tbuckley/cabot-search huggingface dataset:
Clinical image: An old fascination
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2014)

What's in an image? What's to like? Clinicians spend much of their time staring at scans and X-rays optimistic that a lesion will become obvious, eager to demonstrate a talent for interpretation. The rise of radiologists has rendered such amateur diagnostics less necessary. Clearly, even a radiologist's interpretation should be open to challenge but there is comfort in knowing an image is honoured by the expert verdict written in a radiologist's report.

Even good sense doesn't prevent clinicians from being fascinated by clinical images. Nor should it. Applying your diagnostic skills is one of the more stimulating elements of a clinician's work. A team of doctors haphazardly peering at a clinical image is a medical ritual, an ancient method of cultural bonding. In the old days, the most senior doctor would thrust a radiograph upon an unsuspecting X-ray box, and probably interrogate somebody less senior about its meaning. Now, a sharper image is electronically transmitted to the screen of a computer or a mobile device, and the interrogation may resemble more gentle coaxing. But the group X-ray huddle is preserved. Variation in interpretation and uncertainty lives on. We know what we do but we still do it.

In the spirit of fascination with scans and X-rays, this month sees the launch of a new section of JRSM. Intriguing, important or unusual images will feature in the clinical image section, which begins with the case of the bot fly.1 Articles for this section should be submitted via the usual online route.2 The image should be strong, clear, compelling and accompanied by a brief case summary of no more than 300 words. Up to 5 references will be allowed. All submissions that are being considered for publication will be peer-reviewed. It is best to ensure the image has been reported on by a radiologist before submission, and the radiologist's role in the article is appropriately acknowledged. Written patient consent to publication will be required. The full colour design of JRSM makes this new section much more viable and useful.

A section of this kind is nothing new in medical journals, few ideas are, but the educational role of a medical journal is an important one and images are a helpful way to learn about clinical scenarios in an easily digestible format. Readers tend to enjoy case histories with clinical images. Editors like clinical images too. They brighten an otherwise humdrum page, add valuable extra information to an article, and bail out the journal production team when it is time to select an image for the journal's cover.

All in all, in the modern vernacular, what's not to like?
Chronic Epstein-Barr Virus Infection and Human Immunodeficiency Virus Infection
Authors: ROBERT DENGLER
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 May 1987Chronic Epstein-Barr Virus Infection and Human Immunodeficiency Virus InfectionROBERT DENGLER, HENRIKE THOMSSEN, MARTIN VOLKMAN, BERTOLD EMMERICH, M.D.ROBERT DENGLERSearch for more papers by this author, HENRIKE THOMSSENSearch for more papers by this author, MARTIN VOLKMANSearch for more papers by this author, BERTOLD EMMERICH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-5-775_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent article by Schooley and associates (1) was read in our student seminar as an example of the impact of biotechnologic methods on diagnosis in hematologic and infectious diseases. We noted that both case reports describe findings also seen in patients with the acquired immunodeficiency syndrome, such as lymphadenopathy, splenomegaly, interstitial pneumonitis, humoral immune abnormalities, and in particular lymphocytopenia with a reduced T4/T8 ratio. We would like to ask why there is no information about serologic studies concerning the human immunodeficiency virus infections, which would have been done according to the case reports, and whether this...Reference1. SCHOOLEYCAREYMILLER RRG. Chronic Epstein-Barr virus infection associated with fever and interstitial pneumonitis: clinical and serologic features and response to antiviral chemotherapy. Ann Intern Med. 1986;104:636-643. LinkGoogle Scholar1. SCHOOLEYCAREYMILLER RRG. Chronic Epstein-Barr virus infection associated with fever and interstitial pneumonitis: clinical and serologic features and response to antiviral chemotherapy. Ann Intern Med. 1986;104:636-43. LinkGoogle Scholar2. SANDSTROMSCHOOLEYHO ERD. Detection of human anti-HTLV-III antibodies by indirect immunofluorescence using fixed cells. Transfusion. 1985;25:308-12. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Technical University of Munich Munich West Germany PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1987Volume 106, Issue 5Page: 775-775KeywordsAIDSEpstein-Barr virusHIVInfectious disease immunologyInfectious diseasesInterstitial lung diseasesLymphopeniaSplenomegaly Issue Published: 1 May 1987 PDF DownloadLoading ...
An Entirely Benign Disorder
Authors: Sebastian Fetscher
Journal: Annals of Internal Medicine (1999)

On Being a Patient16 November 1999An Entirely Benign DisorderSebastian Fetscher, MDSebastian Fetscher, MDFreiburg University Medical Center; Freiburg D-791046, Germany (Fetscher)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-10-199911160-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail It all started when I was a child. I had a bad cold, and our family physician, a rather uncouth middle-aged matron, auscultated my heart. “Oh,” she exclaimed, “oh-oh, we are having a heart murmur. We should have a cardiac catheterization done. You know, my brother, the cardiologist, does them all the time. However, when I think of it, the last patient he did died of the procedure, so I think we had better forget about the catheterization and treat your infection.” For reasons known only to her, the well-meaning physician never mentioned the issue again. But she did manage ... Author, Article, and Disclosure InformationAffiliations: Freiburg University Medical Center; Freiburg D-791046, Germany (Fetscher)Corresponding Author: Sebastian Fetscher, MD, Department of Hematology and Oncology, Freiburg University Medical Center, Hugsteiter Strasse 55, D-79106 Freiburg, Germany; e-mail, [email protected]ukl.uni-freiburg.de. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, [email protected]acponline.org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByLife on the Receiving End: A Qualitative Analysis of Health Providers??? Illness NarrativesCaring for Colleagues 16 November 1999Volume 131, Issue 10Page: 786-788KeywordsArmed forcesArrhythmiaAtrial fibrillationEchocardiographyHeartMitral insufficiencyMitral valve repairSurgeonsSurgeryValve replacement Issue Published: 16 November 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Neonatal Mortality Risk Associated with Preterm Birth in East Africa, Adjusted by Weight for Gestational Age: Individual Participant Level Meta-Analysis
Authors: Tanya Marchant, Barbara Willey, Joanne Katz, Siân Clarke, Simon Kariuki, Feiko ter Kuile, John Lusingu, Richard Ndyomugyenyi, Christentze Schmiegelow, Deborah Watson-Jones, Joanna Armstrong Schellenberg
Journal: PLoS Medicine (2012)

In an analysis of four datasets from East Africa, Tanya Marchant and colleagues investigate the neonatal mortality risk associated with preterm birth and how this changes with weight for gestational age.
Report Notes Increase in Kidney Disease
Authors: Mike Mitka
Journal: JAMA (2008)

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
Verapamil for Control of Ventricular Rate in Paroxysmal Supraventricular Tachycardia and Atrial Fibrillation or Flutter
Authors: Harvey L. Waxman, Robert J. Myerburg, Ruth Appel, Ruey J. Sung
Journal: Annals of Internal Medicine (1981)

The effectiveness of verapamil in controlling ventricular rate was evaluated in 20 patients with atrial fibrillation or flutter with a rapid ventricular response (Group 1) and 30 patients with paroxysmal supraventricular tachycardia (Group 2). In Group 1 low-dose verapamil (0.075 mg/kg body weight) decreased the mean ventricular rate from 146 to 114 beats/min (p < 0.01) compared to a decrease of 145 to 132 beats/min (p < 0.01) after placebo. In Group 2, 14 of 29 patients converted to sinus rhythm after low-dose verapamil, nine of 15 after high-dose verapamil (0.15 mg/kg body weight), and one of 24 after placebo (p < 0.01). We conclude that verapamil results in a clinically significant slowing of the ventricular response in atrial fibrillation or atrial flutter and is superior to placebo for conversion of paroxysmal supraventricular tachycardia to sinus rhythm.
CERTAIN POPULAR BUT ERRONEOUS NOTIONS CONCERNING ANGINA PECTORIS
Authors: JAMES B. HERRICK
Journal: JAMA (1910)

Severe substernal pain coming on after exertion, radiating to the left arm, lasting a brief moment, yet compelling the patient to remain immobile from the physical suffering and from a mental anguish that overwhelms him with a sense of imminent death—this picture is looked on by all as that of typical, true, cardiovascular angina, and especially when the arteries are found to be sclerotic and the blood-pressure high. A prognosis is made of sudden death in the near future from a recurrence of the paroxysm, a prediction only too often correct.  So indelibly is this image of the phenomena and course of the affection fixed in the minds of many physicians that they are unable to admit any deviation from its details as consistent with this disease. In this way there have become prevalent several notions concerning angina pectoris that are more or less erroneous, chiefly in that they fail
Mechanisms for Controlling Costs
Authors: Kevin Grumbach
Journal: JAMA (1995)

A previous article in this series, "Painful vs Painless Cost Control,"<sup>1</sup>discussed the overall relationship between costs and health outcomes. In this article, we examine specific methods for controlling costs. Financial transactions under private or public health insurance have two components<sup>2</sup>: (1) a financing transaction consisting of the flow of dollars (premiums or taxes) from the payers (individuals and employers) to the health insurance plan (private health insurance or government programs), and (2) a reimbursement transaction involving the flow of dollars from insurance plans to physicians, hospitals, and other providers (Figure). Cost-control strategies can be divided into those that target the financing side vs those that impact the reimbursement side of the funding stream (Table). <h3>FINANCING CONTROLS</h3> Cost controls aimed at the financing of health insurance attempt to limit the flow of funds into health insurance plans, with the expectation that the plans will then be forced to
The incidence of false-positive cultures for Mycobacterium tuberculosis.
Authors: W J Burman, B L Stone, R R Reves, M L Wilson, Z Yang, H El-Hajj, J H Bates, M D Cave
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

The frequency of false-positive cultures for Mycobacterium tuberculosis due to cross-contamination has been difficult to determine because of the lack of specific strain markers. Isolates collected prospectively over 5 yr from a municipal health department laboratory underwent DNA fingerprinting using the IS6110 and pTBN12 sequences. We reviewed the clinical and laboratory records of all isolates that had matching DNA fingerprints and were processed within 42 d of each other; 8 isolates were classified as probable or definite false-positives, representing 4.0% (8/199) of the culture-positive patients. A convenience sample of 42 isolates from three other mycobacterial laboratories also underwent DNA fingerprinting, and five (12%) were found to be definite or probable false-positives. Cross-contamination during initial processing of specimens was the most common source of false-positive cultures. The source of cross-contamination for three false-positive cultures was a laboratory proficiency survey specimen containing strain H37Ra. Ten of the 13 patients were misdiagnosed as having tuberculosis, and seven received unnecessary multidrug treatment. Clinicians should be aware of the potential for false-positive cultures for M. tuberculosis, and mycobacteriology laboratories need to carefully review procedures to minimize this occurrence. DNA fingerprinting provides a valuable tool for the study of false-positive cultures.
A multi-institutional trial of polymerized whole ragweed for immunotherapy of ragweed allergy
Authors: Stephen G. Hendrix, Roy Patterson, C.Raymond Zeiss, Jacob J. Pruzansky, Irena M. Suszko, Robert C. McQueen, Raymond G. Slavin, Michael P. Miller, Philip L. Lieberman, Albert L Sheffer
Journal: Journal of Allergy and Clinical Immunology (1980)
Arthritis and Allied Conditions
Authors: J. T. Scott
Journal: Annals of the Rheumatic Diseases (1980)

<h3>Aim</h3> To identify preoperative features associated with surgical failure following vitrectomy using data collected in a large, prospective randomised controlled trial. Outcomes of patients who redetached were then examined in more detail. <h3>Methods</h3> 615 patients were analysed as part of an randomised controlled trial investigating the use of 5-fluorouracil and low-molecular-weight heparin. Treatment status had no effect on success rates and did not therefore form part of the analyses. Failure was defined as retinal redetachment within 6 months of primary vitrectomy. Univariate logistic regression analysis was used to assess association between failure and putative risk factors (age, pathological myopia, intraocular pressure, vitreous haemorrhage, previous lens extraction, uveitis, number of retinal quadrants detached, number and distribution of retinal breaks, and grade C proliferative vitreoretinopathy (PVR)). Additional characteristics of patients were then elucidated including number of operations required to achieve retinal reattachment, surgical techniques used and final logMAR visual acuity. <h3>Results</h3> 96 patients (15.6%) redetached following surgery, and 37 failed due to PVR. Surgical failure was associated with number of retinal quadrants detached (OR per increase, 1.69 (1.33 to 2.15) p&lt;0.001) and grade C PVR (OR 3.98 (1.47 to 10.73) p=0.006). Inferior breaks were not identified as a risk factor (p=0.602). Repeat retinal detachment surgery showed a trend towards reduced visual acuity at 6 months providing PVR did not develop. PVR resulted in a significant deterioration in visual acuity. <h3>Conclusions</h3> The extent of retinal detachment and preoperative PVR are risk factors for surgical failure following vitrectomy for primary retinal detachment. PVR was again confirmed as the major factor influencing visual outcomes.
Occlusion of chest drain bottle air outlet
Authors: J A CORLESS
Journal: Thorax (2001)

Treatment of a pneumothorax often requires insertion of an intercostal chest drain. Usually the tube is connected to an underwater seal which acts as a one way valve, allowing air to escape from the pleural space and thereby preventing the development of a tension pneumothorax. We wish to highlight the case of a patient who developed a potentially life threatening problem resulting from the partial occlusion of a chest drain bottle air outlet port by a plastic cap supplied with the equipment.

A 60 year old man with COPD developed a large right pneumothorax. Aspiration was unsuccessful so a chest drain was inserted. This was connected …
Estrogen Use in Postmenopausal Women — Costs, Risks, and Benefits
Authors: Milton C. Weinstein
Journal: New England Journal of Medicine (1980)

Abstract The cost effectiveness of estrogen use in postmenopausal women was analyzed with use of data from the medical and epidemiologic literature. Risks of endometrial cancer, uterine bleeding, and gallbladder disease were weighed against benefits associated with relief of menopausal symptoms and with prevention of osteoporosis and consequent fractures. Net effects on life expectancy are probably small in either direction, although they are likely to be positive in women with existing osteoporosis or prior hysterectomy. Treatment appears to be relatively cost effective in menopausal women with prior hysterectomy or osteoporosis but does not appear to be cost effective as a prophylactic measure in asymptomatic women with intact uteri. For women with menopausal symptoms and intact uteri, the decision to prescribe estrogens for the individual patient and the cost effectiveness of estrogen use at the societal level depend critically on the subjective values assigned to symptomatic relief. (N Engl J Med. 1980; 303:308–16.)
Lack of ACTH and Androgen Receptor Expression in a Giant Adrenal Myelolipoma Associated with 21-hydroxylase Deficiency
Authors: Hanae Hagiwara, Takeshi Usui, Takashi Kimura, Tetsuya Tagami, Mitsuhide Naruse, Sachiko Minamiguchi, Takuma Kato, Hiroshi Okuno, Akira Shimatsu
Journal: Endocrine Pathology (2008)
Choroidal Melanoma and Levodopa
Authors: David H. Abramson
Journal: JAMA (1984)

<h3>To the Editor.—</h3><h3>Report of a Case.—</h3> A 67-year-old man with a history of parkinsonism, successfully managed with levodopa therapy since 1981, noted a superior visual field deficit in the right eye in 1982. Our evaluation disclosed an inferior choroidal malignant melanoma with a large, overlying sensory retinal detachment. Results of metastatic workups, at that time and since, have been normal. The patient was treated with placement of a cobalt 60 plaque over the tumor, delivering a total apex radiation dose of 10,000 rad over the 10-mm tumor base. During the course of the following eight months, the tumor substantially decreased in size and vision was restored. <h3>Comment.—</h3> The case reports by Skibba<sup>1</sup>and others<sup>2-4</sup>have stimulated a growing concern in the relationship between dihydroxyphenylalanine therapy and the occurrence of malignant melanoma, uveal or cutaneous. These reports discussed patients with parkinsonism treated with levodopa who subsequently suffered recurrence of
Fundamentals of Urology
Authors: Alan H. Bennett
Journal: JAMA (1977)

<i>Fundamentals of Urology</i>, edited by Jack Lapides and dedicated to Reed Nesbit, is a must for every medical student and should certainly have a place in the library of the surgical resident. All too often, urology is given a low priority in medical school curricula. In a few evenings of easy reading,<i>Fundamentals of Urology</i>can make the student feel comfortable and confident in his initial contact with the urological patient. Few subjects are left uncovered. The introductory chapters on the anatomy, physiology, and embryology of the genitourinary tract are excellent. In just 20 well-illustrated, concise chapters, the orderly discipline of genitourinary surgery is described. The workup of patients, whether it be for the more unusual diseases such as Cushing syndrome or more common disorders such as hematuria or urinary calculi, is clear and concise. A well-selected bibliography concludes each chapter so that the student may pursue a topic further
The Biologic Possibility of HIV Transmission During Passionate Kissing
Authors: John C. Petricciani
Journal: JAMA (1989)

To the Editor.—  Piazza et al1recently presented evidence that microlesions of the oral mucosa occur during passionate kissing and that small amounts of blood could be found in saliva. They then suggested that because of the presence of blood in saliva after passionate kissing, human immunodeficiency virus (HIV) may be transmitted by the oral route and that kissing should not be considered safe.  In contrast to those conclusions, there is considerable evidence pointing toward an extremely low probability that passionate kissing contributes significantly to new HIV infections. Perhaps the most compelling fact is that the risk of infection has been consistently less than 1% in follow-up studies of health care workers who were exposed to the blood of HIV-infected persons through accidental needle sticks.2Since the risk of transmitting HIV through small amounts of blood by the direct parenteral route is so low, one would assume an
Psychosomatic Symptoms in Preadolescent Children
Authors: T.M. Tamminen, P. Bredenberg, T. Escartin, P. Kaukonen, K. Puura, M. Rutanen, I. Suominen, H. Leijala, R. Salmelin
Journal: Psychotherapy and Psychosomatics (1991)

As part of a Finnish national epidemiological study on child psychiatric disorders, psychosomatic symptoms were studied in a sample (n = 1,100) of 8-year-old children on the basis of self-report questionnaires by the children, their parents and teachers. Psychosomatic symptoms were common, although constant symptoms were rare. There were no sex differences in the occurrence of symptoms, but interesting differences were observed in associations between symptoms and other factors. Psychosomatic symptoms were strongly associated with depression scores and school performance.
Primary Malignant Lymphoma of the Central Nervous System by Ga-67 and TI-201 Brain SPECT
Authors: SHIGERU KOSUDA, SHIGEKI AOKI, KENZO SUZUKI, HIROHIKO NAKAMURA, OSAMU NAKAMURA, NOBUYUKI SHIDARA
Journal: Clinical Nuclear Medicine (1992)

Two patients with primary lymphoma of the central nervous system underwent both Ga-67 and TI-201 brain SPECT. Ga-67 scans showed remarkable accumulation of radiotracer corresponding to tumors detected by CT and MRI. More avid uptake was noted on the Ga-67 scans than on the TI-201 scans. In one patient, the intense tracer uptake had disappeared in the Ga-67 study performed after irradiation with 50 Gy. We are convinced that Ga-67 SPECT is useful for detecting and following the progress of primary lymphoma of the central nervous system.
Heart rate variability monitored by the implanted device predicts response to CRT and long‐term clinical outcome in patients with advanced heart failure
Authors: Maurizio Landolina, Maurizio Gasparini, Maurizio Lunati, Massimo Santini, Roberto Rordorf, Antonio Vincenti, Paolo Diotallevi, Annibale S. Montenero, Carlo Bonanno, Tiziana de Santo, Sergio Valsecchi, Luigi Padeletti
Journal: European Journal of Heart Failure (2008)