tbuckley/cabot-search huggingface dataset:
My disappointment with an ethics committee
Authors: Siao Pei Tan
Journal: BMJ (2004)

F our years ago my grandmother had a stroke. When my grandfather found out he took it very badly and had a major stroke himself. The doctors had to perform emergency surgery, but he could not give his consent because of his illness. It saved his life but left him severely disabled: unable to speak, bedridden, and paralysed for eight months before he died. Was the surgery a mistake? Knowing that the surgery carried such risk, would he have wanted it?

When I was a fourth year medical student I got the opportunity to study a topic I am passionate about: the factors that affect someone's desire for active medical intervention. I intended to describe to the research participants a stroke scenario very similar to my grandfather's and ask them would they have wanted the surgery if they were a member of the victim's family or if they themselves had had the stroke. I would then relate the participants' characteristics, such as age, social support, perception of health status, and social and financial background, to their …
The Use of Nuclear Medicine Procedures in the Diagnosis of Budd-Chiari Syndrome
Authors: L G THUS, G A K HEIDENDAL, P C HUIJGENS, J J MOL, M VERKUYL
Journal: Clinical Nuclear Medicine (1978)

The case history of a patient with Budd-Chiari syndrome (BCS) is described. The underlaying disease proved to be essential thrombocytosis. Congential elliptocytosis was also present. The value of the conventional liver scan, percutaneous splenoportoscintigraphy and isotopic phlebography of the inferior vena cava in the diagnosis of BCS is described. It is suggested that a combination of these three noninvasive techniques be used when BCS is suspected.
Maternal Growth During Adolescent Pregnancy
Authors: Theresa O. Scholl
Journal: JAMA (1995)

<h3>To the Editor.</h3> —We have reported that maternal growth during adolescent pregnancy, as indexed using the Knee Height Measuring Device, is associated with greater maternal weight gain during pregnancy and increased maternal accrual of subcutaneous fat.<sup>1,2</sup>Changes such as these typically are associated with increased infant weight at birth, as opposed to the birth weight reductions we have observed for still-growing gravidas (about 150 to 200 g birth weight). During pregnancy, we use the Knee Height Measuring Device to index maternal growth because serial measures of stature are an insensitive indicator of growth.<sup>2</sup>
From black bag to black box: will computers improve the NHS?
Authors: L. J Donaldson
Journal: BMJ (1996)

As information technology advances, the drumbeat of punditry is swelled by visions of social upheaval, personal enrichment and fulfilment, and even a new world order. The word most often used to describe this prospect is revolution. If our lives are to be transformed and our world remodelled, will our health services too be revolutionised by computers? Some would say they are already poised on the brink of fundamental change. Telemedicine and the Internet have already created a “virtual hospital” in Iowa and a “cyberspace hospital” in Singapore, and the time is said to be coming when it will be as easy to consult a physician across the Atlantic as across the corridor.1

Faced with such captivating images of the future of medical practice, it may seem churlish to stop and ask for evidence of the benefit of computers to health care. In this issue of the BMJ (p 1407), Lock highlights the irony of the NHS, constantly exhorted to strive for greater evidence based cost effectiveness, spending £220 million a year on information …
112 Vascular hypocontractility to angiotensin-II in human and experimental cirrhosis is not related to changes in AT1-receptorexpression, but associated with overexpression of receptor-desensitizing proteins
Authors: M. Hennenberg, J. Trebicka, G. Hack, E. Biecker, M. Schepke, T. Sauerbruch, J. Heller
Journal: Journal of Hepatology (2006)
Impact of regional ventricular function, geometry, and dobutamine stress on quantitative 99mTc-sestamibi defect size.
Authors: A J Sinusas, Q Shi, P J Vitols, R C Fetterman, P Maniawski, B L Zaret, F J Wackers
Journal: Circulation (1993)

BACKGROUND Serial myocardial perfusion imaging with 99mTc-sestamibi (MIBI) was used to evaluate infarct risk area and salvage after thrombolysis. The purpose of this investigation was to determine whether changes in MIBI defect size observed after reperfusion may result in part from distortion of regional and global left ventricular geometry. METHODS AND RESULTS Twenty-five open-chest dogs were subjected to either 15 minutes (groups 1A and 1B) or 3 hours (group 2) of left anterior descending coronary artery occlusion followed by 3 hours of reperfusion. MIBI was injected before occlusion (group 1A) or during occlusion (groups 1B and 2), and serial ECG-gated planar imaging was performed. Dobutamine was infused after 3 hours of reperfusion (groups 1B and 2) to transiently alter left ventricular size and function. Perfusion defect magnitude (DM) and extent (DE) were serially quantified with circumferential profile analysis of end-systolic (ES), end-diastolic (ED), and summed images. Flow was assessed with radiolabeled microspheres and correlated with myocardial MIBI activity. Myocardial thickening was assessed in the risk area with sonomicrometers. In group 1A dogs, ischemic dyskinesis produced large artifactual quantitative MIBI defects on ES images (DM, 9.3 +/- 1.3; DE, 27.8 +/- 6.0) that were significantly smaller on ED images (DM, 4.5 +/- 0.9, P &lt; .05; DE, 4.4 +/- 2.3, P &lt; .05). In addition, DM and DE correlated inversely with myocardial thickening on ES images (DM, r = -.84; DE, r = -.78) and summed images (DM, r = -.72; DE, r = -.61) but not ED images (DM, r = -.12; DE, r = -.15). An index of defect reduction derived from summed images correlated well with thickening fraction in stunned dogs (group 1B, r = .89) but poorly in infarcted dogs (group 2, r = .41) subjected to dobutamine stress. CONCLUSIONS 99mTc-MIBI defect size may be affected by alteration of left ventricular geometry. Changes in regional function may confound analysis of risk area and myocardial salvage with serial 99mTc-MIBI imaging and may also affect defect size during pharmacological stress with dobutamine. Dobutamine 99mTc-MIBI imaging may be useful for distinguishing viable and nonviable myocardium.
DOSAGE OF VIOSTEROL
Authors: N. B. Taylor
Journal: JAMA (1931)

<h3>To the Editor:</h3> —In reference to your editorials inThe Journal, October 4 and November 22, I enclose a reprint which we believe offers some evidence for the view that vitamin D acts through the parathyroid glands, and that overdosage with viosterol is not without danger. [Comment.—The first editorial points out that there is a wide margin between the therapeutic dose of viosterol and the amount which produces definitely pathologic results; that in view of the present caution exercised in dosage the Council on Pharmacy and Chemistry has deemed it advisable to increase the concentration of viosterol in oil and in fortified cod liver oil; and that the source of the increased calcium in the circulation after overdosage with viosterol is probably in the bones rather than in an increased absorption. The second editorial comment points out the probability, based on recent experiments, of separating the toxic effects from
VARIATIONS IN STROKE VOLUME AND AORTIC VALVE AREA IN PATIENTS WITH AORTIC STENOSIS AND ATRIAL FIBRILLATION: AN EASIER APPROACH TO QUANTIFICATION OF AORTIC VALVE AREA IN THE SETTING OF AN IRREGULAR RHYTHM
Authors: Aboorva Sudhakar, Hamid Salehi, Rabiya Malik, Natesa Pandian
Journal: Journal of the American College of Cardiology (2014)
Abstract IA03: Combinatorial targeting of endothelial growth factor pathways
Authors: Kari K. Alitalo
Journal: Cancer Research (2015)

Abstract Solid tumors require blood vessels for growth and dissemination, and use lymphatic vessels as additional conduits for metastatic spread. The identification of growth factor receptor pathways regulating angiogenesis has led to clinical approval of the first anti-angiogenic molecules targeted against the vascular endothelial growth factor (VEGF)-VEGFR-2 pathway. However, in many cases resistance to anti-VEGF-VEGFR therapy occurs, and thus far the clinical benefit has been limited to only modest improvements in overall survival. Therefore, novel treatment modalities are required. I will discuss the other members of the VEGF-VEGFR family, as well as the angiopoietin growth factors and their Tie2 receptor as targets for the inhibition of tumor angiogenesis, lymphangiogenesis and metastasis. Our recent studies reveal that also the orphan receptor Tie1 is crucial for tumor angiogenesis and growth, but not for steady-state function of the vasculature. Combinatorial targeting of multiple vascular growth factor pathways shows promise for improving the efficacy of anti-angiogenic tumor therapy. Citation Format: Kari K. Alitalo. Combinatorial targeting of endothelial growth factor pathways. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr IA03. doi:10.1158/1538-7445.CHTME14-IA03
Intermediate acting insulin given at bedtime: effect on blood glucose concentrations before and after breakfast.
Authors: A J Francis, P D Home, I Hanning, K G Alberti, W M Tunbridge
Journal: BMJ (1983)

Six C-peptide deficient diabetics receiving twice daily mixtures of short and intermediate acting insulins were selected for study because of persistently raised blood glucose concentrations before and after breakfast. They were investigated to assess the effect of moving their evening injection of intermediate acting insulin to bedtime. The patients9 usual twice daily insulin treatment was optimised and compared with the bedtime regimen during inpatient metabolic studies and an outpatient crossover study. With the conventional injection regimen blood glucose concentration rose sharply from 0500 to reach a fasting mean value of 10 +/- SE 1 . 6 mmol/l (180 +/- 29 mg/100 ml) and 16 . 8 +/- 2 . 2 mmol/l (303 +/- 40 mg/100 ml) after breakfast. By contrast, when the evening dose of intermediate acting insulin was delayed until bedtime the nocturnal rise in blood glucose concentration started later and was significantly lower both fasting (7 . 5 +/- 1 . 1 mmol/l (135 +/- 20 mg/100 ml); p less than 0 . 02) and after breakfast (13 . 2 +/- 1 . 4 mmol/l(238 +/- 25 mg/100 ml); p less than 0 . 02). Fasting blood concentrations of ketone bodies (3-hydroxybutyrate) were also significantly decreased. Plasma free insulin concentrations showed the predicted changes in five of the six patients. Blood glucose profiles collected over four months during the outpatient study confirmed the beneficial effect of giving intermediate acting insulin at bedtime.
Antithrombotic Effects of Thrombolytic Agents in a Platelet-Rich Femoral Vein Thrombosis Model in the Hamster
Authors: Jean Marie Stassen, Åke Nyström, Marc Hoylaerts, Désiré Collen
Journal: Circulation (1995)

Background The extent and mechanism of the antithrombotic properties of fibrin-selective and non–fibrin-selective thrombolytic agents have not yet been established. Methods and Results The antithrombotic, thrombolytic, fibrinogenolytic, and pharmacokinetic properties of the following substances were determined in hamsters in the absence of conjunctive anticoagulant or antiplatelet therapy: recombinant tissue-type plasminogen activator (rTPA), recombinant single-chain urokinase-type plasminogen activator (rscu-PA), two-chain urokinase-type plasminogen activator (UK), with a rTPA deletion mutant lacking amino acids 6 to 173 and a mutation N184E (K 2 Pt), a rTPA/rscu-PA chimeric plasminogen activator consisting of amino acids 1 to 3 and 87 to 274 of rTPA and amino acids 138 to 411 of rscu-PA (K 1 K 2 Pu), streptokinase (SK), and recombinant staphylokinase (STAR). The antithrombotic effect, defined as the intravenous dose required to reduce mural thrombus formation to 50% in a platelet-mediated femoral vein thrombosis model in the hamster, was 6±1, 5±2, 1±0.05, 2.5±0.2, 0.02±0.002, 1±0.09, and 2±0.3 mg/kg (mean±SEM), respectively. The amounts, given as intravenous infusion over 60 minutes that induced 50% clot lysis in a hamster pulmonary embolism model, were 0.18±0.03, 1.1±0.05, 0.9±0.13, 0.34±0.03, 0.04±0.003, 0.05±0.005, and 0.04±0.001 mg/kg, respectively, indicating that for most thrombolytic agents the antithrombotic dose is much higher than their thrombolytic dose. The fibrinogen levels, measured 40 minutes after bolus injection, were reduced to 50% of baseline with 3.1±0.2, 2.5±0.3, 1.2±0.08, 2.0±0.14, 1.7±0.65, 0.54±0.03, and 1.2±0.11 mg/kg, respectively. Mean residence times following intravenous bolus injection were: 18±1, 14±1, 100±10, 80±2, 20±3, and 34±5 minutes for rTPA, rscu-PA, K 2 Pt, K 1 K 2 Pu, SK, and STAR, respectively. Regression analysis revealed a significant correlation of the antithrombotic effect with the fibrinogen breakdown ( P =.006) but not with the thrombolytic potency or with the mean residence time. Conclusions These observations support the hypothesis that thrombolytic therapy with fibrinogen-sparing agents requires the conjunctive use of anticoagulant and/or antiplatelet agents.
Elephantiasis Parasite Genome
Authors: Joan Stephenson
Journal: JAMA (2007)

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
THE SURGICAL TREATMENT OF A CERTAIN TYPE OF PENETRATING WOUNDS OF THE SCLERA, MEANS OF A DOUBLA CONJUNCTIVAL FLAP
Authors: LEE MASTEN FRANCIS
Journal: JAMA (1913)

The use of some form of conjunctival plasty to close and reinforce penetrating wounds of sclera is a too well-established principle of surgery to need elaboration, although, when Kuhmt published his work, as great a surgeon as Herman Knapp expressed himself as being somewhat dubious as to whether Kuhmt had materially improved on Nature's way. To Kuhnt, ofcourse, belongs credit for having been one of the foremost and most persistent advocates of the use of the conjunctiva in ocular wounds. Nothing of an essentially fundamental nature can be added to the surgical principle as has been set forth by him. It is the purpose of this paper to discuss the surgical treatment of a certain type of penetrating wounds, in reference to the advisability of the use of scleral sutures, and to call attention to a method of sealing the wound by means of a double conjunctival flap in such a way as to avoid their use if possible. After a review of the
Frequent TET2 mutations in systemic mastocytosis: clinical, KITD816V and FIP1L1-PDGFRA correlates
Authors: Tefferi A, Levine Rl, Lim Kh, Abdel-Wahab O, Lasho Tl, Patel J, Finke Cm, Mullally A, Li Cy, Pardanani A, Gilliland Dg
Journal: Leukemia (2009)
More on Gilder's South Africa
Authors: L. C. CHUMBLEY
Journal: Annals of Internal Medicine (1976)

Comments and Corrections1 February 1976More on Gilder's South AfricaL. C. CHUMBLEY, M.D.L. C. CHUMBLEY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-2-222_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I am surprised that you printed Hoffenberg's letter (Ann Intern Med 83:428, 1975), which is essentially a vitriolic critique of a paper by Gilder, "South Africa: Research Worker's Paradise" (Ann Intern Med 82:588, 1975). Gilder reviewed two studies, one psychiatric (1) and the other epidemiologic (2), of societies in South Africa in transition from a preindustrial to an industrial mode of living.Hoffenberg refers to stresses placed upon families in the Transkei (an independent, black-ruled territory) in which the men have chosen to work on contract in South Africa, entailing separation from their families. He asserts that...References1. AMESDAYNES FW: Some impressions of family life in Tsolo (Transkei). S Afr Med J 48:1961, 1974 MedlineGoogle Scholar2. WALKER A: Survival outlook for middleaged populations in South Africa. S Afr Med J 48:2053, 1974 MedlineGoogle Scholar3. WILLIAMS C: Gold Coast Annual Report of Medical Department for 1931-32, Appendix E. Accra, Government Printing Office, 1931-32 Google Scholar4. WILLIAMS C: Malnutrition and mortality in the pre-school child, in Pre-School Child Malnutrition: Primary Deterrent to Human Progress. Washington D.C., National Academy of Sciences—National Research Council Publication 1282 NAS-NRC 1966, p. 5 Google Scholar5. MACCARTHY D: Effects of emotional disturbance and deprivation (maternal rejection) on somatic growth, in Scientific Foundations of Paediatrics, edited by DAVIS GA, DOBBING J. London, Wm. Heinemann Medical Books Ltd., 1974, p. 56 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Harari Hospital Box ST14 Southernton, Salisbury Rhodesia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1976Volume 84, Issue 2Page: 222-223KeywordsEpidemiology Issue Published: 1 February 1976 PDF downloadLoading ...
Antisubstitution Law Controversy—A Solution?
Authors: BRIAN L. STROM
Journal: Annals of Internal Medicine (1974)

Antisubstitution laws are the state laws that require the pharmacist to dispense exactly the brand of drug prescribed by the physician. Repeal of these laws may result in saving a significant amount of money for consumers but may involve additional costs in terms of quality of health care delivery. Issues of economics, drug-product equivalence, drug-product quality, and physicians' prerogatives are discussed. The state of Maryland has recently enacted a partial repeal of its antisubstitution law. Maryland's law is evaluated in terms of these issues and the different savings and costs that the law could produce for consumers. A modified version of this law is proposed as a model for all states.
ABDOMINAL PAIN AT ONSET OF RHEUMATIC FEVER
Authors: Albert S. Hyman
Journal: JAMA (1930)

To the Editor:  —The abdominal pain arising at the onset or during the course of acute rheumatic fever has been the subject of much speculative comment among both cardiologists and pediatricians. A paper by Costedoat ( Bull. et mem. Soc. med. d. Hop. de Paris  53 :1353 [Dec. 2] 1929) and a subsequent communication by Dr. J. D. Geissenger (The Journal, May 3, p. 1427) indicates the paucity of literature on this subject, which, strangely enough, is not unfamiliar, especially among physicians practicing in the Eastern seaboard cities of this country, where acute rheumatic fever is endemic.  At a meeting of the Metropolitan Medical Society held at the New York Academy of Medicine, Jan. 25, 1927, I reported a case of rheumatic pericarditis simulating an acute surgical condition of the abdomen. The patient was a child about 6 years old who was suddenly seized with epigastric pain while playing in the
Zinc deficiency alters host response and pathogen virulence in a mouse model of enteroaggregative<i>escherichia coli</i>-induced diarrhea
Authors: David T Bolick, Glynis L Kolling, John H Moore, Luís Antônio de Oliveira, Kenneth Tung, Casandra Philipson, Monica Viladomiu, Raquel Hontecillas, Josep Bassaganya-Riera, Richard L Guerrant
Journal: Gut Microbes (2014)

Enteroaggregative Escherichia coli (EAEC) is increasingly recognized as a major cause of diarrheal disease globally. In the current study, we investigated the impact of zinc deficiency on the host and pathogenesis of EAEC. Several outcomes of EAEC infection were investigated including weight loss, EAEC shedding and tissue burden, leukocyte recruitment, intestinal cytokine expression, and virulence expression of the pathogen in vivo. Mice fed a protein source defined zinc deficient diet (dZD) had an 80% reduction of serum zinc and a 50% reduction of zinc in luminal contents of the bowel compared to mice fed a protein source defined control diet (dC). When challenged with EAEC, dZD mice had significantly greater weight loss, stool shedding, mucus production, and, most notably, diarrhea compared to dC mice. Zinc deficient mice had reduced infiltration of leukocytes into the ileum in response to infection suggesting an impaired immune response. Interestingly, expression of several EAEC virulence factors were increased in luminal contents of dZD mice. These data show a dual effect of dietary zinc in benefitting the host while impairing virulence of the pathogen. The study demonstrates the critical importance of zinc and may help elucidate the benefits of zinc supplementation in cases of childhood diarrhea and malnutrition.
Rapidly Progressive (Nonstreptococcal) Glomerulonephritis
Authors: ROBERTO A. BACANI
Journal: Annals of Internal Medicine (1968)

Eight patients with renal failure associated with a rapidly progressive glomerulonephritis were observed. The onset of illness was insidious and remarkable for the lack of a history suggesting a severe acute glomerulonephritis. The clinical course was brief, lasting from 5 to 27 weeks, and resulted in death from uremia and congestive heart failure. Clinical, bacteriologic, and serologic studies revealed no evidence of previous streptococcal infection, systemic disease, or significant drug ingestion. Histopathologic analysis of renal biopsy specimens revealed marked extracapillary cell proliferation with pronounced crescent formation, moderate to marked glomerulosclerosis, and only minimal or mild hypercellularity of the glomerular tufts. There was a rapid evolution of extensive fibrotic changes in the glomerular epithelial crescents. There was no arteritis or arteriolitis. Material with periodicity of fibrin was seen by electron microscopy and demonstrated by immunofluorescence among cells forming crescents. Subepithelial "humps" considered diagnostic of acute poststreptococcal glomerulonephritis were not seen in any specimens studied by electron microscopy. Although rapidly progressive glomerulonephritis has been described previously, it has never been distinguished clearly from acute poststreptococcal glomerulonephritis. Its pathogenesis is unknown. Nevertheless, our findings suggest that rapidly progressive glomerulonephritis may be a distinct clinical and morphologic primary renal disease of unknown cause, with a malignant clinical course.