tbuckley/cabot-search huggingface dataset:
Professional Monopolies in Medicine
Authors: Mark O. Baerlocher
Journal: JAMA (2009)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Dermal Neurovascular Dysfunction in Type 2 Diabetes
Authors: Aaron I. Vinik, Tomris Erbas, Tae Sun Park, Kevin B. Stansberry, John A. Scanelli, Gary L. Pittenger
Journal: Diabetes Care (2001)

To review evidence for a relationship between dermal neurovascular dysfunction and other components of the metabolic syndrome of type 2 diabetes.We review and present data supporting concepts relating dermal neurovascular function to prediabetes and the metabolic syndrome. Skin blood flow can be easily measured by laser Doppler techniques.Heat and gravity have been shown to have specific neural, nitrergic, and independent mediators to regulate skin blood flow. We describe data showing that this new tool identifies dermal neurovascular dysfunction in the majority of type 2 diabetic patients. The defect in skin vasodilation is detectable before the development of diabetes and is partially correctable with insulin sensitizers. This defect is associated with C-fiber dysfunction (i.e., the dermal neurovascular unit) and coexists with variables of the insulin resistance syndrome. The defect most likely results from an imbalance among the endogenous vasodilator compound nitric oxide, the vasodilator neuropeptides substance P and calcitonin gene-related peptide, and the vasoconstrictors angiotensin II and endothelin. Hypertension per se increases skin vasodilation and does not impair the responses to gravity, which is opposite to that of diabetes, suggesting that the effects of diabetes override and counteract those of hypertension.These observations suggest that dermal neurovascular function is largely regulated by peripheral C-fiber neurons and that dysregulation may be a component of the metabolic syndrome associated with type 2 diabetes.
Thymic Stromal Lymphopoietin (TSLP) is Released by Human Epithelial Cells in Response to Microbes and Potently Activates Mast Cells
Authors: Z. Allakhverdi, M. Comeau, S.F. Ziegler, M. Sarfati, G. Delespesse
Journal: Journal of Allergy and Clinical Immunology (2007)
Malaria and sickle-cell disease.
Authors: F I Konotey-Ahulu
Journal: BMJ (1971)

Bisphosphonates are strong inhibitors of osteoclastic bone resorption in both benign and malignant bone diseases. The nitrogen-containing bisphosphonates (N-BPs) have strong cytotoxicity via inhibition of protein prenylation in the mevalonate pathway, and also demonstrate direct cytostatic and proapoptotic effects on prostate cancer cells. We confirmed the usefulness of a co-culture system comprised of prostatic LNCaP cells, ST2 cells (mouse-derived osteoblasts) and MLC-6 cells (mouse-derived osteoclasts) in vitro. N-BPs (pamidronate and zoledronic acid) inhibited both androgen receptor transactivation and tumor cell proliferation by suppressing the activities of both osteoclasts and osteoblasts with low-dose exposure. This indirect inhibition of prostate cancer cells via bone cells could be beneficial in treating prostate cancer patients with bone metastases.
Improving the health of NHS workers
Authors: J. Harrison
Journal: BMJ (1998)

News p 958 

At 50 years of age the NHS might be excused for undergoing a mid-life crisis. For most of its life its existence, albeit turbulent, has been unchallenged. The past few years have brought into focus its role as a public service while its professional ethos has been eroded by the doctrine of business management. The vision of universal health provision that is free for all has been replaced by an increasing awareness of inevitable restrictions in service delivery, while the rapid development of information technology is likely to change radically access to health information and models of health care. This might explain why attention is now being paid to the health of the people who work in the NHS and who make the service what it is.

The publication by the Nuffield Trust of a report on …
Day 30: Changing the Angle
Authors: H. S. Meyer
Journal: JAMA (2003)

From The Radiation Sonnets: For My Love, in Sickness and in Health, by Jane Yolen, 90 pp, $14.95, ISBN 1-56512-402-2, Chapel Hill, NC, Algonquin Books of Chapel Hill, 2003 (sonnets written daily during husband's radiation treatments).
A Novel Program of Continuing Medical Education
Authors: Malin R. Dollinger
Journal: JAMA (1972)

Practicing physicians have great demands on their time and energy and it is increasingly difficult to continue medical education on a systematic and regular basis. Most continuing education courses stress passive transfer of information in a classroom type of situation, typically a short burst of didactic instruction lasting one to five days, usually at a medical center remote from the physician's home and area of practice. Most of these formal courses do not involve continuous education over a relatively long period of time, or active participation on the part of the doctor. During the past three years, practicing physicians in the South Bay area of Los Angeles, the full-time staff of the Department of Medicine at Harbor General Hospital, and California Regional Medical Programs Area IV (UCLA) have recognized the need for a continuing education program which would keep practicing physicians, especially generalists and internists, up-to-date in various specialties of
Tissue harmonic imaging enables improved detection of left ventricular endocardial border comparable and complementary to contrast blood pool enhancement
Authors: J.D. Kasprzak, B. Paellinck, W.B. Vletter, A. Elhendy, R.T. van Domburg, N. de Jong, F.J. Ten Cate
Journal: Journal of the American College of Cardiology (1998)
BMA annual meeting: BMA chairman attacks government for "bleeding every penny" out of NHS
Authors: G. Iacobucci
Journal: BMJ (2014)

The chairman of the BMA has called on the UK government to abandon the “bizarre market culture” that it has created in the NHS, saying that this wastes valuable resources.

In his keynote speech to the BMA’s Annual Representative Meeting in Harrogate, Mark Porter said that reforms enacted in the Health and Social Care Act 2012 were fragmenting care and were diverting energies and funding away from frontline services. He also attacked the Treasury for …
Protection of kidney function and decrease in albuminuria by captopril in insulin dependent diabetics with nephropathy.
Authors: H. H. Parving, E. Hommel, U. M. Smidt
Journal: BMJ (1988)

STUDY OBJECTIVE--To assess whether long term inhibition of angiotensin converting enzyme with captopril and frusemide or bendrofluazide protects kidney function in diabetic nephropathy. DESIGN--Non-randomised controlled before-after trial of matched hypertensive insulin dependent diabetics with nephropathy treated with captopril and frusemide or bendrofluazide. SETTING--Outpatient diabetic clinic in tertiary referral centre. PATIENTS--Treatment group of 18 hypertensive insulin dependent diabetics with nephropathy (mean age 33), who had not been treated previously. Control group of 13 patients (mean age 32) fulfilling the same entry criteria from a prospective study. INTERVENTIONS--Treatment group was given daily captopril 37.5-100.0 mg and frusemide (mean) 98 mg (10 patients) or bendrofluazide (mean) 4 mg (seven). Treatment was continued for about two and a half years. Controls were not treated. END POINT--Measurement of arterial blood pressure, albuminuria, and glomerular filtration. MEASUREMENTS AND MAIN RESULTS--Baseline values were identical in treated and untreated groups respectively: mean blood pressure 146/93 (SE 3/1) mm Hg v 137/95 (2/1) mm Hg; geometric mean albuminuria 982 (antilog SE 1.2) micrograms/min v 936 (1.2) micrograms/min; and mean glomerular filtration rate 98 (SE 5) ml/min/1.73 m2 v 96 (6) ml/min/1.73 m2. Mean arterial blood pressure fell by 8.7 (1.3) mm Hg with captopril and rose by 6.6 (1.5) mm Hg in controls, (p less than 0.001); Albumin excretion decreased to 390 (1.1) micrograms/min with captopril and rose to 1367 (1.3) micrograms/min in controls (p less than 0.001). The rate of decrease in glomerular filtration rate was lower with captopril (5.8 (0.7) ml/year v 10.0 (1.3) ml/year) (p less than 0.01). Rate of fall in glomerular filtration rate and mean arterial blood pressure were significantly correlated (n = 31, r = 0.37, p less than 0.05). CONCLUSIONS--Captopril is a valuable new drug for treating hypertension in insulin dependent diabetics with nephropathy.
Thomas Eldon Scott Stowell
Authors: Michael Williams
Journal: BMJ (2005)

Former general practitioner Southampton (b Northwich, Cheshire, 1919; q Oxford/St Thomas' Hospital, London; FRCGP), d 5 January 2005.​2005.




Figure 1




After qualifying Eldon Stowell became an orthopaedic specialist in the Royal Air Force Volunteer Reserve. He entered general practice in Southampton in 1949 and became a founder member of the College of General Practitioners in 1952. An enthusiast for the concept of group practice, he was one of the first GPs appointed as a teacher to the new faculty of medicine at Southampton University. In 1938 he was awarded a Royal Humane Society testimonial for helping to rescue a drowning man. His computer, at first a substitute for his bad handwriting, became a source of comfort to him in his last months. Predeceased by his first wife, Hilda, and a son, he leaves his second wife, Christina, and two children from his first marriage.
Involvement in Caregiving and Adjustment to Death of a Spouse
Authors: Richard Schulz, Scott R. Beach, Bonnie Lind, Lynn M. Martire, Bozena Zdaniuk, Calvin Hirsch, Sharon Jackson, Lynda Burton
Journal: JAMA (2001)

ContextMost deaths in the United States occur among older persons who have 1 or more disabling conditions. As a result, many deaths are preceded by an extended period during which family members provide care to their disabled relative.ObjectiveTo better understand the effect of bereavement on family caregivers by examining predeath vs postdeath changes in self-reported and objective health outcomes among elderly persons providing varying levels of care prior to their spouse's death.Design and SettingProspective, population-based cohort study conducted in 4 US communities between 1993 and 1998.ParticipantsOne hundred twenty-nine individuals aged 66 to 96 years whose spouse died during an average 4-year follow-up. Individuals were classified as noncaregivers (n = 40), caregivers who reported no strain (n = 37), or strained caregivers (n = 52).Main Outcome MeasuresChanges in depression symptoms (assessed by the 10-item Center for Epidemiological Studies–Depression [CES-D] scale), antidepressant medication use, 6 health risk behaviors, and weight among the 3 groups of participants.ResultsControlling for age, sex, race, education, prevalent cardiovascular disease at baseline, and interval between predeath and postdeath assessments, CES-D scores remained high but did not change among strained caregivers (9.44 vs 9.19; P = .76), while these scores increased for both noncaregivers (4.74 vs 8.25; F1,116 = 14.33; P&lt;.001) and nonstrained caregivers (4.94 vs 7.13; F1,116 = 4.35; P = .04). Noncaregivers were significantly more likely to be using nontricyclic antidepressant medications following the death than the nonstrained caregiver group (odds ratio [OR], 12.85; 95% confidence interval [CI], 1.02-162.13; P = .05). The strained caregiver group experienced significant improvement in health risk behaviors following the death of their spouse (1.47 vs 0.66 behaviors; F1,118 = 20.23; P&lt;.001), while the noncaregiver and nonstrained caregiver groups showed little change (0.27 vs 0.27 [P = .99] and 0.46 vs 0.27 [P = .39] behaviors, respectively). Noncaregivers experienced significant weight loss following the death (149.1 vs 145.3 lb [67.1 vs 65.4 kg]; F1,101 = 8.12; P = .005), while the strained and nonstrained caregiving groups did not show significant weight change (156.2 vs 155.2 lb [70.3 vs 69.8 kg] [P = .41] and 156.2 vs 154.0 lb [70.3 vs 69.3 kg] [P = .12], respectively).ConclusionsThese data indicate that the impact of losing one's spouse among older persons varies as a function of the caregiving experiences that precede the death. Among individuals who are already strained prior to the death of their spouse, the death itself does not increase their level of distress. Instead, they show reductions in health risk behaviors. Among noncaregivers, losing one's spouse results in increased depression and weight loss.
Resources must be used to reduce inequalities
Authors: B. Barr
Journal: BMJ (2012)

Andrew Lansley’s pronouncement that age, not poverty, is the principal determinant of healthcare demand is apparently intended to “test the water” for an age only proposal for NHS resource allocation.1 That the crude prevalence of some diseases is higher in more affluent areas (with older populations) than in more deprived areas is taken to indicate greater demand for healthcare resources.2

However, …
Removal of a doubly impacted plastic stent: a new technique
Authors: M. Mutignani, R. Salerno, V. Perri, A. Tringali, G. Costamagna
Journal: Endoscopy (2008)

Plastic stents are commonly used for various indications including drainage, stricture dilatation, and leakage. A complication is migration. The “Amsterdam” type stents have a slightly curved shaft and flaps near each end to prevent proximal or distal migration [1]. Despite the presence of flaps, proximal migration into the bile ducts or distal migration into the duodenum with subsequent passage per rectum are relatively frequent, but impaction and perforation of the bowel are rare [2].
THE MECHANISM OF THE GALLBLADDER AND ITS RELATION TO CHOLELITHIASIS
Authors: LESTER R. WHITAKER
Journal: JAMA (1927)

It is generally agreed that bile from the gallbladder is delivered into the intestine after the ingestion of food,<sup>1</sup>but opinions differ widely as to the degree of evacuation and the mechanism involved.<sup>2</sup> There are two views as to the mechanism; one, most commonly held, that emptying is a passive process depending on external pressure<sup>3</sup>and elasticity of the viscus;<sup>4</sup>the other, that the contents of the gallbladder are forced out by the action of its musculature.<sup>5</sup>There are two views also as to the degree of emptying of the gallbladder. Some contend that it is never completely empty,<sup>6</sup>and others that its entire contents may be evacuated following a meal,<sup>7</sup>especially of fat.<sup>8</sup> There is further difference of opinion as to the relationship between the gallbladder and the sphincter of the common bile duct. The generally accepted view is that there
Venous Thromboembolic Disease and Pregnancy
Authors: Paul E. Marik, Lauren A. Plante
Journal: New England Journal of Medicine (2008)

The incidence of venous thromboembolic disease increases by a factor of four with pregnancy, and in developed countries pulmonary embolus is the leading cause of maternal death. This review provides guidance on the diagnosis and management of thromboembolic disease in pregnant women, including guidelines for the prophylactic use of anticoagulant agents in women at high risk during pregnancy and the puerperium.
Effects of alpha-glucosidase inhibitors on mouth to caecum transit time in humans.
Authors: S D Ladas, A Frydas, A Papadopoulos, S A Raptis
Journal: Gut (1992)

The alpha-glucosidase inhibitors acarbose and miglitol have been successfully used to control postprandial hyperglycaemia in diabetics. They probably work by slowing carbohydrate digestion and absorption, but their effect on mouth to caecum transit time has not been studied. The effect acarbose (100 mg), miglitol (100 mg), and placebo on mouth to caecum transit time (380 kcal breakfast with 20 g of lactulose) was investigated in 18 normal volunteers using breath hydrogen analysis. Both miglitol and acarbose significantly increased breath hydrogen excretion (F2,34 = 6.31, p = 0.005) and shortened the mouth to caecum transit time (F2,34 = 3.49, p = 0.04) after breakfast compared with placebo. There was a significant negative correlation between breath hydrogen excretion and mouth to caecum transit time suggesting that with shorter transit times significantly more carbohydrates were spilled into the colon. These results indicate that alpha-glucosidase inhibitors accelerate mouth to caecum transit time by inducing carbohydrate malabsorption.
531 EARLY IDENTIFICATION OF TWO PATTERNS OF HEPATITIS C RECURRENCE (RAPID AND SLOW PROGRESSORS) AFTER LIVER TRANSPLANTATION: A PROSPECTIVE LONG-TERM FOLLOW-UP STUDY
Authors: G. Crespo, J.A. Carrión, S. Lens, M. García-Retortillo, R. Miquel, J.C. García-Pagan, C. Fondevila, J.C. García-Valdecasas, J. Bosch, M. Bruguera, M. Navasa, X. Forns
Journal: Journal of Hepatology (2011)
Hepatic ischemic preconditioning is most effective in patients with a small resection volume and long ischemic intervals: a prospective randomized study in 100 patients
Authors: Hannes A. Rudiger, Koo J. Kang, Markus Selzner, Nazia Selzner, Daniel R. Dindo, Hans M. Riehle, Wolfram Jochum, Zakiyah Kadry, Pierre-A. Clavien
Journal: Journal of Hepatology (2002)
FURTHER STUDIES IN EXPERIMENTAL ATHEROSCLEROSIS
Authors: I. Adler
Journal: The Journal of Experimental Medicine (1917)

Cholesterol dissolved in sesame oil and injected regularly for a period of from 7 to 8 months into the jugular vein of four young dogs has caused in each animal larger and smaller nodules protruding to some degree into the lumen of the pulmonary artery and also here and there some diffuse thickenings, the whole closely resembling human arteriosclerosis. These changes commence at the origin of the pulmonary artery immediately behind the semilunar valves. They seem a little more pronounced in those dogs that had the aorta tied. Microscopically the lesions are seen to be primary in the media. They consist of a more or less violent disorganization of the elastic elements and displacement of the muscular tissue. As a consequence wide gaps, apparently filled with plasma, are formed in the media. The entire process is localized principally in the inner third of the media. There is no evidence of fatty degeneration either in the elastic elements or the muscle. Typical sclerotic hyperplasia of the intima is found over some of the prominent median nodulations while over others the intima is normal. Hyperplastic sclerosis of the intima is also found in places where the media is intact or only slightly damaged. Some of the larger branches of the pulmonary artery well within the lung tissue are somewhat dilated and show extensive hyperplasia of the intima over almost normal media. Peculiar small nodules are seen in the media of the two main branches of the pulmonary artery which are found to consist of frank hyperplasia of the elastic and muscular elements arranged in more or less regular concentric circles. The capillaries and smaller and smallest arteries within the lungs are not affected. Cholesterol in phagocytes and in droplets between the tissue elements is present in very small quantities and does not take any active part in the process. The entire process represents in all probability an early stage of arteriosclerosis, a result of purely mechanical stress brought about by the very extensive but more or less intermittent blocking of the pulmonary circulation by the oil. The musculature of the artery appears to be the main force applied to overcome the resistance in the circulation. In no case has hypertrophy of the right heart been found. The lesions in the pulmonary arteries of the dogs produced experimentally are closely analogous to atherosclerosis of the human pulmonary artery.
Blisters, ulceration and autonomic neuropathy in carpal tunnel syndrome
Authors: N. H. COX, D. M. LARGE, W. D. PATERSON, F. A. IVE
Journal: British Journal of Dermatology (2008)

Summary We describe three patients with trophic ulceration and blistering of the fingertips associated with carpal tunnel syndrome. One of the patients also had non-insulin-dependent diabetes mellitus. Autonomic neuropathy distal to the carpal tunnel was probably present in all subjects at the time of presentation: in the patient with recent symptoms the skin was warm, and sweating was virtually absent, whilst the other two patients described cold skin, consistent with prolonged autonomic neuropathy.
Acute anti-ischemic effect of estradiol 17β in menopausal women with coronary artery disease
Authors: Giuseppe M.C. Rosano, Adriano Mendes Caixeta, Siguemituzo Arie, Miguel Lopez Hidalgo, Wagner I. Pereira, Filippo Leonardo, Peter Collins, Fulvio Pileggi
Journal: Journal of the American College of Cardiology (1996)
Exome sequencing identifies GATA-2 mutation as the cause of dendritic cell, monocyte, B and NK lymphoid deficiency
Authors: Rachel Emma Dickinson, Helen Griffin, Venetia Bigley, Louise N. Reynard, Rafiqul Hussain, Muzlifah Haniffa, Jeremy H. Lakey, Thahira Rahman, Xiao-Nong Wang, Naomi McGovern, Sarah Pagan, Sharon Cookson, David McDonald, Ignatius Chua, Jonathan Wallis, Andrew Cant, Michael Wright, Bernard Keavney, Patrick F. Chinnery, John Loughlin, Sophie Hambleton, Mauro Santibanez-Koref, Matthew Collin
Journal: Blood (2011)
SEM-EDS analysis of glass fibers corroded in physiological solutions by dynamic tests with variable flow rates.
Authors: P Lehuédé, A de Meringo
Journal: Environmental Health Perspectives (1994)

The dissolution of mineral fibers has been studied in simulated physiological fluids using a dynamic testing procedure. Fibers of different chemical composition and obtained by different processes with a mean diameter of about 1 micron, have been characterized with respect to their solubility under various test conditions of flow-rate. The surfaces were analyzed using scanning electron microscopy (SEM), energy dispersive spectrometry (EDS) and X-ray diffraction techniques. SEM examinations show the formation of various corrosion patterns: porous, gel-like outer layers; precipitation zones and even, in some cases, no modification of the surface aspect. EDS analyses performed on the fibers, on the fiber surface layers, or on the deposits show three types of chemical composition: areas enriched in Al, in Ca and P, or in Al, Ca, and P. These surface compositions can be found for the same type of fiber tested, depending on the flow rate of the solution. Surface changes depend strongly on the initial composition of the glass and on the test conditions, particularly the flow rate. It is of particular interest to characterize the remaining surfaces (if any) obtained at the end of the in vitro test run and to compare them with surface analysis of the recovered fibers from the in vivo tests to assess the validity of the in vitro tests.