tbuckley/cabot-search huggingface dataset:
Useless and dangerous—fine needle aspiration of hepatic colorectal metastases
Authors: M S Metcalfe, F H G Bridgewater, E J Mullin, G J Maddern
Journal: BMJ (2004)

Fine needle aspiration cytology (FNAC) is an established tool for diagnosing liver tumours. It has recognised complications, however. Use of the procedure in abdominal tumours is fatal in 0.006 to 0.031% of cases.1 2 Most deaths occur with liver tumours and are due to haemorrhage. Another complication is that metastases can seed along biopsy needle tracts, although this has been reported to be rare, with an incidence of 0.003% to 0.07%, mostly from pancreatic tumours.1 2 More recently, much higher rates (0.4% to 5.1%) of needle tract metastases have been reported when FNAC is used in liver lesions, usually for primary liver tumours.3–7

Only 13 cases of needle tract colorectal metastases caused by FNAC in liver lesions are described in journals listed in Medline.7–13 Several authors have commented that the procedure should be avoided because of the risk of this complication. A further similar case is reported here, extending the contraindication of FNAC in hepatic tumours to include lesions for which no primary malignancy has been found. Therefore in Western populations, in which primary liver malignancy is rare, the diagnosis of apparently malignant liver lesions should centre on searching for the primary tumour, rather than on FNAC of the lesion.

A 78 year old man presenting with back pain was found on computed tomography of his abdomen to have a lesion in the right lobe of his liver. FNAC of the lesion was done without referral to a surgeon, …
THE DIPLOBACILLUS OF MORAXAXENFELD.
Authors: BROWN PUSEY
Journal: JAMA (1906)

there could be no motion between them.The bony tis- sue may even be continuous, but I have not myself ob- served this condition.Leboucq believes that fusion of these bones leads to a break-down of the plantar arch.In my cases of fibrocartilaginous union I have found some support for this view, but on the whole I am inclined to associate this connection with a high in- step.Apart from its influence on the shape of the foot this peculiarity is interesting from the opposition it would offer to a Chopart's amputation.
Choosing Wisely
Authors: Christine K. Cassel
Journal: JAMA (2012)

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
Lichen scrofulosorum with tuberculous dactylitis
Authors: R.A.C. GRAHAM-BROWN, I. SARKANY
Journal: British Journal of Dermatology (1980)

A patient with tuberculosis of cervical lymph nodes, lichen scrofulosorum on the trunk and limbs and tuberculous dactylitis of the hands is reported. Both the clinical and histological features of her lichen scrofulosorum conformed to the characteristic pattern described in other recently reported cases and the association with extra-pulmonary tuberculosis was again evident. There have been no other recent reports of tuberculous dactylitis, which was always said to be due to underlying tuberculous bony involvement. In our patient tuberculous dactylitis, which was clinically indistinguishable from previous cases, was found to be due to granulomatous involvement of the overlying skin with no associated bony abnormality.
The Checklist Conundrum
Authors: Lucian L. Leape
Journal: New England Journal of Medicine (2014)

The story of the patient-safety movement is one of slow progress punctuated by episodes of inspiring successes that are slow to be replicated. So it is not surprising that when promising innovations are not universally adopted, the public and policymakers are outraged and sometimes turn to regulation to ensure compliance. The surgical safety checklist is such an innovation.1 The use of such checklists has been mandated or strongly encouraged by several governments, including those of the United Kingdom, the Netherlands, and Ontario, Canada.A study reported in this issue of the Journal by Urbach and colleagues2 shows the limitations of . . .
Efficacy of Selected Hand Hygiene Agents Used to Remove <i>Bacillus atrophaeus</i> (a Surrogate of <i>Bacillus anthracis</i>) From Contaminated Hands
Authors: David J. Weber, Emily Sickbert-Bennett, Maria F. Gergen, William A. Rutala
Journal: JAMA (2003)

<h3>Context</h3> The intentional use of<i>Bacillus anthracis</i>transmitted via the US mail in October-November 2001 resulted in 22 people developing inhalation or cutaneous anthrax. Glove use with handwashing prior to and after contact with potential contaminated environmental surfaces and cutaneous lesions has been recommended. However, only limited data are available on the susceptibility of<i>B anthracis</i>to antiseptics. <h3>Objective</h3> To evaluate the efficacy of several hand antiseptics (interventions) and soap and water (control) against<i>Bacillus atrophaeus</i>, a surrogate of<i>B anthracis</i>. <h3>Design, Setting, and Participants</h3> Challenge study conducted among healthy adult volunteers, using the Standard Test Method for Evaluation of the Effectiveness of Health Care Professional Handwash Formulations (American Society for Testing and Materials E 1174-94) to determine the efficacy of various hand hygiene products at wash times of 10, 30, and 60 seconds. Volunteers were excluded if they had eczema, psoriasis, or other chronic skin conditions; nonintact skin; or allergies to any study agent. Study agents were a waterless rub containing 61% ethyl alcohol, a 2% chlorhexidine gluconate preparation, and an antibacterial microfiber towel that releases hypochlorite. A nonantimicrobial soap was used as a control. <h3>Main Outcome Measure</h3> Reduction of<i>B atrophaeus</i>spores (log<sub>10</sub>CFU/mL) on contaminated hands. <h3>Results</h3> Washes of 10, 30, and 60 seconds with either soap and water or 2% chlorhexidine gluconate eliminated 1.5 to 2.0 log<sub>10</sub>CFUs/mL of<i>B atrophaeus</i>spores at wash 3. Mean reductions (95% confidence intervals) with 10-, 30-, and 60-second washes with soap and water were 2.4 (2.2-2.5), 2.3 (2.2-2.4), and 2.1 (1.9-2.4) log<sub>10</sub>CFUs/mL, respectively; and with 2% chlorhexidine gluconate, 2.1 (2.0-2.3), 1.8 (1.5-2.0), and 1.7 (1.5-1.9) log<sub>10</sub>CFUs/mL, respectively. Handwashing with chlorine-containing towels was increasingly effective as the wipe time increased; reductions at 10, 30, and 60 seconds were 1.3 (1.1-1.5), 1.6 (1.2-2.0), and 2.2 (2.1-2.2) log<sub>10</sub>CFUs/mL, respectively. A waterless rub containing 61% ethyl alcohol was ineffective in eliminating<i>B atrophaeus</i>spores at all times tested (0 [−0.1 to 0.1], −0.2 [−0.3 to −0.1], and 0 [−0.2 to 0.2] log<sub>10</sub>CFUs/mL). <h3>Conclusions</h3> In this evaluation of hand hygiene agents, handwashing with soap and water, 2% chlorhexidine gluconate, or chlorine-containing towels reduced the amount of<i>B atrophaeus</i>spore contamination, whereas use of a waterless rub containing ethyl alcohol was not effective in removing spores.
Chronic Respiratory Symptoms, Skin Test Results, and Lung Function as Predictors of Peak Flow Variability
Authors: KIRSI L. TIMONEN, JØRN NIELSEN, JOEL SCHWARTZ, ANDREA GOTTI, VLADIMIR VONDRA, CHRISTINA GRATZIOU, PETTER GI ÆVER, WILLEM ROEMER, BERT BRUNEKREEF
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

We examined how chronic respiratory symptoms, reported in a questionnaire, and results of skin prick tests and spirometry predicted variability in peak expiratory flow (PEF) among 6-12-yr-old children (n = 1,854). After characterization with skin tests and spirometry, children were followed for 2-3 mo during the winter of 1993-1994. Peak expiratory flow was measured daily in the morning and evenings. Children with asthmatic symptoms (wheeze and/or attacks of shortness of breath with wheeze in the past 12 mo and/or ever doctor diagnosed asthma) had a greater variation in PEF than children with dry nocturnal cough as their only chronic respiratory symptom. Similarly, doctor-diagnosed asthma was associated with a greater variation in PEF, also among children with asthmatic symptoms. Peak flow variability increased with an increasing number of symptoms reported in the questionnaire. Atopy, positive skin test reactions to house dust mite and cat and lowered level (as % of predicted) in FEV1 and in MMEF were also associated with an increased variation in PEF. All the differences were observed in both diurnal and day-to-day variation in PEF. In conclusion, chronic respiratory symptoms reported in a questionnaire, spirometric lung function and skin prick test results among asthmatic children predicted variation in PEF measured during a 2-3 mo follow-up. The difference in morning PEF coefficient of variation (CV) between children with asthmatic symptoms and children with cough only was somewhat bigger in girls than in boys. The effect of atopy on morning PEF CV was somewhat bigger in young than in older children.
ABUSES OF COCAIN IN NASAL TREATMENTRead in the Section on Laryngology and Otology, at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: GEORGE WILKINSON
Journal: JAMA (1893)

nasal polypus and various other deformities present in these cases, and these conditions persist to a greater or less degree throughout the year.We can all agree to the following propositions : first, that
Anatomy of the Soul
Authors: George Bernard Shaw
Journal: JAMA (1965)

<h3>To the Editor:—</h3> Meeting the problem of a mysterious entity by giving it a descriptive name is a convenience. Naming gives the satisfaction of identification and a feeling of understanding. Sometimes the name guesses at the substance of the entity such as ether and ozone for interstellar space. Numerous descriptive names guess at the nature of mysteries in physics, chemistry, astronomy, and medicine. Breaking through the mysteries gives vistas of a limitless ultramicroscopic world or an expanding universe. The mind is never content with enjoyment of the known world, but must constantly probe the mysteries of the unknown. Impressive advances of research have emphasized our mental limitations by revealing limitless fields, previously unsuspected of existence. Such curiosity may be merely a characteristic of the mind. Thought is a function of cells in a portion of the brain which send activating stimuli to other such cells. Encounter with a basically meaningless
Responsiveness of muscle protein synthesis to growth hormone administration in HIV-infected individuals declines with severity of disease.
Authors: M A McNurlan, P J Garlick, R T Steigbigel, K A DeCristofaro, R A Frost, C H Lang, R W Johnson, A M Santasier, C J Cabahug, J Fuhrer, M C Gelato
Journal: Journal of Clinical Investigation (1997)

This study was undertaken to determine if human recombinant growth hormone (hrGH, 6 mg/d for 2 wk) would stimulate muscle protein synthesis in AIDS wasting. Healthy controls were compared with patients who were HIV+, had AIDS without weight loss, and had AIDS with > 10% weight loss. Before hrGH, rates of skeletal muscle protein synthesis, measured with l-[2H5]phenylalanine, were the same in controls and in all stages of disease. Rates of myofibrillar protein degradation, however, assessed from urinary excretion of 3-methyl histidine, were higher in AIDS and AIDS wasting than in HIV+ or healthy individuals. The group with weight loss had significantly higher TNFalpha levels but not higher HIV viral loads. Muscle function, as determined by isokinetic knee extension and shoulder flexion, was significantly higher in controls than all infected individuals. After GH, rates of protein synthesis were stimulated 27% in controls, with a smaller increase (11%) in HIV+, and a significant depression (42%) in AIDS with weight loss, despite fourfold elevation in insulin-like growth factor-I in all groups. There was a significant correlation of hrGH-induced changes in muscle protein synthesis with severity of disease (P = 0.002). The results indicate increased basal muscle protein degradation and decreased responsiveness of muscle protein synthesis to GH in the later stages of disease.
Timing for Repeated Treatment of Hyperthyroid Disease with Radioactive Iodine After Initial Treatment Failure
Authors: ISIS GAYED, JULIET WENDT, THOMAS HAYNIE, RAMESH DHEKNE, WARREN MOORE
Journal: Clinical Nuclear Medicine (2001)

It has been reported that the effect of radioactive iodine (RAI) treatment is complete in 4 to 6 months. This retrospective study evaluated the appropriate time for repeated treatment of hyperthyroid disease with RAI after initial treatment failure.Outcomes of 128 patients treated with RAI for hyperthyroid disease were reviewed retrospectively at 3 and 6 months.Eighty patients (group A) were treated successfully with a single dose of RAI. Twenty patients (group B) required a second treatment dose. Twenty-eight patients were lost to follow-up. All patients in group A were clinically improved to various degrees at 3 months and continued to improve at 6 months. All eight patients in group B who showed no improvement at 3 months remained the same at 6 months. The difference between the two groups was statistically significant.Patients with hyperthyroid disease who are unimproved at 3 months can be retreated with RAI without further delay.
Mitochondria and ischemia–reperfusion injury of the heart: Fixing a hole
Authors: F DILISA, P BERNARDI
Journal: Cardiovascular Research (2006)

Ischemia and post-ischemic reperfusion cause a wide array of functional and structural alterations of mitochondria. Although mitochondrial impairment is recognized as pivotal in determining loss of viability, the causal relationships among the various processes involved is ill defined. Nevertheless, a wide consensus exists in attributing a crucial role to opening of the mitochondrial permeability transition pore (PTP). Strong support for this concept has recently been provided by the reduced infarct size observed in mice lacking cyclophilin D. This protein located within the mitochondrial matrix favours PTP opening by increasing its sensitivity to Ca2+ in a process that is antagonized by cyclosporin A. Genetic approaches have also been used to demonstrate that adenine nucleotide translocase is not an essential component of the PTP. Here, we discuss our current understanding of the structure and function of PTP in the context of heart injury caused by ischemia and reperfusion.
Tissue Targeting in Cancer: eIF4E's Tale
Authors: Katherine L.B. Borden
Journal: Clinical Cancer Research (2009)

The eukaryotic translation initiation factor eIF4E is elevated in many human cancers. Tissue-specific targeting of eIF4E activity in ovarian cancer cells is achieved in cell culture and in mice by fusing a peptide corresponding to the eIF4E inhibitor, the eIF4E binding protein 1 (BP1), to an agonist of the gonadotropin receptor.
Preventing the Heterosexual Spread of AIDS
Authors: Roger Lake
Journal: JAMA (1988)

To the Editor.—  In the article entitled Preventing the Heterosexual Spread of AIDS [acquired immunodeficiency syndrome]: Are We Giving Our Patients the Best Advice? in the April 22/29 issue, Drs Hearst and Hulley 1 state that patients should be told not to have sex with anyone in a high-risk group who has not stopped all high-risk activities for at least six months and subsequently tested negative for HIV [human immunodeficiency virus] antibody.  This statement seems to imply that it may be safe to have sex with members of high-risk groups who have stopped high-risk activities for six months and then tested negative for HIV antibody, but the authors don't provide an estimate of HIV prevalence in such people. They divide HIV-seronegative people into two groups: those with no history of high-risk behavior and those with continuing high-risk behavior. The third possible group, seronegative people with a history of high-risk behavior who
Evidence for decreased splanchnic glucose uptake after oral glucose administration in non-insulin-dependent diabetes mellitus.
Authors: B Ludvik, J J Nolan, A Roberts, J Baloga, M Joyce, J M Bell, J M Olefsky
Journal: Journal of Clinical Investigation (1997)

The role of splanchnic glucose uptake (SGU) after oral glucose administration as a potential factor contributing to postprandial hyperglycemia in non-insulin-dependent diabetes mellitus (NIDDM) has not been established conclusively. Therefore, we investigated SGU in six patients with NIDDM and six weight-matched control subjects by means of the hepatic vein catheterization (HVC) technique. In a second part, we examined the applicability of the recently developed OG-CLAMP technique in NIDDM by comparing SGU and first-pass SGU during HVC with SGU during the OG-CLAMP experiment. The OG-CLAMP method combines a euglycemic, hyperinsulinemic clamp and an oral glucose tolerance test (75 g) during steady state glucose infusion (GINF). During HVC, SGU equals the splanchnic fractional extraction times the total (oral and arterial) glucose load presented to the liver. For OG-CLAMP, SGU was calculated as first-pass SGU by subtracting the integrated decrease in GINF over 180 min from 75 g. Cumulative splanchnic glucose output after oral glucose correlated significantly between both methods and was increased significantly in NIDDM patients (73.1+/-5.1 g for HVC, 76.5+/-5.5 for OG-CLAMP) compared with nondiabetic patients (46.7+/-4.4 g for HVC, 57.5+/-1.9 for OG-CLAMP). Thus, in NIDDM patients, SGU (7.4+/-2.1 vs. 37.8+/-5.9% in nondiabetic patients, P < 0.001) and first-pass SGU (4.7+/-1.7 vs. 26.5+/-5.1% in nondiabetic patients, P < 0.01) were decreased significantly during HVC, as was SGU during OG-CLAMP (3.9+/-1.7 vs. 23.4+/-2.5% in nondiabetic patients, P < 0.0001). SGU measured during OG-CLAMP correlated significantly with SGU (r = 0.87, P < 0.05 for NIDDM patients; r = 0.94, P < 0.01 for nondiabetic patients) and first-pass SGU (r = 0.87, P < 0.05 for NIDDM patients; r = 0.84, P < 0.05 for nondiabetic patients) during HVC. In conclusion, (a) SGU after oral glucose administration is decreased in NIDDM as measured by both methods, and (b) SGU during the OG-CLAMP is well-correlated to SGU and first-pass SGU during HVC in NIDDM. The decrease in SGU in NIDDM might contribute to postprandial hyperglycemia in diabetic subjects.
Cimetidine, Lupus Erythematosus, and Granulocytopenia
Authors: GEOFFREY O. LITTLEJOHN
Journal: Annals of Internal Medicine (1979)

Letters1 August 1979Cimetidine, Lupus Erythematosus, and GranulocytopeniaGEOFFREY O. LITTLEJOHN, M.B., B.S., MURRAY B. UROWITZ, M.D.GEOFFREY O. LITTLEJOHN, M.B., B.S.Search for more papers by this author, MURRAY B. UROWITZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-2-317_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The association between cimetidine and agranulocytosis has recently been reviewed (1). We report a patient with systemic lupus erythematosus who developed this complication.An 18-year-old Chinese woman with a 4-month history of Raynaud's phenomenon was admitted to another hospital on 29 December 1978 with fever, sore throat, photosensitivity rash, and a butterfly facial rash. The antinuclear antibody titre was 1:160 with an homogenous pattern, lupus erythematosus-cell phenomenon positive and DNA-binding 97%. Initial haemoglobin was 12.0 g/dL; platelet count, 137 000/mm3; and leukocyte count, 1500/mm3with a normal differential (Figure 1). Bone-marrow examination on 8 January 1979 was...References1. FRESTON J. Cimetidine and granulocytopenia. Ann Intern Med. 1979;90:264-65. Editorial. LinkGoogle Scholar2. HARVEYSHULMANTUMULTYCONLEYSCHOENRICH ALACE. Systemic lupus erythematosus: review of the literature and clinical analysis of 138 cases. Medicine (Baltimore). 1954;33:291-437. CrossrefMedlineGoogle Scholar3. BYRON J. Cimetidine and bone-marrow toxicity. Lancet. 1977;2:555-6. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Wellesley Hospital Toronto, Ontario M4Y 1J3 Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTrigger factors of cutaneous lupus erythematosus: a review of current literatureDrug ReactionsLichenoid and subacute cutaneous lupus erythematosus-like dermatitis associated with antihistamine therapyDrug-induced immune dysregulation as a cause of atypical cutaneous lymphoid infiltrates: A hypothesisHaematological Adverse Effects of Histamine H2-Receptor AntagonistsCimetidine suppression of CFU-C in malesFATAL AGRANULOCYTOSIS ATTRIBUTABLE TO CIMETIDINEAntihistaminesCimetidine-induced bone marrow suppressionCimetidine and Hematologic EffectsROBERT RATE, M.D., MARK BONNELL, M.D., CAROL CHERVENAK, R.PH., GARY PAVINICH, R.PH. 1 August 1979Volume 91, Issue 2Page: 317-318KeywordsAntinuclear antibodiesFeversHemoglobinLupus erythematosusPharyngitisPlateletsRashesRaynaud syndrome Issue Published: 1 August 1979 PDF DownloadLoading ...
POSTERIOR GASTROJEJUNOSTOMY IN ACUTE PERFORATIVE ULCER OF THE STOMACH AND DUODENUM
Authors: JOHN B. DEAVER
Journal: JAMA (1913)

There are but few affections which can be compared with acute perforation of a duodenal or gastric ulcer in respect to the certainty of death without operation, contrasted with almost equal certainty of recovery if the appropriate operation is done in the early hours after perforation. Prompt diagnosis and rational treatment, therefore, are the chief issues, and the necessities of immediate action in the event of perforation demand a condition of preparedness on the part of the physician and surgeon if they are to seize the opportunity of performing the modern miracle of transmuting the very throes of death into life and health. Perforation of duodenal or gastric ulcers is infrequent, but not so rare that any active physician will fail to encounter one or more instances in the course of his practice, while the active surgeon will see even more. In the last ten years I have had thirty-six
Investigating Diseases No One's Got
Authors: I. Herbert Schinberg
Journal: New England Journal of Medicine (1983)

I love the doctors — they are dears; But must they spend such years and years Investigating such a lot Of illnesses which no one's got, When everybody, young and old, Is frantic with the common cold? And I will eat my only hat If they know anything of that!1 IN this issue of the Journal, Carpenter, Carnes, and Anast report the results of intensive studies of one patient with two rare illnesses — Wilson's disease and hypoparathyroidism. The authors conclude from their experimental data and from the very low probability that both disorders could have occurred independently in . . .