α (AP-2) transcription factor plays a key role in regulating expression of genes involved in tumor growth and metastasis of human melanoma. We sought to assess the prognostic significance of AP-2 expression and its role in the transition of nevi to metastatic melanoma. Two cohorts were analyzed. One was a “progression” microarray containing melanoma specimens from M.D. Anderson Cancer Center representing 84 cases and the other was a retrospective cohort from Yale University representing 214 primary melanomas and 293 metastases. Analysis of total AP-2 expression using two quantitative systems [automated quantitative analysis (AQUA) and laser scanning cytometry (LSC)] revealed no correlation with diagnosis group. LSC analysis of the M.D. Anderson Cancer Center array showed that the number of cells expressing nuclear AP-2 was highest in the benign nevi group (11.85%) and significantly decreased in each phase of melanoma progression to 0.39% in the metastatic group. Both LSC and AQUA showed decreased nuclear AP-2 levels and increased cytoplasmic AP-2 that is directly proportional to progression. Neither nuclear nor cytoplasmic expression levels correlated with outcome. Intriguingly, the ratio of cytoplasmic to nuclear AP-2 predicted outcome in the entire population and in the primary tumors alone, demonstrating the power of the ratio to normalize for variations. Furthermore, the AP-2 ratio directly correlated with other clinicopathologic factors, including Breslow depth (R = 0.334, P &amp;lt; 0.001). We show that a high level of AP-2 expression in the cytoplasm relative to the nucleus correlates with poor prognosis and the loss of nuclear AP-2 expression is associated with malignant transformation and progression of melanoma.
PARMA international protocol: Pilot study on 50 patients and preliminary analysis of the ongoing randomized study (62 patients)
Authors: T. Philip, F. Chauvin, D. Bron, C. Guglielmi, A. Hagenbeek, B. Coiffier, C. Gisselbrecht, J.C. Kluin Nelemans, R. Somers, J.C. Misset, J. Vanderlely
Journal: Annals of Oncology (1991)
Linking Payment for Care to Informed Consent-Reply
Authors: Marshall B. Kapp
Journal: JAMA (1989)

In Reply.—  Dr Bierly correctly notes that several of the premises that underlie my proposal for linking reimbursement to informed consent currently lack  data. Similarly, he cites no data supporting his own categorical assertion that imposition of proposed regulations clearly would increase the paperwork burden, thus increasing the cost to financially overburdened hospitals without effectively altering the informed consent procedure. As noted in my article, both my underlying assumptions and the assumptions of those who might object to my proposal are subject to empirical investigation, and I welcome research projects that investigate the accuracy of both my assumptions and Dr Bierly's assertions.  I commend the observation of Dr Bierly that informed consent is a time when patient and physician have an opportunity to exchange ideas and questions regarding medical options and treatments in a dynamic and empathetic fashion. I argue that the quality of the informed consent process has
Wernicke-Korsakoff Encephalopathy After Gastric Plication
Authors: Regis W. Haid
Journal: JAMA (1982)

WERNICKE-KORSAKOFF encephalopathy is a serious neurological syndrome caused by thiamine deficiency and characterized by ataxia, ophthalmoplegia, nystagmus, and mental confusion.<sup>1</sup>Although this syndrome is common in alcoholics, it may occur in a number of other circumstances, including gastric carcinoma, pyloric obstruction,<sup>2</sup>hyperemesis gravidarum,<sup>1</sup>and prolonged intravenous (IV) hyperalimentation.<sup>3</sup> We report two cases of Wernicke-Korsakoff encephalopathy as a previously unrecognized complication of gastric plication for the treatment of morbid obesity. Both patients were young women, two to four months after gastric plication, and had protracted vomiting after surgery without vitamin supplementation. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 33-year-old woman weighing 130 kg was admitted to a community hospital for a gastric plication for morbid obesity on July 31, 1980. She tolerated the procedure well and was discharged on a postgastrectomy diet. She required two hospitalizations during the ten weeks after plication for persistent nausea and vomiting. She
The Nephrotoxicity of Antimicrobial Agents
Authors: Gerald B. Appel, Harold C. Neu
Journal: New England Journal of Medicine (1977)

VancomycinVancomycin is excreted chiefly by the kidney, with more than 80 per cent of the administered dose recovered in the urine within 24 hours.84 Its half-life is six hours. In patients with impaired renal function, very high serum concentrations accumulate,85 , 86 and the drug is not removed by either hemodialysis or peritoneal dialysis.Animal studies have found vancomycin to have little nephrotoxicity, although the highest concentrations of vancomycin are recovered in the kidneys of the animals post mortem.87 , 88 Although ototoxicity due to vancomycin has been clearly established in man, nephrotoxicity has not. Direct injection of 2-g doses intravenously into healthy . . .
The current status of hazardous solid waste management.
Authors: H B Kaufman
Journal: Environmental Health Perspectives (1978)

Growth of the population and of industrialization, and substandard disposal of the increased waste products thus generated, have resulted in numerous documented cases of harm to human, plant, and animal health. The Resource Conservation and Recovery Act (1976), its stated goals, and its intended means of implementation, are discussed relative to hazardous waste problems. Subtitle C of this Act, and the authority granted by it to the U.S. Environmental Protection Agency, are explained. Standards and regulations have been imposed upon those responsible for generating and transporting hazardous wastes, to ensure the ultimate safe disposal of such wastes in environmentally suitable, properly licensed facilities.
Th2 cell hyporesponsiveness during chronic murine schistosomiasis is cell intrinsic and linked to GRAIL expression
Authors: Justin J. Taylor, Connie M. Krawczyk, Markus Mohrs, Edward J. Pearce
Journal: Journal of Clinical Investigation (2009)

Chronic infections are associated with progressively declining T cell function. Infections with helminth parasites, such as Schistosoma mansoni, are often chronic and characterized by the development of strong Th2 responses that peak during the acute stage of infection and then decline despite ongoing infection; this minimizes Th2-dependent immunopathology during the chronic stage of infection. We sought to understand the basis for the decline in Th2 responses in chronic schistosomiasis. Using IL-4 reporter mice (mice that express EGFP as a reporter for Il4 gene expression) to identify Th2 cells, we found that Th2 cell numbers plateaued during acute infection and remained constant thereafter. However, the percentages of Th2 cells proliferating during late infection were strikingly lower than those during acute infection. Th2 cell hyporesponsiveness was evident within 10 d of initiation of the Th2 response and became progressively ingrained thereafter, in response to repeated Ag stimulation. Gene expression analyses implicated the E3-ubiquitin ligase gene related to anergy in lymphocytes (GRAIL) in the hyporesponsive state. Consistent with this, suppression of GRAIL expression using retrovirally delivered siRNA prevented the development of hyporesponsiveness induced by repeated Ag stimulation in vitro or in vivo. Together, these data indicate that the decline in Th2 cell responsiveness during chronic schistosomiasis is the net result of the upregulation of GRAIL expression in response to repeated Ag stimulation.
"A MULTIPLE ELECTRICAL STETHOSCOPE FOR TEACHING PURPOSES"
Authors: George F. Keiper
Journal: JAMA (1923)

<h3>To the Editor:</h3> —I was much interested in reading Dr. Richard Cabot's communication (The Journal, July 28). It may be of interest to know that this idea had its inception in the laboratory of physics of Purdue University. Prof. R. B. Abbott of that department had been working with the same idea in view and finally perfected the instrument, which he demonstrated first to the summer school of Purdue University in 1922. Oct. 27, 1922, he demonstrated the apparatus to the Tippecanoe County Medical Society; November 3, to the faculty of Purdue University, and November 10, to the student body of Purdue University. In each instance the large lecture room in the physics building was used. It seats 250 persons, and each was able to hear heart beats even though the auditors were in the distant corners of the room. Professor Abbott makes phonographic records with this instrument. These he
Accidental burns associated with electrocautery
Authors: A. S. Wald
Journal: JAMA (1971)

Burns were caused in two patients by an electrocautery used in conjunction with electronic monitoring equipment. The causes of these accidents were found to be faulty equipment with inadequate safety precautions taken to allow for their possible malfunction. Additional safety features are now used to prevent recurrence of similar incidents. These safety measures include an auxiliary electrocautery ground wire and special patient-plate.
Urgent reform of NHS governance needed
Authors: C. White
Journal: BMJ (2002)

The government's plans to improve and modernise the NHS will fail unless management is radically reformed, concludes a report from the Royal Society for the Encouragement of Arts, Manufactures and Commerce (RSA), published last week.

Over 140 chairs, chief executives, non-executive directors, and trustees of public and voluntary sector organisations, including 62 from the NHS, were surveyed. Additional input came from a further 100 board members.

The findings showed that NHS board management was guilty of tokenism, lack of focus and cohesion, and confusion about its roles and responsibilities and the legislative framework within …
Obesity and Efforts to Lose Weight
Authors: Elliot Danforth, Ethan A.H. Sims
Journal: New England Journal of Medicine (1992)

Lichtman et al. report in this issue of the Journal 1 that a subgroup of obese subjects whom they identified as resistant to dieting have failed to lose weight because they eat more and exercise less than they think. Doubly labeled water was used to measure total energy expenditure for two weeks. This method allows the accurate (±5 percent) and noninvasive measurement of total energy expenditure in free-living subjects without their awareness of the actual measurement. In combination with measurement of the components of daily energy expenditure by indirect calorimetry and analysis of body composition, the doubly-labeled—water method can be used . . .
Detection of HTLV-III RNA in Lungs of Patients With AIDS and Pulmonary Involvement
Authors: Karen J. Chayt, Mary E. Harper, Lisa M. Marselle, Edward B. Lewin, Richard M. Rose, James M. Oleske, Leon G. Epstein, Flossie Wong-Staal, Robert C. Gallo
Journal: JAMA (1986)

A majority of pediatric patients and rare adult patients with the acquired immunodeficiency syndrome (AIDS) develop a chronic respiratory disorder referred to as "lymphocytic interstitial pneumonitis" (LIP). Efforts to identify an infectious agent responsible for this process so far have failed. In this study, frozen sections of lungs from patients with AIDS and pulmonary disease were tested by in situ molecular hybridization for the presence of cells infected with human T-cell lymphotropic virus type III (HTLV-III) and expressing viral RNA. In the case of an infant with LIP, a relatively high frequency (0.1 %) of cells in the lung were found to be positive for HTLV-III RNA. This number is the lower limit of total cells infected since the in situ hybridization technique as applied in this study depends on expression of HTLV-III genes, and previous evidence indicates that a proportion of cells infected with HTLV-III may not express viral RNA. Moreover, this degree of infection of the lung is likely limited to LIP, since in ten patients with AIDS and pulmonary diseases other than LIP, only 0% to 0.002% of cells in lung were positive for viral RNA expression. Thus, HTLV-III may play a direct causal role in the development of LIP in infected patients, implicating its involvement in yet another of the diverse clinical diseases associated with this virus. (<i>JAMA</i>1986;256:2356-2359)