tbuckley/cabot-search huggingface dataset:
ABC of the upper gastrointestinal tract: Upper abdominal pain: Gall bladder
Authors: C D Johnson
Journal: BMJ (2001)

Gall stones are common but often do not give rise to symptoms. Pain arising from the gall bladder may be typical of biliary colic, but a wide variety of atypical presentations can make the diagnosis challenging. After a period of uncertainty in the 1980s, when operative techniques were challenged by drug treatment and lithotripsy, it is now widely accepted that symptomatic gallbladder stones should be treated by laparoscopic cholecystectomy. Clinical judgment and local expertise will greatly influence the management of bile duct stones, particularly if cholecystectomy is also required.

Asymptomatic gall stones are common and require no treatment Typical symptoms include biliary colic—right upper quadrant pain, radiating to the back, and lasting less than 12 hours Symptomatic gall stones are usually treated by laparoscopic cholecystectomy 

In the United Kingdom about 8% of the population aged over 40 years have gall stones, which rises to over 20% in those aged over 60. Fortunately, 90% of these stones remain asymptomatic, but cholecystectomy is the most commonly performed abdominal procedure.

#### Risk factors for gall stones

##### Cholesterol stones

##### Pigment stones



Mixed gall stone with bilirubin nucleus and attached clear cholesterol crystals



The incidence of gall stones varies widely, being greatly influenced by dietary intake, particularly of fat. For example, in Saudi Arabia gallstone disease was virtually unheard of 50 years ago, but, with increasing affluence and a Western type diet, gall stones are now as common there as in many Western countries. Genetic factors also contribute. The native Indian populations of Chile and Peru are highly susceptible, with a close to 100% lifetime risk of gall stones …
TUBERCULIN.ITS VALUE AS A SCIENTIFIC DISCOVERY, APART FROM ITS THERAPEUTIC IMPORTANCE; TOGETHER WITH A CONSIDERATION OF THE MOST RATIONAL MODE OF EMPLOYING THE PRINCIPLE INVOLVED IN IT. Read in the Section of Practice of Medicene and Physiology, at the Forty-second Annual Meeting of the American Medical Association, held at Washington, D. C., May 5-8, 1891.
Authors: S. K. JACKSON
Journal: JAMA (1891)

Whatever may be the estimate forwed of Koch's lymph—whether or not it shall be determined to have a curative influence in the class of diseases for which it has been proposed, it must be recognized as of incalculable value in illustrating, or rather, I should say, in demonstrating, the truth of one of the most important principles of biological science. It is running but little risk to prophesy that this generalization will, before long, revolutionize the practice of medicine, by compelling a resort to Nature's mode of curing disease; that is,, by using the means that Nature employs for inhibiting or arresting the life-processes of organisms which are known to be the causative factors, in the production of certain diseases. While recent clinical records have caused a great distrust in Koch's method as a safe remedy in pulmonary tuberculosis, no one has doubted, or questioned, its power of producing
Dual Function of p38α MAPK in Colon Cancer: Suppression of Colitis-Associated Tumor Initiation but Requirement for Cancer Cell Survival
Authors: Jalaj Gupta, Ivan del Barco Barrantes, Ana Igea, Stratigoula Sakellariou, Ioannis S. Pateras, Vassilis G. Gorgoulis, Angel R. Nebreda
Journal: Cancer Cell (2014)
COMBINED CYTOSTATIC AND SURGICAL TREATMENT OF EXTENSIVE BASAL CELL EPITHELIOMATA
Authors: GERHARD WEBER, WILHELM MEINERT
Journal: British Journal of Dermatology (1972)

Summary.— Two essentially similar cases of extensive basal cell epitheliomata of the face are reported, which had been treated with x-rays without a definite cure and were treated by us with 5-fluorouracil ointment until the epithelioma was totally destroyed. This was followed by free transplantation of a split skin flap with primary healing and an excellent cosmetic result. The method offers an alternative treatment for extensive basal-cell epitheliomata which are not cured by radiotherapy and operative measures.
To Die Well: Your Right to Comfort, Calm, and Choice in the Last Days of Life
Authors: Jack Yensen
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
Alpha 1 adrenergic receptor-induced c-fos gene expression in rat aorta and cultured vascular smooth muscle cells.
Authors: M Okazaki, Z W Hu, M Fujinaga, B B Hoffman
Journal: Journal of Clinical Investigation (1994)

While growth of blood vessels is important in hypertension, relatively little is known about the contribution of catecholamines. Using isolated rat aorta and cultured smooth muscle cells, we examined adrenergic stimulation of gene expression. Phenylephrine, a selective alpha 1 adrenergic receptor agonist, caused a rapid and transient increase in c-fos mRNA accumulation which was inhibited by prazosin, an alpha 1 receptor antagonist. Similarly, phenylephrine stimulated c-jun and c-myc mRNA accumulation. Chloroethyl-clonidine, a compound which irreversibly blocks alpha 1B receptors, completely blocked the phenylephrine-induced increase in c-fos mRNA. RNase protection experiments demonstrated that rat aorta prominently expressed mRNA for alpha 1B and alpha 1A/D receptors. Phenylephrine-induced c-fos mRNA was partially inhibited by H-7, a protein kinase C inhibitor, and by nifedipine, a Ca2+ channel blocker; these two compounds together had additive effects. In situ hybridization showed that expression of c-fos mRNA induced by phenylephrine was localized to aorta's medial layer. These results suggest that alpha 1 receptor-induced increase in c-fos mRNA in aorta is mediated by a chloroethyl-clonidine-sensitive receptor subtype signaling via increasing intracellular Ca2+ concentrations and activating protein kinase C.
Evidence for the presence of xenopsin-related peptide(s) in the gastric mucosa of mammals.
Authors: G E Feurle, R E Carraway, E Rix, W Knauf
Journal: Journal of Clinical Investigation (1985)

Using immunohistochemistry and radioimmunoassay, substance(s) related to the amphibian octapeptide xenopsin (XP) were demonstrated in the gastric mucosa of humans and dogs. Immunohistochemistry localized XP-immunoreactive epithelial cells in the gastric antral mucosa. The reaction was abolished by preabsorption of the antiserum with XP but not by neurotensin or other peptides. Immunoreactive XP (iXP) was found by radioimmunoassay in extracts of both the antrum and body of the stomach prepared with acid/acetone or acetic acid. A study of its distribution in the dog indicated that the level of iXP was highest in the stomach, lower in the pancreas and duodenum, and not measurable in the jejunoileum and colon. Gel chromatography on Sephadex G-25 indicated the presence of at least two forms of iXP, one larger and the other about the same size as XP. Reverse-phase high pressure liquid chromatography on mu-Bondapak C-18 yielded several peaks of iXP, one of which eluted at the position of synthetic XP. The results of immunochemical analyses using four different antisera towards XP were consistent with structures for canine iXPs that were closely related to XP only in their C-terminal regions. These results suggest that mammalian counterparts to amphibian XP reside within endocrine cells of the gastric mucosa. It seems possible that these peptides function as gastrointestinal signals.
Sequential changes of parathyroid hormone related protein (PTHrP) in articular cartilage during progression of inflammatory and degenerative arthritis
Authors: E Gomez-Barrena
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objective:</b> To investigate immunolocalisation of parathyroid hormone related protein (PTHrP) in two sequential models of experimental cartilage damage (inflammatory and degenerative) in order to elucidate differences in chondrocyte response to the disease. <b>Methods:</b> Immunohistochemistry with a polyclonal rabbit antiserum to the N-terminal domain of PTHrP was used to detect this protein in two different rabbit models sharing progressive cartilage damage: antigen induced arthritis (AIA) and osteoarthritis (OA) secondary to partial medial meniscectomy. Cartilage specimens from early (2 days in AIA; 8 weeks in experimental OA) and late (3 weeks in AIA; 52 weeks in OA) disease were compared. <b>Results:</b> Cell and matrix PTHrP staining in early AIA and OA was similar to that in controls. Late AIA cartilage showed a significant decrease in PTHrP positive cells and in the cartilage matrix. In contrast, at late OA stages, distinct PTHrP positivity was detected in proliferating cell clones, as assessed by proliferating cell nuclear antigen staining around cartilage damaged areas. <b>Conclusion:</b> PTHrP staining of hyaline articular cartilage shows a different pattern during progression of each type of arthritis: an overall decrease associated with the inflammatory disease, and an increase in the proliferating chondrocyte clones with degenerative arthritis.
Learning from evidence based mistakes
Authors: Hilda Bastian
Journal: BMJ (2004)

I guess it's safe to say I'm a diehard evidence enthusiast. It's essential to get as close to the truth as you can, especially through the tangled mix of commercial and power biases that so plague health information. But if we all paid more attention to the potential adverse effects of evidence based medicine (EBM) too, maybe there would be even fewer mistakes.

My first evidence based mistake came early in my involvement with EBM. When two of the member organisations of the consumer coalition I was involved with were set against each other because of a controversy, we did the evidence based thing. We turned to the systematic review to decide what stand we should take.

The subject? Bromocriptine for lactation suppression. One of our member groups demanded that we support a call for a ban of the drug for this indication, while another objected just as vehemently to removal of access. The systematic review concluded that the drug was effective, with no concerning adverse effects. We didn't support the …
Correction: Table on the Confusion Assessment Method
Authors: S.K. Inouye
Journal: Annals of Internal Medicine (1991)

Letters1 March 1991Correction: Table on the Confusion Assessment MethodS.K. Inouye, MD, MPHS.K. Inouye, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-5-433_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn Inouye and colleagues' article on the confusion assessment method (1), Table 1 has two errors. The units for gender and race should be "number of women" and "number of white persons," respectively....Reference1. Inouyevan DyckAlessiBalkinSiegalHorwitz SCCSAR. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113:941-8. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: S.K. Inouye, MD, MPHAffiliations: Yale-New Haven Hospital New Haven, CT 06504 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDelirium After Spinal Surgery in Korean Population 1 March 1991Volume 114, Issue 5Page: 433-433KeywordsRacial and ethnic issuesSexual identity ePublished: 1 December 2008 Issue Published: 1 March 1991 PDF downloadLoading ...
SIMPLE METHOD OF RETAINING THE ANESTHETIC MASK IN PLACE.
Authors: MAYNARD C. HARDING
Journal: JAMA (1907)

On reading a recent article inThe JournalI was reminded of a simple appliance which can be used to hold any kind of an anesthetic mask in place. I make no claim for originality, but do not remember to have seen it described. On each side of the center of the oval base wire of say the ordinary Esmarch mask, loop two or three small rubber bands, end to end, and pass the last ones around the patient's ears. The tension should be slight—just enough to keep the mask in place. The curved handle is better turned toward the chin, then the mask can be raised like a trap door to regulate the air supply or to allow access to the mouth. With a struggling patient the advantages are obvious and it can be removed instantly, when desired, by a simple pull. <h3>The Best Bovine Wet Nurse.</h3> —In an
A STUDY OF THE DISTRIBUTION AND FATE OF ANTIMONY WHEN USED AS TARTAR EMETIC AND FUADIN IN THE TREATMENT OF AMERICAN SOLDIERS WITH SCHISTOSOMIASIS JAPONICA
Authors: Stuart W. Lippincott, Lester D. Ellerbrook, Mark Rhees, Porter Mason
Journal: Journal of Clinical Investigation (1947)

During the Leyte campaign in the Philippines a number of American soldiers were infected by the cercariae of Schistosoma japonicum.While under observation at Harmon General Hospital, 138 out of 495 such previously treated patients were found to be passing eggs in their stools and were, therefore, treated again either with tartar emetic or fuadin.The purpose of this report is to present data on the concentrations of antimony attained in body fluids under given dosages of these drugs, together with the amount and rate of excretion in urine and stool.Reference is also made to the therapeutic efficiency of the chemical regimes employed.
COMPARISON OF DIFFUSE WITH FOCAL CORONARY ARTERY SPASM IN PATIENTS WITH VASOSPASTIC ANGINA ON 3-YEAR CLINICAL OUTCOMES
Authors: Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Yoonjee Park, akkala goud, Sunki Lee, Ji Bak Kim, Sung Il Im, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong-Seog Seo, Dong Joo Oh, Taehoon Ahn
Journal: Journal of the American College of Cardiology (2014)
Fish Consumption and Mercury Exposure among Louisiana Recreational Anglers
Authors: Rebecca A. Lincoln, James P. Shine, Edward J. Chesney, Donna J. Vorhees, Philippe Grandjean, David B. Senn
Journal: Environmental Health Perspectives (2010)

Methylmercury (MeHg) exposure assessments among average fish consumers in the United States may underestimate exposures among U.S. subpopulations with high intakes of regionally specific fish.We examined relationships among fish consumption, estimated mercury (Hg) intake, and measured Hg exposure within one such potentially highly exposed group, recreational anglers in the state of Louisiana, USA.We surveyed 534 anglers in 2006 using interviews at boat launches and fishing tournaments combined with an Internet-based survey method. Hair samples from 402 of these anglers were collected and analyzed for total Hg. Questionnaires provided information on species-specific fish consumption during the 3 months before the survey.Anglers' median hair Hg concentration was 0.81 µg/g (n = 398; range, 0.02-10.7 µg/g); 40% of participants had levels >1 µg/g, which approximately corresponds to the U.S. Environmental Protection Agency's reference dose. Fish consumption and Hg intake were significantly positively associated with hair Hg. Participants reported consuming nearly 80 different fish types, many of which are specific to the region. Unlike the general U.S. population, which acquires most of its Hg from commercial seafood sources, approximately 64% of participants' fish meals and 74% of their estimated Hg intake came from recreationally caught seafood.Study participants had relatively elevated hair Hg concentrations and reported consumption of a wide variety of fish, particularly locally caught fish. This group represents a highly exposed subpopulation with an exposure profile that differs from fish consumers in other regions of the United States, suggesting a need for more regionally specific exposure estimates and public health advisories.
Type B Atrial Natriuretic Peptide Receptor in Cardiac Myocyte Caveolae
Authors: Donald D. Doyle, S. Kelly Ambler, Judy Upshaw-Earley, Amir Bastawrous, Gwendolyn E. Goings, Ernest Page
Journal: Circulation Research (1997)

Abstract We have previously shown that atrial natriuretic peptide (ANP) is present in caveolae of in situ rat atrial myocytes. To investigate whether intracaveolar ANP of rat atrial myocytes exists within caveolae bound to type B ANP receptors (ANP-RB, a guanylyl cyclase), we have used confocal immunofluorescence microscopy applied to primary cultures of atrial myocytes from adult rats and to freshly dissociated rat atrial myocytes (not cultured). These experimental designs tested whether atrial myocyte ANP-RB colocalizes at the plasmalemma and elsewhere in the cell with the muscle-specific isoform of the caveolar coating protein, caveolin-3, and with a fraction of cellular ANP. The experiments showed that cellular caveolin-3, a fraction of cellular ANP-RB, and a fraction of cellular ANP colocalize at the plasmalemma of cultured atrial myocytes and of freshly dissociated atrial myocytes. The observations support the hypothesis that in rat atrial myocytes, intracaveolar ANP is bound to ANP-RB, a protein whose cytosolic amino acid sequences are known to encode guanylyl cyclase activity. We suggest that among the (probably multiple) effects of the cGMP thus generated in the cytoplasmic microdomain underlying atrial myocyte caveolae may be the activation of cGMP-dependent protein kinase, which would thereby inhibit plasma membrane Ca 2+ channel activity and contribute to a negative inotropic effect of ANP.
Multiple Symmetric Lipomatosis
Authors: Michael Haap, Cornelia Siewecke, Claus Thamer, Jürgen Machann, Fritz Schick, Hans-U. Häring, Rolf M. Szeimies, Michael Stumvoll
Journal: Diabetes Care (2004)

Excessive fat storage (obesity) is associated with insulin resistance and type 2 diabetes (1). Paradoxically, inability to store fat (lipodystrophy) is also associated with insulin resistance (2). In both obesity and lipodystrophy, the adipocyte’s storage capacity is exceeded and lipids accumulate in liver, muscle, and β-cells. Hypothetically, if adipose tissue had an intrinsic propensity to proliferate, rather than passively respond to energy excess, calories should be extracted from the circulation and the system should become (or remain) insulin sensitive. Such a process would be particularly effective if it occurred preferentially in subcutaneous adipose tissue, which, metabolically, is the least harmful site (3).

We performed extensive metabolic studies in two patients (Table 1) with multiple symmetric lipomatosis (MSL), a condition characterized by regional excess of subcutaneous adipose tissue (4).

Patient 1 had massive symmetrical subcutaneous fat accumulation in the thoracic, abdominal, and upper arm region (Fig. 1 A ) that had begun to develop about 15 years earlier. Patient …
The Ruby Trial
Authors: George F. Brockman
Journal: JAMA (1964)

<h3>To the Editor:—</h3> "The Ruby Trial" (Letters,<i>JAMA</i><b>188:</b>938 [June 8] 1964) was very interesting, but the discussion on expert medical witnesses should have pointed out that perhaps our profession is unduly self-conscious. Our testimony frequently concerns events, like the present one, characterized by human interest and drama. The divergence of our experts tends to be glaringly publicized. Actually, conflict in expert testimony occurs in any dispute where subjects requiring special knowledge are in litigation. In what field can an expert be certain that his judgment on a given set of complex facts would be identical after a ten-year interval of additional experience? Our adversary system of justice recognizes that human knowledge is limited. It holds that our closest approach to truth is the pooled judgment of 12 unprejudiced intelligent observers who have been provided with all pertinent knowledge on the issue. The Ruby jury had to resolve conflicts
Effects propranolol on the Actylcholine Induced Response of the Human Swat Gland
Authors: H. G. W. M. Hemels, F. A. J. Thiele, F. W. Bauer
Journal: British Journal of Dermatology (1972)

Journal Article Effects propranolol on the Actylcholine Induced Response of the Human Swat Gland Get access H. G. W. M. Hemels, H. G. W. M. Hemels Department of Dermatology Head: Prof. Dr. J. W. H. Mali University of Nij$$ Javastreet 104 Nijopegen The Netherlands Search for other works by this author on: Oxford Academic Google Scholar F. A. J. Thiele, F. A. J. Thiele Department of Dermatology Head: Prof. Dr. J. W. H. Mali University of Nij$$ Javastreet 104 Nijopegen The Netherlands Search for other works by this author on: Oxford Academic Google Scholar F. W. Bauer F. W. Bauer Department of Dermatology Head: Prof. Dr. J. W. H. Mali University of Nij$$ Javastreet 104 Nijopegen The Netherlands Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 86, Issue 2, 1 February 1972, Pages 206–207, https://doi.org/10.1111/j.1365-2133.1972.tb16092.x Published: 01 February 1972
Points from letters: Junior hospital staff contract
Authors: P R S Tasker
Journal: BMJ (1975)

<h3>Aims</h3> Noncommunicable diseases (NCD) cause 71% of all deaths worldwide. More than 85% of premature deaths (ages 30–69) occur in low- and middle-income countries (LMIC).] LMICs are not on target to achieve the United Nations’ Sustainable Develop Goals (UN SDG) 3.4. The aims were to create a multi-stakeholder forum to review NCD burden in LMICs; consider pragmatic solutions; and lead the conversation to inform the broader agenda on NCDs. <h3>Methods</h3> As key health stakeholders, medical leaders in Upjohn invited others to form an Expert Forum on NCDs in LMICs. These experts in clinical practice in primary and specialty care; academic research; patient advocacy; community pharmacy; public and health policy; civil society; mobile health; and private industry were chosen because they worked in LMICs; published peer-reviewed papers; committed to act together on NCDs. After an accelerated development sequence through storming, forming and norming, we commenced reviewing the NCD burden and challenges to overcome it. Through facilitated workshops, the team articulated how different sectors could, together, generate concepts for systemic solutions. <h3>Results</h3> The 19-member team has published a paper in a peer-reviewed journal that reviews the NCD-burden in LMICs; captures the rich workshop dialogue; presents the evidence and posits pragmatic solutions to combat the burden. Team members have further led the conversation through abstracts at international conferences and opinion editorials in key media, and communicated them via social media. <h3>Conclusions</h3> Private and public health sectors can indeed work together to lead the conversation on change. More partnerships may catalyse regional responses to address NCDs. On downstream efforts we included patients; a rewarding experience that embraced ‘nothing for us without us’. Next time, we would engage with government stakeholders and multilateral organisations. No one can afford to be a bystander; but we cannot do it alone.