tbuckley/cabot-search huggingface dataset:
Minimal access surgery compared with medical management for gastro-oesophageal reflux disease: five year follow-up of a randomised controlled trial (REFLUX)
Authors: A. M. Grant, S. C. Cotton, C. Boachie, C. R. Ramsay, Z. H. Krukowski, R. C. Heading, M. K. Campbell
Journal: BMJ (2013)

<b>Objectives</b> To determine the long term clinical effectiveness of laparoscopic fundoplication as an alternative to drug treatment for chronic gastro-oesophageal reflux disease (GORD). <b>Design</b> Five year follow-up of multicentre, pragmatic randomised trial (with parallel non-randomised preference groups). <b>Setting</b> Initial recruitment in 21 UK hospitals. <b>Participants</b> Responders to annual questionnaires among 810 original participants. At entry, all had had GORD for &gt;12 months. <b>Intervention</b> The surgeon chose the type of fundoplication. Medical therapy was reviewed and optimised by a specialist. Subsequent management was at the discretion of the clinician responsible for care, usually in primary care. <b>Main outcome measures</b> Primary outcome measure was self reported quality of life score on disease-specific REFLUX questionnaire. Other measures were health status (with SF-36 and EuroQol EQ-5D questionnaires), use of antireflux medication, and complications. <b>Results</b> By five years, 63% (112/178) of patients randomised to surgery and 13% (24/179) of those randomised to medical management had received a fundoplication (plus 85% (222/261) and 3% (6/192) of those who expressed a preference for surgery and for medical management). Among responders at 5 years, 44% (56/127) of those randomised to surgery were taking antireflux medication versus 82% (98/119) of those randomised to medical management. Differences in the REFLUX score significantly favoured the randomised surgery group (mean difference 8.5 (95% CI 3.9 to 13.1), P&lt;0.001, at five years). SF-36 and EQ-5D scores also favoured surgery, but were not statistically significant at five years. After fundoplication, 3% (12/364) had surgical treatment for a complication and 4% (16) had subsequent reflux-related operations—most often revision of the wrap. Long term rates of dysphagia, flatulence, and inability to vomit were similar in the two randomised groups. <b>Conclusions</b> After five years, laparoscopic fundoplication continued to provide better relief of GORD symptoms than medical management. Adverse effects of surgery were uncommon and generally observed soon after surgery. A small proportion had re-operations. There was no evidence of long term adverse symptoms caused by surgery. <b>Trial registration</b> Current Controlled Trials ISRCTN15517081.
Low back pain: an intermittent and remittent predicament of life
Authors: N. M HADLER, T. S CAREY
Journal: Annals of the Rheumatic Diseases (1998)

See article on page 13 

For any of us to live a single year without a backache is abnormal. That is true throughout adult life. And that has, no doubt, always been true.

What is mutable is whether, and how, and how well we cope with another such challenge to our sense of invincibility. Mind you, this insight holds for many morbid events: headache and heart ache and heart burn and more. This is not to belittle the affliction; beyond the pain in the back, the contraction in daily functioning can rival severe heart failure. The difference is that we almost always recover from low back pain and we usually can remember a prior episode.

In the last half of this century, when the incidence of the experience of regional low back pain seems stable,1 something is happening to our tolerance. The numbers who are turning to others for help and the numbers who now find backache incapacitating have reached epidemic proportions. This trend defies a concerted effort at intervention that has recruited the cutting edge of allopathic medicine and whatever alternatives society can put forward. And this effort at recourse and redress accounts for an astounding transfer of wealth, much of which is brokered by an enormous public/private enterprise charged with indemnification. Whatever the motivation, whatever the ethic,2 a paradox is painfully clear; the approach to the predicament of …
Treatment of Frostbite with Particular Reference to the Use of Adrenocorticotrophic Hormone (ACTH)
Authors: William W. L. Glenn, Francis B. Maraist, Olaf Marcus Braaten
Journal: New England Journal of Medicine (1952)

THE first part of this communication is a detailed presentation of two patients who sustained cold injuries and who were treated with pituitary adrenocorticotrophic hormone. The dosage of the hormone and the duration of treatment were, of necessity, arbitrarily determined. Both patients were admitted to the hospital before thawing of the tissues had progressed beyond the early stages.MethodsStudies were made daily during the first few days after admission and at less frequent intervals thereafter. These studies included a detailed examination of the feet, skin-temperature recordings and photographs of the feet. The skin-temperature recordings were made in a constant-temperature . . .
Testing acuity of vision in general practice: reaching recommended standard
Authors: J C Pandit
Journal: BMJ (1994)

Measurements of acuity of vision are highly reliable with a reliability in excess of 98% according to one important study1—because a standard protocol exists. The British Standards Institution specifies the minimum illumination for externally illuminated charts and the distance that patients should be from the chart.2 Compliance with this standard helps to ensure comparable results in the measurement of acuity of vision. Patients' acuity of vision measured in the eye department at this hospital, however, sometimes differs from the measurement given in their referral letter. I examined whether general practice surgeries complied with standards on illumination and distances.

I randomly selected 24 of the 48 main general practices that fell within the boundaries of the former Torbay District Health Authority. Branch surgeries were excluded from the survey. In September …
Independent Primary Care Practice by Nurse Practitioners
Authors: Harold C. Sox
Journal: JAMA (2000)

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
AUTOTOXAEMIA AS A FACTOR IN THE CAUSATION OF PSYCHOSES
Authors: W. Weygandt
Journal: BMJ (1928)

tMDxC BLJmux 283 which these terms are applicable have a real existence in tlhe adult, and the question for us to-day is whetlher they are also met witlh in childhood.Now, seeing that the splenic anaemia of adults is of its essence a very prolonged disease, the final stage of whlichl, when cirrlrosis of the liver has supervened (so-called Banti's disease) is only reaclhed after some years, it follows that Banti's.disease at least is not likely to be met with whilst the patient is still a cllild.In spite of this I tlhink the diagnosis " Banti's disease " is sometimes justified in childhood, as in the following case.A. boy of 12 was known to have had an enlarged spleen for five years.The liver was not enlarged.The blood count showed 2,750,000 red cells, 45.1 per cent. of haemoglobin, and 3,400 white cells.Wassermann test negative.Haematemesis supervened, after which the spleen was decidedly smaller for some days.There was no leucocytosis during or after the haemorrlhage.Splenectomy was performed, and at the operation the liver " seemed to be the seat of early cirrhosis."His subsequent history is unknown.
Physiological Jak2V617F Expression Causes a Lethal Myeloproliferative Neoplasm with Differential Effects on Hematopoietic Stem and Progenitor Cells
Authors: Ann Mullally, Steven W. Lane, Brian Ball, Christine Megerdichian, Rachel Okabe, Fatima Al-Shahrour, Mahnaz Paktinat, J. Erika Haydu, Elizabeth Housman, Allegra M. Lord, Gerlinde Wernig, Michael G. Kharas, Thomas Mercher, Jeffery L. Kutok, D. Gary Gilliland, Benjamin L. Ebert
Journal: Cancer Cell (2010)
Binge Drinking During Pregnancy as a Predictor of Psychiatric Disorders on the Structured Clinical Interview for DSM-IV in Young Adult Offspring
Authors: Helen M. Barr, Fred L. Bookstein, Kieran D. O’Malley, Paul D. Connor, Janet E. Huggins, Ann P. Streissguth
Journal: American Journal of Psychiatry (2006)

Objective: This study explored the extent to which the high frequency of psychiatric problems reported in clinical groups with fetal alcohol spectrum disorders might also be observed in a nonclinical group of young adults and the psychiatric conditions that are related to prenatal alcohol exposure in this group. Method: From a longitudinal prospective study beginning with interviews of 1,529 pregnant women, a birth cohort of about 500 newborns was chosen to include all of the most heavily alcohol exposed plus a sampling of the continuum of alcohol exposures from total abstinence through heavy drinking. At an average age of 25.7 years, 400 members of this birth cohort were administered valid Structured Clinical Interviews for DSM-IV (SCID), including both the SCID for axis I disorders and the SCID for axis II personality disorders. Results: The odds of the appearance of six psychiatric disorders and traits were more than double in adults exposed to one or more binge alcohol episodes in utero. Three of these six odds ratios were uniformly stable against confounding: axis I substance dependence or abuse disorders and axis II passive-aggressive and antisocial personality disorders or traits. Conclusions: Prenatal exposure to alcohol may be a risk factor for specific psychiatric disorders and traits in early adulthood, even in a nonclinical group.
Endocrine Neoplasm Scintigraphy
Authors: Christian J. Ingui, Nirav P. Shah, M Elizabeth Oates
Journal: Clinical Nuclear Medicine (2006)

Purpose: Positron emission tomography (PET)/computed tomography (CT) imaging integrates physiology and anatomy, providing a powerful dual-modality approach. Analogously, fusing independently acquired single photon emission computed tomography (SPECT) and CT images can overcome interpretive challenges in characterizing and localizing abnormalities by either modality alone, potentially enhancing diagnostic confidence. This study explores the added value of SPECT/CT image fusion compared with traditional “side-by-side” SPECT/CT image review for a variety of endocrine neoplasms. Methods and Materials: We identified 11 abnormal endocrine neoplasm SPECT scans in 10 patients with contemporary relevant CT scans. These cases included: 4 I-131 (posttherapy thyroid cancer), 2 I-123 (pretherapy thyroid cancer), 2 In-111 OctreoScan (neuroendocrine neoplasm), one Tc-99m sestamibi (thyroid cancer), one Tc-99m tetrofosmin (parathyroid adenoma), and one I-123 MIBG (adrenergic neoplasm). SPECT and CT images were uploaded onto side-by-side workstations, one with fusion software. Two experienced nuclear radiologists first reviewed “side-by-side” SPECT/CT images followed by fused SPECT/CT images. They scored 2 parameters—anatomic localization and diagnostic confidence—using a 4-point scale (1 “not helpful” to 4 “very helpful”). Score differences ≥1 indicated “added value”; ≤0 indicated “lack of added value.” Results: Compared with “side-by-side” SPECT/CT images, fused SPECT/CT images yielded “added value” for anatomic localization and diagnostic confidence in two thirds of cases. Fusion led to altered diagnoses in 4 of 11 examinations. Greater confidence was also achieved in 3 of 4 when the interpretation was changed and in 4 of 7 cases when it was not. Conclusions: CT correlation can be helpful in interpreting endocrine neoplasm SPECT imaging. SPECT/CT image fusion outperformed “side-by-side” SPECT/CT analysis for neoplasm anatomic localization and diagnostic confidence. Therefore, SPECT/CT fusion should be performed routinely because it potentially influences clinical decision-making and patient management.
Impaired hormonal responses to hypoglycemia in spontaneously diabetic and recurrently hypoglycemic rats. Reversibility and stimulus specificity of the deficits.
Authors: A M Powell, R S Sherwin, G I Shulman
Journal: Journal of Clinical Investigation (1993)

To evaluate the roles of iatrogenic hypoglycemia and diabetes per se in the pathogenesis of defective hormonal counterregulation against hypoglycemia in insulin-dependent diabetes mellitus (IDDM), nondiabetic, and spontaneously diabetic BB/Wor rats were studied using a euglycemic/hypoglycemic clamp. In nondiabetic rats, recurrent (4 wk) insulin-induced hypoglycemia (mean daily glucose, MDG, 59 mg/dl) dramatically reduced glucagon and epinephrine responses by 84 and 94%, respectively, to a standardized glucose fall from 110 to 50 mg/dl. These deficits persisted for > 4 d after restoring normoglycemia, and were specific for hypoglycemia, with normal glucagon and epinephrine responses to arginine and hypovolemia, respectively. After 4 wk of normoglycemia, hormonal counterregulation increased, with the epinephrine, but not the glucagon response reaching control values. In diabetic BB rats (MDG 245 mg/dl with intermittent hypoglycemia), glucagon and epinephrine counterregulation were reduced by 86 and 90%, respectively. Chronic iatrogenic hypoglycemia (MDG 52 mg/dl) further suppressed counterregulation. Prospective elimination of hypoglycemia (MDG 432 mg/dl) improved, but did not normalize hormonal counterregulation. In diabetic rats, the glucagon defect appeared to be specific for hypoglycemia, whereas deficient epinephrine secretion also occurred during hypovolemia. We concluded that both recurrent hypoglycemia and the diabetic state independently lead to defective hormonal counterregulation. These data suggest that in IDDM iatrogenic hypoglycemia magnifies preexisting counterregulatory defects, thereby increasing the risk of severe hypoglycemia.
Biological False-Positive Reactions in Mononucleosis
Authors: George H. Kostant
Journal: JAMA (1963)

To the Editor:  —In the paper entitled False-Positive Serology in Mononucleosis, which appeared in the Sept 7 issue ofThe Journal( 185 :783), Col Robert J. Hoagland, MC, USA, is to be commended on his personal accumulation of 300 consecutive cases in view of the critical diagnostic criteria laid down.  His conclusion that the incidence of biological false-positive (BEP) reactions in serologic tests for syphilis in this entity is only 0.66% requires explanation. This is especially true since he indicates that the frequently quoted high incidence (approximately 20%) may have arisen from uncritical repetition of statements by earlier writers.  The incidence of BFP reactions 1 in any disease entity depends on a variety of factors including (1) the number of serologic tests performed, (2) the frequency with which the test is done during the course of an illness, (3) the stage of the illness, and (4) the type of test
Toll-like Receptor 4 Signaling by Follicular Dendritic Cells Is Pivotal for Germinal Center Onset and Affinity Maturation
Authors: Alexandre Garin, Michael Meyer-Hermann, Mathias Contie, Marc Thilo Figge, Vanessa Buatois, Matthias Gunzer, Kai-Michael Toellner, Greg Elson, Marie H. Kosco-Vilbois
Journal: Immunity (2010)
SUPPURATIVE PERITONITIS—(CELIOTOMY)—PUERPERAL SEPSIS.
Authors: R. E. HAUGHTON
Journal: JAMA (1896)

The position taken by some of the writers and operators quoted under the heading of celiotomy, in a paper read by Dr. Porter, of Fort Wayne, Ind., if correctly reported, may lead to misconception and error if permitted to go unchallenged by the profession. First, the author of the paper quoted Prandin, who says in regard to general puerperal peritonitis: "The women die, no matter what form of treatment is employed." Dr. Baldy says, as quoted: "To my knowledge there has never been reported an undoubted case of general purulent peritonitis, from any cause whatever, in which an abdominal section or any other line of treatment, has succeeded in saving the patient's life." The writer of this paper above referred to, viz., Dr. Porter, signalizes these statements quoted as being wrong, and he desired to arouse a sentiment against the too prevalent idea, that in septic peritonitis death is inevitable,
FLT3 activation cooperates with MLL-AF4 fusion protein to abrogate the hematopoietic specification of human ESCs
Authors: Clara Bueno, Verónica Ayllón, Rosa Montes, Oscar Navarro-Montero, Verónica Ramos-Mejia, Pedro J. Real, Damià Romero-Moya, Marcos J. Araúzo-Bravo, Pablo Menendez
Journal: Blood (2013)
Levels of Complement Factors in Human Serum during Immediate and Late Asthmatic Reactions and during Acute Hypersensitivity Pneumonitis
Authors: X. Baur, W. Dorsch, T. Becker
Journal: Allergy (1980)

In 16 asthmatic patients and in four subjects suspected of having hypersensitivity pneumonitis, serum levels of CH50, C3, C4, C5 and factor B were measured before, between 10 and 20 min, between 5 and 7 h and, in the latter group, also 24 h after allergen challenges provoking type I bronchial reactions or acute hypersensitivity pneumonitis. There was a significant decrease in one of the complement factors in two patients during the immediate asthmatic phase, but in no patient during the late asthmatic phase and in no patient with hypersensitivity pneumonitis. On the other hand, significant increases of C3, C4, and/or CH50 were seen in five patients during immediate asthmatic reactions, in seven patients during late asthmatic reactions and in all cases with hypersensitivity pneumonitis. However, with respect to the particular complement factors the vast majority of the patients showed no appreciable change. Investigations of C3 split products, which were done in seven patients gave negative results. No correlations existed between the changes in the levels of complement factors to increases of Raw, decreases of DLCO, size of skin test reactions or RAST scores. The cause and pathophysiological role of the non-uniform behaviour of serum complement levels after inhalation challenges is not yet clear; obviously both consumption and formation of complement factors take place during allergen-induced asthmatic reactions and hypersensitivity pneumonitis.
Comparison of prophylactic clip and endoloop application for the prevention of postpolypectomy bleeding in pedunculated colonic polyps: a prospective, randomized, multicenter study
Authors: Jeong-Seon Ji, Seung-Woo Lee, Tae Kim, Young-Seok Cho, Hyung-Keun Kim, Kang-Moon Lee, Sang-Woo Kim, Hwang Choi
Journal: Endoscopy (2014)

<b>Background and study aims:</b> The effectiveness of the prophylactic clip for the prevention of postpolypectomy bleeding in pedunculated colonic polyps has not been confirmed. The aim of this prospective, randomized study was to compare the efficacy of prophylactic clip and endoloop application in the prevention of postpolypectomy bleeding in large pedunculated polyps. <b>Patients and methods:</b> A total of 195 patients who had pedunculated colorectal polyps, with heads ≥ 10 mm and stalks ≥ 5 mm in diameter, were included in the study between July 2010 and January 2013. Polyps were randomized to receive either clips or endoloops. Both devices were applied to the base of the stalk before conventional snare polypectomy. Bleeding complications were analyzed with a noninferiority margin of 5 %. <b>Results:</b> A total of 203 polyps were included in the study (98 in the clip group and 105 in the endoloop group). Bleeding occurred after five polypectomies in the clip group (5.1 %) and after six in the endoloop group (5.7 %) (<i>P</i> = 0.847). Noninferiority of the prophylactic clip to the endoloop could not be confirmed (absolute bleeding rate difference – 0.6 %, 95 % confidence interval – 5.6 % to 6.8 %) due to small sample size. Immediate bleeding episodes occurred in 4/5 polyps in the clip group and 5/6 polyps in the endoloop group. Delayed bleeding occurred in one polyp in each group. <b>Conclusions:</b> These results suggest that the application of a prophylactic clip is as effective and safe as an endoloop in the prevention of postpolypectomy bleeding in large pedunculated colonic polyps. Clinical trial registration: ClinicalTrials.gov (NCT01406379)
Amelioration of Familial Mediterranean Fever during Hemodialysis
Authors: Dvora Rubinger, Michael M. Friedlaender, Mordecai M. Popovtzer
Journal: New England Journal of Medicine (1979)

FAMILIAL Mediterranean fever is characterized by recurrent polyserositis and fever1 2 3 and is a potentially fatal illness, owing to a high incidence of renal involvement.1 2 3 4 5 The main cause of the kidney disease is amyloidosis,4 5 6 which can be associated with renal-vein thrombosis.7 Other manifestations, such as glomerulonephritis and hypersensitivity angiitis, have also been described.5 The amyloidosis is frequent in Jews of Mediterranean (Sephardic) origin, whereas in Ashkenazi Jews and Armenians, only sporadic cases have been reported.4 , 8 During the last decade, patients with familial Mediterranean fever and terminal renal failure have been treated by regular hemodialysis and transplantation.9 10 11 12 13 14 Most cases are recorded in . . .
Calcium antagonist withdrawal syndrome
Authors: J. Nehring, A J Camm
Journal: BMJ (1983)

calculating the receiver operating character- istic for each sensitivity-specificity pair.'2When analysed in this way 10 clinical features emerged as having testing ability; they are listed in the table in order of their value.Receiver operating characteristics of clinical indicators for brain computed tomography in patients with recent onset dementia Sensitivity Specificity Clinical indicator (0,,) (°,) d' Focal neurological signs 42 88 097 Papilloedema
The banyan tree
Authors: Kalyan Banda
Journal: Annals of Internal Medicine (2012)

Ad Libitum15 May 2012The banyan treeKalyan Banda, MBBSKalyan Banda, MBBSFrom University of California, San Diego, San Diego, CA 92103-8425.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-10-201205150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Under the banyan tree,the shade oasisin the swirling summer noonweeks before the monsoon is to arrive,I rest hunched in the dust belowwedged between its large roots.She recognizes who I am,and shyly moves her lumbering selfto share some food;rice and rasam, with me.eating ... Author, Article, and Disclosure InformationAffiliations: From University of California, San Diego, San Diego, CA 92103-8425.Current Author Address: Kalyan Banda, MBBS, Department of Internal Medicine, University of California, San Diego, 402 Dickinson Street, MC 8425, San Diego, CA 92103-8425. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 2012Volume 156, Issue 10Page: 751KeywordsDustEatingEmotionsFood ePublished: 15 May 2012 Issue Published: 15 May 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...