tbuckley/cabot-search huggingface dataset:
Doctors and divorce
Authors: A. Howe
Journal: BMJ (2015)

Behind every statistic lies a human story

In The BMJ this week a study (doi:10.1136/bmj.h706) by Ly and colleagues shows that doctors in the United States have a comparable or lower risk of divorce than other health related professionals, and the general population.1 The researchers, however, admit the limitations of this large cross sectional study—as with many such studies there is no qualitative component to help explore the reasons for these figures; no data on the quality of the marriage, which might explain the findings; and no data on medical specialties or whether divorces are more common when both partners are medical doctors. The authors did find that divorce is more likely among female doctors than among male doctors, and that for women, the risks increased with hours worked.

Behind each of these statistics lies a human story, which in the case of divorce is usually one of broken dreams, personal damage (including to children), and material loss. One in four doctors’ marriages ends in divorce, which is hardly a cause for celebration; and nurses fare even worse, at one in three failed marriages.

Societal changes …
High-Dose Statins and the IDEAL Study
Authors: Samuel J. Mann
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
Comparison between siblings and twins supports a role for modifier genes in ADPKD
Authors: Alexandre Persu, Michel Duyme, Yves Pirson, Xosé M. Lens, Thierry Messiaen, Martijn H. Breuning, Dominique Chauveau, Micheline Levy, Jean-Pierre Grünfeld, Olivier Devuyst
Journal: Kidney International (2004)
Echocardiographic abnormalities in sickle cell disease
Authors: Shahid Ahmed, Anita K. Siddiqui, Adnan Sadiq, Rabia K. Shahid, Dilip V Patel, Linda A. Russo
Journal: American Journal of Hematology (2004)

Abstract Echocardiographic abnormalities in patients with sickle cell disease (SCD) were determined, and pulmonary arterial systolic pressure (PASP) was estimated. Clinical data and echocardiograms of 38 adult hospitalized patients with SCD at two tertiary care hospitals were reviewed. Fisher's exact test was performed to determine correlation between pulmonary hypertension and various clinical variables. Pulmonary hypertension was the most common abnormality identified in 22 (58%) patients. The estimated mean PASP was 37.5 ± 10.9 mmHg. Older age and prior history of acute chest syndrome were significantly correlated with an increased prevalence of pulmonary hypertension ( P &lt; 0.05). Patients with hemoglobin levels &lt;8 g/dL had PASP 43.2 ± 0.5 compared to a mean PASP of 33.3 ± 6.0 in patients with hemoglobin ≥8 g/dL ( P = 0.01). Eight (21%) patients had evidence of a hyperdynamic left ventricle. Left heart abnormalities included dilated atrium in 14 (37%), dilated ventricle in 5 (13%), ventricle hypertrophy in 5 (13%), and ventricle dysfunction in 3 (9%) patients. Right heart abnormalities included dilated atrium in 9 (24%), dilated ventricle in 6 (16%), and ventricle dysfunction in 3 (9%) patients. Despite an increased incidence of abnormal flow across the valves on Doppler analysis, no patient had structurally abnormal valves. A majority of patients with SCD had evidence of pulmonary hypertension, which correlated with older age and history of acute chest syndrome. Other structural and functional echocardiographic abnormalities were less common. Am. J. Hematol. 76:195–198, 2004. © 2004 Wiley‐Liss, Inc.
Gastrin, acid, and bile.
Authors: G J Cole, A M Connell
Journal: Gut (1968)

Bile in the stomach has been suspect for some time in connexion with the processes of gastritis and even gastric ulcer.James and Pickering (1949), inspecting night aspirates, found bile in the stomach of 70% of gastric ulcer patients and in 30% of duodenal ulcer patients.Siurala and Tawast (1956) studied 366 patients by gastroscopy, gastric biopsy, and by measuring the surface tension of the resting stomach juice.By these means they observed that surface tension- lowering agents, presumed to be from bile, were more general in cases of gastric atrophy and in resting juice with a high pH.DuPlessis (1962; 1965) in two studies decided that gastritis in 93 specimens resected from gastric and duodenal ulcer patients 'might be' due to pyloric reflux, and after gastrectomy and gastrojejunostomy gastritis, ulcer, and even carcinoma might be associated with the backflow of duodenal juice that these operations allow.Capper, Butler, and Buckler (1966) and Capper, Airth, and Kilby (1966), also in two series of patients, measured the alkaline area of stomachs at operation after Billroth and Polya resections, and watched pyloric regurgitation radiologically in a variety of patients.Their conclusions were that gastritis and
The Growth of Bureaucratic Medicine: An Inquiry Into the Dynamics of Patient Behavior and the Organization of Medical Care
Authors: Vernon E. Wilson
Journal: JAMA (1977)

This is one of the more difficult books to read on this topic. It is clear that the author and his colleagues have perused the literature extensively. It is not quite so clear that they have reached either consistent or understandable conclusions from the perusal. In addition to being a tedious book to read, there are a number of internally inconsistent themes in the book; the same test for success is not placed against the advantages of bureaucratic medicine when operated by government as is placed against bureaucratic medicine in the fee-forservice general environment. The author starts and concludes with a heavy bias in the direction of governmentally directed medicine, but at no time in the course of the book does he present an adequate rationale for that bias. In light of his seeming allergy to large bureaucracies, it is particularly intriguing to see his bent to take medicine from
Restoration of p53 function: A new therapeutic strategy to induce tumor regression?
Authors: Naiara Beraza, Christian Trautwein, Kris Kowdley, Geoffrey McCaughan
Journal: Hepatology (2007)

Abstract Although cancer arises from a combination of mutations in oncogenes and tumour suppressor genes, the extent to which tumour suppressor gene loss is required for maintaining established tumours is poorly understood. p53 is an important tumour suppressor that acts to restrict proliferation in response to DNA damage or deregulation of mitogenic oncogenes, by leading to the induction of various cell cycle checkpoints, apoptosis or cellular senescence. Consequently, p53 mutations increase cell proliferation and survival, and in some settings promote genomic instability and resistance to certain chemotherapies. To determine the consequences of reactivating the p53 pathway in tumours, we used RNA interference (RNAi) to conditionally regulate endogenous p53 expression in a mosaic mouse model of liver carcinoma. We show that even brief reactivation of endogenous p53 in p53-deficient tumours can produce complete tumour regressions. The primary response to p53 was not apoptosis, but instead involved the induction of a cellular senescence program that was associated with differentiation and the upregulation of inflammatory cytokines. This program, although producing only cell cycle arrest in vitro, also triggered an innate immune response that targeted the tumour cells in vivo, thereby contributing to tumour clearance. Our study indicates that p53 loss can be required for the maintenance of aggressive carcinomas, and illustrates how the cellular senescence program can act together with the innate immune system to potently limit tumour growth.
Notch1 and TGFβ1 cooperatively regulate Foxp3 expression and the maintenance of peripheral regulatory T cells
Authors: Jeremy B. Samon, Ameya Champhekar, Lisa M. Minter, Janice C. Telfer, Lucio Miele, Abdul Fauq, Pritam Das, Todd E. Golde, Barbara A. Osborne
Journal: Blood (2008)
Book Review Graft-vs.-Host Disease: Immunology, pathophysiology, and treatment (Hematology. Vol. 12.) Edited by Steven J. Burakoff, H. Joachim Deeg, James Ferrara, and Kerry Atkinson. 725 pp., illustrated. New York, Marcel Dekker, 1990. $175.
Authors: George W. Santos
Journal: New England Journal of Medicine (1991)
Elevated urinary leukotriene E<sub>4</sub> levels are associated with hospitalization for pain in children with sickle cell disease
Authors: Jeanine E. Jennings, Thiruvamoor Ramkumar, Jingnan Mao, Jessica Boyd, Mario Castro, Joshua J. Field, Robert C. Strunk, Michael R. DeBaun
Journal: American Journal of Hematology (2008)

Cysteinyl leukotrienes (CsyLTs) are inflammatory mediators produced by white blood cells. Leukotriene LTE(4) is the stable metabolite of CsyLTs, which can be measured in urine. We tested two hypotheses among children with sickle cell disease (SCD): (1) baseline urinary LTE(4) levels are elevated in children with SCD when compared with controls; and (2) baseline LTE(4) levels are associated with an increased incidence rate of hospitalization for SCD-related pain. Baseline LTE(4) levels were measured in children with SCD (cases) and children without SCD matched for age and ethnicity (controls). Medical records of cases were reviewed to assess the frequency of hospitalization for pain within 3 years of study entry. LTE(4) levels were obtained in 71 cases and 22 controls. LTE(4) levels were higher in cases compared with controls (median LTE(4): 100 vs. 57 pg/mg creatinine, P < 0.001). After adjustment for age and asthma diagnosis, a greater incidence rate of hospitalization for pain was observed among children with SCD in the highest LTE(4) tertile when compared with the lowest (114 vs. 52 episodes per 100 patient-years, P = 0.038). LTE(4) levels are elevated in children with SCD when compared with controls. LTE(4) levels are associated with an increased rate of hospitalizations for pain.
Effect of insulin induced hypoglycaemia on in vitro uptake of 3-O-methylglucose by rat jejunum.
Authors: A K Banerjee, K Raja, T J Peters
Journal: Gut (1989)

Acute hypoglycaemia (less than 2.0 mmol/l) selectively increased in vitro 3-O-methylglucose uptake by rat jejunum. In contrast, uptake of 3H-phenylalanine or 59Fe (III) was unchanged in the hypoglycaemic animals. The hypoglycaemia was accompanied by decreased tissue adenosine nucleotide energy charge. The increased uptake was phlorrhidzin-inhibitable and therefore reflected increased Na+ dependent glucose carrier activity. Cycloheximide did not block the increased 3-O-methylglucose uptake, implying that the mechanism is not the result of increased de novo carrier protein synthesis.
High Telomerase Activity in Neutrophils From Unstable Coronary Plaques
Authors: Maria Lucia Narducci, Annalisa Grasselli, Luigi Marzio Biasucci, Antonella Farsetti, Antonino Mulè, Giovanna Liuzzo, Giuseppe La Torre, Giampaolo Niccoli, Rocco Mongiardo, Alfredo Pontecorvi, Filippo Crea
Journal: Journal of the American College of Cardiology (2007)
Multicenter randomized trial of a comprehensive prepared meal program in type 2 diabetes.
Authors: F X Pi-Sunyer, C A Maggio, D A McCarron, M E Reusser, J S Stern, R B Haynes, S Oparil, P Kris-Etherton, L M Resnick, A Chait, C D Morris, D C Hatton, J A Metz, G W Snyder, S Clark, M McMahon
Journal: Diabetes Care (1999)

OBJECTIVE: To evaluate the clinical effects of a comprehensive prepackaged meal plan, incorporating the overall dietary guidelines of the American Diabetes Association and other national health organizations, relative to those of a self-selected diet based on exchange lists in free-living individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 202 women and men (BMI &amp;lt; or = 42 kg/m2) whose diabetes was treated with diet alone or an oral hypoglycemic agent were enrolled at 10 medical centers. After a 4-week baseline period, participants were randomized to a nutrient-fortified prepared meal plan or a self-selected exchange-list diet for 10 weeks. On a caloric basis, both interventions were designed to provide 55-60% carbohydrate, 20-30% fat, and 15-20% protein. At intervals, 3-day food records were completed, and body weight, glycemic control, plasma lipids, and blood pressure were assessed. RESULTS: Food records showed that multiple nutritional improvements were achieved with both diet plans. There were significant overall reductions in body weight and BMI, fasting plasma glucose and serum insulin, fructosamine, HbA1c, total and LDL cholesterol, and blood pressure (P &amp;lt; 0.001 or better for all). In general, differences in major end points between the diet plans were not statistically significant. CONCLUSIONS: Glycemic control and cardiovascular risk factors improve in individuals with type 2 diabetes who consume diets in accordance with the American Diabetes Association guidelines. The prepared meal program was as clinically effective as the exchange-list diet. The prepared meal plan has the additional advantages of being easily prescribed and eliminating the complexities of meeting the multiple dietary recommendations for type 2 diabetes management.
Comment on Breiner et al. Does the Prevailing Hypothesis That Small-Fiber Dysfunction Precedes Large-Fiber Dysfunction Apply to Type 1 Diabetic Patients? Diabetes Care 2014;37:1418–1424
Authors: Prashanth R.J. Vas, Sanjeev Sharma, Gerry Rayman
Journal: Diabetes Care (2014)

We read with great interest the article by Breiner et al. (1) demonstrating the presence of small-fiber dysfunction in type 1 diabetes of significant duration in the absence of perceptible abnormalities in large-fiber function, and we congratulate the authors for their simple, clear, and elegant study design. We also agree with the authors that this study “has made an important contribution to the literature” in understanding the development of early neuropathy in type 1 diabetes. As reviewed by the authors, the association of small-fiber dysfunction prior to large-fiber change is already an established concept in the neuropathy of type 2 diabetes and, indeed, in impaired glucose metabolism. It …
Abstract 5581: Korean Angelica gigas Nakai (AGN) and Oriental herbal cocktail ka-mi-kae-kyuk-tang (KMKKT) inhibit prostate carcinogenesis in TRAMP model
Authors: Lei Wang, Yong Zhang, Jinhui Zhang, Katai Nkata, Emily Quealy, Li Li, Hyo-Jeong Lee, Soo-Jin Jeong, Joshua Liao, Cheng Jiang, Sung-Hoon Kim, Junxuan Lu
Journal: Cancer Research (2011)

Abstract The ka-mi-kae-kyuk-tang (KMKKT) is a formula of ten Oriental herbs containing Korean Angelica gigas Nakai (AGN) root. Previous studies by our collaborative team found that the KMKKT ethanol extract exerted anti-angiogenesis, apoptosis and anti-metastasis in vitro and in vivo (carcinogenesis 2006). We also showed that AGN extract suppressed DU-145 &amp; PC-3 xenograft growth (Am J Chin Med 1009). In the present study, we used the transgenic adenocarcinoma of the mouse prostate (TRAMP) spontaneous primary carcinogenesis model to establish the chemoprevention efficacy of KMKKT and AGN and to explore cellular and molecular correlates of the in vivo anti-cancer effects. Male C57BL6 TRAMP mice were given a daily gavage (5 times per wk, 5 mg/mouse) as KMKKT and AGN beginning at 8 weeks of age (1% Tween-80 as vehicle n=13; KMKKT n=14; AGN n=17). We treated wild-type littermates also with KMKKT and AGN. All mice were terminated at 24 weeks of age, unless earlier euthanasia was necessitated by large tumor size. The results show that the genitourinary (GU) tract weight was decreased in both KMKKT (66.4%) and AGN (57.6%) treated groups compared to vehicle group (100%). The dorsal-lateral prostate (DLP) weight was significantly lower in KMKKT and AGN groups compared to control group (P=0.02), with no difference found in the wild-type mice cohorts. In TRAMP and wild-type mice that received KMKKT and AGN vs. vehicle, there is no significant difference of the body weight and main organs (liver and kidney) (P&amp;gt;0.05). Additionally, macroscopical prostate tumors were found 46.2% (6/13) in control group, but just 14.3% (2/14) and 17.6% (3/17) in KMKKT and AGN group (Chi-square analysis P=0.07 and P=0.09). The average tumor burden was 0.81g/mouse in control group, 0.27 and 0.12 g/mouse in KMKKT and AGN group, respectively. All these macroscopical tumors are T-antigen (+), synaptophysin(+), androgen-receptor(−) and E-cadherin(−) poorly differentiated neuro-endocrine carcinoma (NECa). Furthermore, KMKKT and AGN-treated NECa contained lower basic fibroblast growth factor (bFGF) detectable by WB, antibody array and IHC. Decursinol, the hydrolysis product of decursin and DA was detectable in the plasma of AGN-treated mice. In summary, results from this pilot study indicate that oral administration of KMKKT and AGN may inhibit prostate primary carcinogenesis in the TRAMP model. Additional chemoprevention studies are merited. [Grant support: NCCAM 1R21AT005383, NCI R01CA136953, R01CA126880 and Korean KOSEF-MEST No. 2009-0063466]. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5581. doi:10.1158/1538-7445.AM2011-5581
Dermatoglyphics Associated with Fetal Wastage
Authors: Leslie I. Rose, Steven G. Gabbe, Louis E. Teichholz, Dorothy B. Villee, Gordon H. Williams
Journal: New England Journal of Medicine (1972)

AN increased frequency of chromosomal abnormalities has been noted in fetuses from spontaneous abortions.1 Because some chromosomal deviations are associated with dermatoglyphic abnormalities, this study was undertaken to determine if any specific dermatoglyphic pattern was more prevalent in women with increased fetal wastage. The dermatoglyphic findings in these women were compared to the fingerprints of women proved to have had no reproductive failure.MethodsFingerprints were obtained from 25 consecutive women with two or more episodes of fetal wastage followed in the Special Obstetrics Clinic at the Boston Hospital for Women and from 58 consecutive normal women who had had . . .
PTU-021 Do all regenerative nodules become hepatocellular carcinoma? The outcome of 4 years MRI surveillance
Authors: B Hogan, P M Trembling, S Tanwar, D Yu, J P O'Beirne, W M Rosenberg
Journal: Gut (2012)

<h3>Introduction</h3> There are few epidemiological data on the longitudinal follow-up of nodular lesions in cirrhotic patients. <h3>Methods</h3> The Royal Free Hospital database was searched for all reports of MRI scans of the liver in which the term "nodule" was used. 630 such scans were identified in 369 individual patients between 1 January 2006 and 1 January 2011. Patients were then excluded if there was &lt;1-year follow-up (45), if hepatocellular carcinoma (HCC) was identified on the initial scan (135), if an alternative diagnosis was made (129) or if no significant arterialised lesion was reported despite previous suspicion on ultrasound scanning (31). Retrospective analysis was, therefore, performed on 29 cirrhotic patients with a diagnosis of regenerative, indeterminate or dysplastic arterialised nodules at baseline and &gt;1 year total follow-up with MRI and alpha-fetoprotein (AFP) surveillance. <h3>Results</h3> The median age at first scan was 55 years (range 36–73) and the most common aetiologies of cirrhosis were hepatitis C (55%), hepatitis B (10%) and alcohol (25%) with 10% other. The median follow-up period was 22 months (12–56) and the median number of scans 4 (2–10). At baseline nodules were described as indeterminate in 48%, regenerative in 45% and dysplastic in 7%. The prevalence of HCC after 1, 2, 3 and 4 years of follow-up was 5 (17%), 9 (31%), 11 (38%) and 11 (38%) respectively, with the highest incidence occurring in the first 2 years of follow-up (82% of cases). The median size of nodule at baseline in those who developed HCC was 10 mm (5–18) and it was 9 mm (5–26) in those who did not. There was no association between the description of the nodule and the likelihood of developing HCC (five arising from indeterminate and 6 from regenerative nodules) and the two nodules initially described as dysplastic did not transform to tumour. AFP results were not informative. <h3>Conclusion</h3> 31% of lesions described as arterialised nodules when first scanned developed into HCC within 2 years and initial radiological features consistent with "regenerative" nodules are not reassuring. Patients with discrete arterialised nodules should be enrolled in enhanced surveillance programmes. <h3>Competing interests</h3> None declared.
Increasing the Global Health Workforce
Authors: Kate Tulenko
Journal: JAMA (2011)

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
Dr Shipman's review copy
Authors: T. Dalrymple
Journal: BMJ (2011)

In Manchester earlier this year, I happened into a shop that specialised in remaindered books and in resold review copies. The stock was small and miscellaneous; I picked up a slim paperback volume with the title Making Sense of the NHS Complaints and Disciplinary Procedures , published in a series called “The Business Side of General Practice.” It was edited by David Pickersgill and Tony Stanton, and it had a foreword by Sir Donald Irvine, then president of the General Medical Council.

It was not a title that normally would have attracted me much, even if, having been published in 1997 (an eternity ago in terms of NHS reorganisation), it were not …