tbuckley/cabot-search huggingface dataset:
Achalasia Presenting as a Neck Mass
Authors: TIMOTHY G. LANE
Journal: Annals of Internal Medicine (1981)

Brief Reports1 June 1981Achalasia Presenting as a Neck MassTIMOTHY G. LANE, Ph.D., M.D., WALLACE C. WU, M.B., B.S., DAVID J. OTT, M.D.TIMOTHY G. LANE, Ph.D., M.D.Search for more papers by this author, WALLACE C. WU, M.B., B.S.Search for more papers by this author, DAVID J. OTT, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-6-786 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAchalasia of the esophagus is characterized by failure of relaxation of the lower esophageal sphincter, aperistalsis, and an increased sensitivity of the esophagus to cholinergic agents. Classical signs and symptoms of this disease include gradually progressive painless dysphagia; weight loss; and frequent regurgitation of previously ingested food, especially in the supine position. Furthermore, regurgitation with aspiration can cause wheezing, coughing, and choking, eventually progressing to chronic lung disease (1, 2). We report a patient with achalasia presenting as a changeable neck mass due to a markedly dilated cervical esophagus. This presentation has not been previously described.An 87-year-old woman was...References1. CASTELL D. Achalasia and diffuse esophageal spasm. Arch Intern Med. 1976;136:571-9. CrossrefMedlineGoogle Scholar2. POPE C. Motor disorders. In: SLEISENGER MH, FORDTAN JS. Gastrointestinal Disease. Philadelphia: WB Saunders Co; 1978: 519-30. Google Scholar3. DELPMANNING MR, eds. Major's Physical Diagnosis. 8th ed. Philadelphia, London, Toronto: WB Saunders Co; 1975: 212-27. Google Scholar4. VANTRAPPENDELOOF GW. Esophageal diverticula. In: VANTRAPPEN G, HELLEMANS J. Diseases of the Esophagus. New York, Heidelberg, Berlin: Springer-Verlag; 1974: 591-604. CrossrefGoogle Scholar5. LAHEYWARREN FK. Esophageal diverticula. Surg Gynecol Obstet. 1954; 98:1-28. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: TIMOTHY G. LANE, Ph.D., M.D.; WALLACE C. WU, M.B., B.S.; DAVID J. OTT, M.D.Affiliations: Bowman Gray School of Medicine Wake Forest University Winston-Salem, North Carolina PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAcute Upper Airway Obstruction in AchalasiaSouthwestern Internal Medicine Conference: Esophageal Achalasia SyndromesSudden airway obstruction in achalasia 1 June 1981Volume 94, Issue 6Page: 786-787KeywordsCholinergicsCoughingDysphagiaEsophagusFoodLungsProgressive diseasesSigns and symptomsWeight loss ePublished: 1 December 2008 Issue Published: 1 June 1981 PDF downloadLoading ...
Can telemedicine be used to improve communication between primary and secondary care?
Authors: R. Harrison, W. Clayton, P. Wallace
Journal: BMJ (1996)

To test feasibility and acceptability of teleconferencing routine outpatient consultations.Exploratory trial of teleconferenced outpatient referrals of general practitioners.An inner city teaching hospital and surrounding general practices.Six general practices linked to hospital outpatient clinics.Levels of participants' satisfaction measured with self administered questionnaires.54 teleconsultations were performed in 10 different specialties. Few serious technical problems were encountered, and high levels of satisfaction with the consultations were reported by patients, hospital specialists, and general practitioners.Teleconferenced consultations for routine outpatient referrals with joint participation of general practitioner were feasible. These may have an important potential benefit for improving communication between primary and secondary care.
Phenytoin and Phenobarbital Concentrations in Renal Insufficiency
Authors: John W. Turk, Jack H. Ladenson
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 October 1984Phenytoin and Phenobarbital Concentrations in Renal InsufficiencyJOHN W. TURK, M.D., PH.D., JACK H. LADENSON, PH.D.JOHN W. TURK, M.D., PH.D.Search for more papers by this author, JACK H. LADENSON, PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-4-568_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: It is generally true that immunologic and chromatographic measurements of anticonvulsant drug levels yield equivalent results as stated in Troupin's (1) review. One setting in which this is not the case is renal insufficiency. In that setting, hydroxylated metabolites of phenytoin and phenobarbital accumulate to unusually high levels due to reduced renal clearance rates. The hydroxylated metabolite of phenytoin is not distinguished well from phenytoin by the antibody used in the EMIT assay (SYVA Company, Palo Alto, California) of phenytoin (2-5). A similar situation occurs with the hydroxylated metabolite of phenobarbital and the antibody used in the...References1. TROUPIN A. The measurement of anticonvulsant agent levels. Ann Intern Med. 1984;100:854-8. LinkGoogle Scholar2. BURGESFRIELBLAIRRAISYS EPAV. Serum phenytoin concentrations in uremia. Ann Intern Med. 1981;94:59-60. LinkGoogle Scholar3. ALDWINKABAKOFF LD. Serum phenytoin concentrations in uremia [Letter]. Ann Intern Med. 1981;95:785. LinkGoogle Scholar4. APPLEWALKERDIETZLER FFD. Serum creatinine concentration and the discrepancy between enzyme multiplied immunoassay technique and gas-liquid chromatographic phenytoin levels. Ann Clin Lab Sci. 1983;13:385-92. MedlineGoogle Scholar5. MCCLELLANCHANLICHTIMELTZERLADENSON AKDVJ. Comparison of the EMIT phenytoin procedure with old and new antibodies. Clin Chem. 1984;30:808-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JOHN W. TURK, M.D., PH.D.; JACK H. LADENSON, PH.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySuivi thérapeutique pharmacologique de la primidone et du phénobarbital 1 October 1984Volume 101, Issue 4Page: 568-569KeywordsAnticonvulsantsAttentionMetabolites ePublished: 1 December 2008 Issue Published: 1 October 1984 PDF downloadLoading ...
New Requirements for Authors Submitting Manuscripts to JAMA
Authors: Richard M. Glass
Journal: JAMA (1997)

In this issue, we publish an updated version of The Journal's Instructions for Authors.<sup>1</sup>These instructions include 2 new requirements. See also p 74. The first, as we announced in the August 28, 1996, issue,<sup>2</sup>requires authors submitting reports of randomized controlled trials to complete and submit a checklist of 21 items providing information pertinent to the trial and to submit a flow diagram illustrating the progress of participants through the trial. These requirements were developed by a group of editors, clinical epidemiologists, and statisticians and were reported previously as the Consolidation and Standards of Reporting Trials (CONSORT) Statement.<sup>3</sup> The second new requirement complies with a recommendation of the International Committee of Medical Journal Editors, by asking authors to obtain written permission from all individuals named as sources of information in personal communications, whether the communications are oral or written. Thus, the corresponding author is responsible for obtaining signed statements of permission for personal
My Favorite Diagnostic Tool
Authors: Adam Possner
Journal: JAMA (2011)

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
Sleep apnea and its causes.
Authors: N S Cherniack
Journal: Journal of Clinical Investigation (1984)

Perspectivesver long periods oftime, months and years, arterial Pco2 and P02 are closely regulated, but over shorter periods, constancy of arterial blood gas tensions is perhaps an impractical or even an undesirable objective.It is now appreciated that fluctuation within limits is an inherent feature ofnormal function and that there are cycles of activity and rest that modify re- spiratory regulation as well as other regulatory processes (1, 2).Many of these cycles, like the sleep-waking cycle, are circadian, with a period of -24 h, and seem to be keyed to the revolution of the earth.Sleep, like breathing, seems to be essential to health, and adverse physiological and psychological consequences occur with sleep deprivation (3, 4).However, the need to adjust breathing to physiological requirements during both sleep and wakefulness complicates the task of the respiratory control system because sleep alters the response characteristics of the respiratory con- troller and the performance of the respiratory muscles.There may be a hierarchy of neurological organization that governs physiological regulations that determines priorities and arbitrates among conflicting demands as activity levels change.In some individuals with the sleep apnea syndrome, adequate sleep and sufficiently stable breathing, both necessary to prevent dangerous fluctuations in blood gas tensions, seem to be in- compatible (5,6).Sleep is interspersed with periods when airflow stops and profound hypoxemia develops.Sometimes it seems as if death is averted only by arousal and the termination of sleep.While the biochemical basis of neither sleep nor breathing are known, much has been learned in recent years about sleep and about the mechanisms by which it affects respiratory control.Several effective methods of treatment of the sleep apnea syn- drome have been developed based on our understanding of the effects of sleep on breathing.Breathing during sleep.Neither sleep nor wakefulness are uniform states.Even in awake individuals, cyclic changes in breathing with both long and short periods can be obvious at altitude and can be discerned at sea level by sophisticated math-
Effects of Oral Theophylline Combined with Oral and Inhaled β<sub>2</sub>‐Adrenostimulants in Asthmatics
Authors: K. Svedmyr
Journal: Allergy (1982)

The acute ventilatory, cardiovascular and tremorogenic effect of a high oral dose of terbutaline (5 mg) was compared with that of half the dose (2.5 mg) combined with 280 mg anhydrous theophylline orally in a randomized, double‐blind, cross‐over study in eight asthmatics. After 120 min. when steady‐state bronchodilation was achieved, five terbutaline inhalations (1.25 mg terbutaline sulphate) were added to both treatment regimens. The mean maximum plasma concentration of theophylline was then 7 μg/ml (39 μmol/l). Inhalation of a β 2 ‐adrenostimulant had a very good additional effect without increasing side effects in these patients with good inhalation technique. The oral low‐dose combination gave significantly better bronchodilation than the high dose of terbutaline alone and caused significantly less tremor. Although the combination only had an additive bronchodilating effect, it may offer important clinical advantages. If the patient cannot use the metered dose aerosol, an oral low dose combination should be preferred to a single high dose of either theophylline or β 2 ‐adrenostimulants. In patients with good inhalation technique but not controlled by inhalations from a metered dose aerosol alone, a combination of oral theophylline and terbutaline in “suboptimal” dose and an inhaled β 2 ‐agonist in individually titrated optimal dose gave a maximal bronchodilating effect with minimum side effects.
Selective Downregulation of the Angiotensin II AT <sub>1</sub> -Receptor Subtype in Failing Human Ventricular Myocardium
Authors: Koji Asano, Darrin L. Dutcher, J. David Port, Wayne A. Minobe, Kelli D. Tremmel, Robert L. Roden, Teresa J. Bohlmeyer, Erik W. Bush, Matthew J. Jenkin, William T. Abraham, Mary V. Raynolds, Lawrence S. Zisman, M. Benjamin Perryman, Michael R. Bristow
Journal: Circulation (1997)

Background The regulation of angiotensin II receptors and the two major subtypes (AT 1 and AT 2 ) in chronically failing human ventricular myocardium has not been previously examined. Methods and Results Angiotensin II receptors were measured by saturation binding of 125 I-[Sar 1 ,Ile 8 ]angiotensin II in crude membranes from nonfailing (n=19) and failing human left ventricles with idiopathic dilated cardiomyopathy (IDC; n=31) or ischemic cardiomyopathy (ISC; n=21) and membranes from a limited number of right ventricles in each category. The AT 1 and AT 2 fractions were determined by use of an AT 1 -selective antagonist, losartan. β-Adrenergic receptors were also measured by binding of 125 I-iodocyanopindolol with the β 1 and β 2 fractions determined by use of a β 1 -selective antagonist, CGP20712A. AT 1 but not AT 2 density was significantly decreased in the combined (IDC+ISC) failing left ventricles (nonfailing: AT 1 4.66±0.48, AT 2 2.73±0.39; failing: AT 1 3.20±0.29, AT 2 2.70±0.33 fmol/mg protein; mean±SE). The decrease in AT 1 density was greater in the IDC than in the ISC left ventricles (IDC: 2.73±0.40, P &lt;.01; ISC: 3.89±0.39 fmol/mg protein, P =NS versus nonfailing). β 1 but not β 2 density was decreased in the failing left ventricles. AT 1 density was correlated with β 1 density in all left ventricles ( r =.43). AT 1 density was also decreased in IDC right ventricles. In situ reverse transcription–polymerase chain reaction in sections of nonfailing and failing ventricles indicated that AT 1 mRNA was present in both myocytes and nonmyocytes. Conclusions AT 1 receptors are selectively downregulated in failing human ventricles, similar to the selective downregulation of β 1 receptors. The relative lack of AT 1 downregulation in ISC hearts may be related to differences in the degree of ventricular dysfunction.
Medicine as a Social Instrument: Medical Social Service
Authors: Ida M. Cannon
Journal: New England Journal of Medicine (1951)

SOCIAL service integrated with organized medical care and public-health activities as we know them today may be traced back to the initiative, idealism and consistent interest of two remarkable men — Sir Charles Loch of London and Richard C. Cabot of Boston.This is not the occasion for review of the well known record of the services of the Church in aid to the sick and helpless through the centuries. Many doctors and laymen associated with hospitals in the past have called attention to the adverse social conditions pressing upon the sick and have made efforts to help. Nurses, with . . .
Oxidative stress and its determinants in the airways of children with asthma
Authors: R. Dut, E. A. Dizdar, E. Birben, C. Sackesen, O. U. Soyer, T. Besler, O. Kalayci
Journal: Allergy (2008)

Background: There is ample evidence for the existence of a systemic oxidative stress in childhood asthma but relatively little information on the oxidant stress in the airways. Objective: To determine the extent of oxidant/antioxidant imbalance and describe its determinants in the airways of asthmatic children including asthma severity and the genotype of the antioxidant enzymes. Methods: One hundred and ten children with mild asthma, 30 children with moderate asthma and 191 healthy controls were included in the study. Exhaled breath condensate (EBC) was collected from all children with EcoScreen ® . Levels of malondialdehyde were measured as the indicator of oxidative stress, and of reduced glutathione as the indicator of antioxidant defense. Children were genotyped for the presence of null variants of glutathione S transferase (GST) T1 and GSTM1, and ile105val variant of GSTP1. Risk factors were analyzed with multivariate logistic regression. Results: EBC contained significantly higher levels of malondialdehyde and lower levels of reduced glutathione in asthmatic children compared with healthy controls ( P &lt; 0.001 for each), whereas there was no difference between mild and moderate asthmatics. Multivariate logistic regression identified asthma as the only independent factor contributing to oxidative stress. Genotypes of the antioxidant enzymes had no effect on the oxidative burden. Conclusions: Asthma is associated with an extremely powerful oxidative stress not only in the systemic circulation but also in the airways.
An Outbreak of Nonparenterally Transmitted Hepatitis B
Authors: John A. Bryan
Journal: JAMA (1973)

Between Sept 14, 1968, and May 1, 1969, twelve employees of the Children's Hospital Medical Center (CHMC), Boston, contracted viral hepatitis, type B (hepatitis B). Ten had been contacts of an 11-year-old patient with aplastic anemia who had received multiple transfusions and who harbored the hepatitis-B antigen (HBAg). Serum from seven of the 12 ill employees was tested for HBAg; only one was positive, but in most instances serum was obtained late in the convalescent period or following recovery. Investigation showed that, because of an associated hemorrhagic diathesis, the 11-year-old patient was most likely the source of infection. This outbreak demonstrates how hepatitis B can be transmitted via a nonparenteral route and illustrates the occupational hazard to medical personnel involved in this seemingly innocuous and routine exposure.
Use of Mendelian randomisation to assess potential benefit of clinical intervention
Authors: S. Burgess, A. Butterworth, A. Malarstig, S. G. Thompson
Journal: BMJ (2012)

Mendelian randomisation is a technique for assessing causal associations in observational data. Genetic variants associated with the risk factor of interest are regarded in a similar way to random assignment in a clinical trial. The difference in the risk factor due to the genetic variation, however, is materially distinct from the change due to any proposed therapeutic intervention and so might affect the outcome differently. Consequently, it can be misleading to generalise the magnitude of a Mendelian randomisation estimate to the effect of a potential intervention on the risk factor in practice. Awareness of the limitations of such estimates is important for the use of Mendelian randomisation in target based drug development
Extramural cross-validation of the mayo primary biliary cirrhosis survival model establishes its generalizability
Authors: Patricia M. Grambsch, Rolland E. Dickson, Marshall Kaplan, Gene Lesage, Thomas R. Fleming, Alice L. Langworthy
Journal: Hepatology (1989)

The generalizability of the Mayo model for predicting survival in individual primary biliary cirrhosis patients without liver transplantation was tested and confirmed. The model was applied to a data base of patients from the New England Medical Center Hospitals (n = 141) and the Scott and White Clinic (n = 35) and found to predict their survival accurately. It was also shown to be accurate for Mayo primary biliary cirrhosis patients with very advanced disease (n = 30), those with less than a 33% chance of surviving 12 months. The analyses confirmed that the addition of histologic stage did not significantly improve the predictive power of the model (p greater than 0.10). We suggest that the Mayo model is a practical tool for clinical management and decision making.
CRITIQUE AND CAVIL
Authors: George X. Trimble
Journal: JAMA (1964)

A new undertaking is usually approached with some concern, some misgiving, and some trepidation. Whether it be a business venture, a military engagement, a political campaign, or an editorial effort, its entrepreneur, though optimistic about the outcome, finds that his optimism may wane a trifle at times. And so it is with your critic and caviler. Critique and Cavil, the title of this editorial, is also the title of a new section inThe Journal. Like Just Words, Medical Postage Stamps, and more recently, Irish Poets, Critique and Cavil is a special item, brief but not barren, which will appear from time to time inThe Journal. As its name implies, Critique and Cavil will comment on the current medical literature, and in a manner befitting the subject. For the most part, this will be in the nature of a critique: constructive, rather than merely corrective, comment. But when a nit
Decreased Measles Antibody Response After Measles-Mumps-Rubella Vaccine in Infants With Colds
Authors: Marvin S. Krober
Journal: JAMA (1991)

We examined the possibility that the common cold or afebrile upper respiratory tract infection might interfere with successful immunization in children who receive standard measles-mumps-rubella vaccine. Infants 15 to 18 months of age presenting at our well-child clinics for routine examination and immunizations were divided into two groups. Those infants with a history and physical findings of upper respiratory tract infection were compared with healthy control group infants who did not have upper respiratory tract infections, and who did not have a history of upper respiratory tract infection symptoms within the previous month. Both groups were studied for their serologic response to measles-mumps-rubella vaccination. Prevaccination serum samples were obtained prior to vaccine administration and postvaccination serum samples were obtained 6 to 8 weeks later. Measles antibody was measured in these serum samples by an indirect fluorescein-tagged antibody test. Ten (21%) of 47 infants with colds failed to develop measles antibody, while only one (2%) of 51 well infants failed to develop antibody. We conclude that infants with colds have a significant seroconversion failure rate associated with measles vaccine administration and that this may be the cause of some primary measles vaccine failures. (<i>JAMA</i>. 1991;265:2095-2096)
Occupational, Commuting, and Leisure-Time Physical Activity in Relation to Heart Failure Among Finnish Men and Women
Authors: Yujie Wang, Jaakko Tuomilehto, Pekka Jousilahti, Riitta Antikainen, Markku Mähönen, Peter T. Katzmarzyk, Gang Hu
Journal: Journal of the American College of Cardiology (2010)
Regression of Left Ventricular Hypertrophy
Authors: Martin Thomas
Journal: JAMA (1996)

—Sloppy use of terminology has never been a sign of good research. Dr Schmieder and colleagues<sup>1</sup>state that they used the databases MEDLINE, DIMDI, RINGDOC, "ADES," and EMBASE as data sources. Three of these 5 terms (60%) are wrong, outdated, or incorrect. DIMDI (ie, Deutsches Institut füer Medizinische Dokumentation und Information) is not a database, but a German database host, offering an array of more than 90 databases in the medical field, including MEDLINE. The database RINGDOC changed its name several years ago to DERWENT DRUG FILE when it became available to users outside the pharmaceutical industry. The proper spelling for "ADES" is ADIS, a database offered by ADIS Press Inc in New Zealand. From the collection of terms that the authors used, it is obvious that they as well as many other end users did not care to delve into the intricacies of the MeSH (Medical Subject Headings) thesaurus,