tbuckley/cabot-search huggingface dataset:
Emergency Room Care
Authors: ROBERT L. DICKMAN
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 July 1973Emergency Room CareROBERT L. DICKMAN, M.D.ROBERT L. DICKMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-1-135_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Brook, Berg, and Schechter in the March issue (pp. 333-339) was stimulating. As one who is concerned daily with the problems of providing ambulatory care in a metropolitan teaching hospital, I wish to comment on some of the important issues in that paper.We must critically assess the role of the emergency room in the provision of primary, nonurgent medical care. The enormous rise in visits to emergency rooms over the past decade attests not to the viability of such services but only to increasing demands and lack of availability of other resources. By... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT L. DICKMAN, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1973Volume 79, Issue 1Page: 135-135KeywordsEmergency department ePublished: 1 December 2008 Issue Published: 1 July 1973 PDF downloadLoading ...
Drug-Induced Hepatotoxicity
Authors: NEIL KAPLOWITZ
Journal: Annals of Internal Medicine (1986)

Drug-induced injury to the liver can mimic any form of acute or chronic liver disease. Acute injury to the liver frequently is due to the action of cytochrome P450, which breaks down drugs into electrophiles or free radicals; these reactive metabolites can covalently bind to protein and unsaturated fatty acids or induce lipid peroxidation, respectively. These events may impair vital functions of the cell, such as maintenance of calcium homeostasis, leading to death; or hypothetically they may elicit a hypersensitivity reaction directed mainly at the liver. Glutathione and tocopherol play critical roles in cellular defense. Cholestatic disease caused by drugs results from a selective disturbance in bile secretion. Agents such as estrogens, chlorpromazine, and monohydroxy bile acids alter the chemical and physical properties of membranes, leading to impaired activity of carriers and pumps for bile acids and electrolytes. Certain drugs produce chronic liver disease that is pathologically identical to chronic active hepatitis, biliary cirrhosis, or alcoholic liver disease.
The Efficacy of Zidovudine Is Time Limited
Authors: Richard D. Moore, Richard E. Chaisson, Julia Hidalgo
Journal: JAMA (1994)

<h3>To the Editor.</h3> —In their well-done study of the duration of survival benefit of zidovudine in patients with AIDS, Dr Lundgren and colleagues<sup>1</sup>comment that visual inspection of product-limit plots for our study<sup>2</sup>suggest a survival benefit of about 1 year's duration. Our observational study reported survival estimates on 352 patients who received zidovudine and 362 patients who did not receive zidovudine who were first diagnosed with AIDS from April 1987 through June 1989 and had longitudinal follow-up through June 1990. A total of 470 patients (66%) died during follow-up. When survival from diagnosis of AIDS was analyzed by a time-dependent Cox regression in a manner similar to Lundgren et al, we derived the results listed in the Table. A second time-dependent Cox regression analysis was also done using the following model: relative hazard (t) = exp(B1+[B2×time]), where B1 provides an estimate of the relative hazard of use vs
Mutations in SRD5B1 (AKR1D1), the gene encoding 4-3-oxosteroid 5 -reductase, in hepatitis and liver failure in infancy
Authors: H A Lemonde
Journal: Gut (2003)

<b>Background:</b> A substantial group of patients with cholestatic liver disease in infancy excrete, as the major urinary bile acids, the glycine and taurine conjugates of 7α-hydroxy-3-oxo-4-cholenoic acid and 7α,12α-dihydroxy-3-oxo-4-cholenoic acid. It has been proposed that some (but not all) of these have mutations in the gene encoding Δ<sup>4</sup>-3-oxosteroid 5β-reductase (<i>SRD5B1</i>; <i>AKR1D1</i>, OMIM 604741). <b>Aims:</b> Our aim was to identify mutations in the <i>SRD5B1</i> gene in patients in whom chenodeoxycholic acid and cholic acid were absent or present at low concentrations in plasma and urine, as these seemed strong candidates for genetic 5β-reductase deficiency. <b>Patients and subjects:</b> We studied three patients with neonatal onset cholestatic liver disease and normal γ-glutamyl transpeptidase in whom 3-oxo-Δ<sup>4</sup> bile acids were the major bile acids in urine and plasma and saturated bile acids were at low concentration or undetectable. Any base changes detected in <i>SRD5B1</i> were sought in the parents and siblings and in 50 ethnically matched control subjects. <b>Methods:</b> DNA was extracted from blood and the nine exons of <i>SRD5B1</i> were amplified and sequenced. Restriction enzymes were used to screen the DNA of parents, siblings, and controls. <b>Results:</b> Mutations in the <i>SRD5B1</i> gene were identified in all three children. Patient MS was homozygous for a missense mutation (662 C&gt;T) causing a Pro198Leu amino acid substitution; patient BH was homozygous for a single base deletion (511 delT) causing a frame shift and a premature stop codon in exon 5; and patient RM was homozygous for a missense mutation (385 C&gt;T) causing a Leu106Phe amino acid substitution. All had liver biopsies showing a giant cell hepatitis; in two, prominent extramedullary haemopoiesis was noted. MS was cured by treatment with chenodeoxycholic acid and cholic acid; BH showed initial improvement but then deteriorated and required liver transplantation; RM had advanced liver disease when treatment was started and also progressed to liver failure. <b>Conclusions:</b> Analysis of blood samples for <i>SRD5B1</i> mutations can be used to diagnose genetic 5β-reductase deficiency and distinguish these patients from those who have another cause of 3-oxo-Δ<sup>4</sup> bile aciduria, for example, severe liver damage. Patients with genetic 5β-reductase deficiency may respond well to treatment with chenodeoxycholic acid and cholic acid if liver disease is not too advanced.
Increased sensitivity to endotoxemia in the bile duct-ligated cirrhotic rat
Authors: David Harry, Radhi Anand, Stephen Holt, Susan Davies, Richard Marley, Bimbi Fernando, David Goodier, Kevin Moore
Journal: Hepatology (1999)

Sepsis is a common complication of cirrhosis with a high mortality. In this study, we have investigated some of the pathways that may be involved in tissue injury and death. Bile duct-ligated (BDL) cirrhotic and control rats were challenged with lipopolysaccharide (LPS). Sensitivity to LPS was markedly enhanced in the BDL group, and was associated with increased liver injury and mortality. There was a 5-fold constitutive activation of nuclear factor κ B (NFκB) in the liver of BDL rat controls ( P &lt; .001), and this was activated further, but to a similar extent, in the liver of both sham and BDL rats after injection of LPS. Plasma tumor necrosis factor α (TNF-α) increased more markedly in the BDL cirrhotic rats (2,463 ± 697 pg/mL in BDL rats versus 401 ± 160 pg/mL in the controls at 3 hours; P &lt; .01). Plasma nitrite/nitrate concentrations were increased in the BDL controls at baseline, and increased further after LPS ( P &lt; .05), but did not differ from sham controls at 6 hours. Plasma F 2 -isoprostanes increased 6-fold in the cirrhotic rats and 2-fold in the controls ( P &lt; .01) indicative of lipid peroxidation. Esterified F 2 -isoprostanes in the liver increased 2- to 3-fold at 1 hour in control and BDL rats, but returned to baseline levels by 3 hours. Esterified F 2 -isoprostanes in the kidney increased by 2-fold in the BDL rats after LPS administration, but remained unchanged in sham controls. We conclude that there is a marked increase in sensitivity to LPS in BDL cirrhotic rats. This is associated with an enhanced TNF-α response and increased lipid peroxidation. These may be directly and causally related to mortality.
ANOMALOUS INTERNAL CAROTID ARTERY AND ITS CLINICAL SIGNIFICANCE IN OPERATIONS ON TONSILS
Authors: P. G. SKILLERN
Journal: JAMA (1913)

In view of the increasing number of operations on the tonsil because of the focusing of medical eyes on it as a primary source of metastatic infections, because of the discovery of more cases in the systematic inspection of schoolchildren, and because of the popularity of complete ablation of the tonsil in preference to partial tonsillectomy, a timely note of warning should be sounded of the liability of serious if not fatal hemorrhage from wounding a loop of an anomalous internal carotid artery. The following specimen, found in the Anatomical Laboratory of the University of Pennsylvania, serves as a striking example of this:  Anomalous Sigmoid Tortuosity of Cervical Portion of Internal Carotid Artery.  —Specimen consists of left side of skull containing the internal carotid arteryin situand dissected free from surrounding tissues. The artery is of uniform caliber throughout its length, and its walls neither thickened nor calcareous. Beginning
Dietary Potassium and Stroke-Associated Mortality
Authors: Kay-Tee Khaw, Elizabeth Barrett-Connor
Journal: New England Journal of Medicine (1987)

Hypertension is the most important known risk factor for stroke. Clinical, experimental, and epidemiologic evidence suggests that a high dietary intake of potassium is associated with lower blood pressure. In hypertensive rats, a high intake of potassium is reported to protect against stroke, even though blood pressure is not affected. We examined the relation between the 24-hour dietary potassium intake at base line and subsequent stroke-associated mortality in a population-based cohort of 859 men and women (aged 50 to 79 years) in Southern California. After 12 years, 24 stroke-associated deaths had occurred. The relative risks of stroke-associated mortality in the lowest fertile of potassium intake, as compared with that in the top two tertiles combined, were 2.6 (P = 0.16) in men and 4.8 (P = 0.01) in women. In multivariate analyses, a 10-mmol increase in daily potassium intake was associated with a 40 percent reduction in the risk of stroke-associated mortality (P<0.001). This effect was independent of other dietary variables, including the intake of calories, fat, protein, fiber, calcium, magnesium, and alcohol. The effect was also apparently independent of known cardiovascular risk factors, including age, sex, blood pressure, blood cholesterol level, obesity, fasting blood glucose level, and cigarette smoking. These findings support the hypothesis that a high intake of potassium from food sources may protect against stroke-associated death. (N Engl J Med 1987; 316:235–40.)
British physicians on medical school faculties in North America.
Authors: T. C. Gibson
Journal: BMJ (1967)

Data on the movement abroad of British medical graduates have been published by several investigators, notably Seale (1964, 1966), Davison (1962), Last (1963), Whitfield (1963), and Abel-Smith and Gales (1964).Different methods have been used to collect such information, and this has led to problems of validity, though, in spite of past Governmental statements, it appears that medical emigration has been considerable.One well-designed study estimates that nearly 500 physicians went abroad each year from 1955 to 1960 (Abel-Smith and Gales, 1964), and Seale (1966) indicated that a numerically similar exodus has continued up to 1965.This represents an important loss of educational investment for the United Kingdom, and terms such as " brain drain " have been used, usually based on isolated and publicized examples.Little attempt, other than that of Abel-Smith and Gales, has been made to evaluate the motives and achievements of physicians who have emigrated, though these matters should be of some interest to those who are responsible for medical administration and education in the United Kingdom.Such facets of medical emigration led to this study of physicians with British medical degrees who are on the faculties of North American medical schools.The whole topic of medical emigration can stir up such emotion that a rational evaluation may not be forthcoming.Nevertheless, it was felt that, apart from documenting numbers, an attempt should be made to obtain a perspective of the personal reasons for making such a major professional move. Materials and MethodsThe initial step was to list all those physicians with registrable British medical degrees who were on the faculties of American and Canadian medical schools on 1 July 1965.Only institu- tional members of the Association of American Medical Col- leges were included, a total of 87 schools in the United States and 12 in Canada.Copies were obtained of all medical school catalogues for the academic year 1965-6, since these normally include a register listing the academic status of faculty physi- cians and their qualifying medical degrees.Next a letter was written to the deans of these medical schools asking for the names of all British-trained medical graduates on the school faculty.
Abstract 3744: Local Transplantation Of Blood-derived Late-outgrowth Progenitor Cells Increased Reendothelialization, Inhibited Smooth Muscle Cell Proliferation And Reduced Neointima Formation After Experimental Carotid Injury
Authors: Maren Schurmann, Martina Knoedler, Philipp Fischer, Christian Peschel, Robert Oostendorp, Ilka Ott
Journal: Circulation (2008)

Introduction : Recent studies demonstrate the vasculoprotective effects of cell-based therapies to inhibit limit restenosis. Delivery of autologous late outgrowth endothelial progenitor cells (eEPC) result in early reendothelialization and inhibition of neointimal hyperplasia. Additional anti-inflammatory treatment may further reduce neointima generation. Methods and Results : CD34+ cells were isolated using immunomagnetic beads and cultured in endothelial cell medium to obtain eEPC. Early passage cells were transduced ex vivo by a retroviral vector expression of IL-1ra (eEPC IL-1ra) or empty vector (eEPC pLXSN) and expanded up to 46 population doublings. Expression levels were confirmed by RT-PCR. Athymic nude rats underwent carotid balloon and wire injury immediately followed by local delivery of eEPCs, eEPC IL-1ra, eEPC pLXSN or buffer for 20 minutes (n=22). Elastica van Giesson staining revealed a decrease in the intima/media ratio from 1.53 ± 0.11 to 1.13 ± 0.09 (mean ± SEM) after transplantation of eEPC (p=0.009). However, no additional reduction in neointima generation was observed after transplantation of eEPC IL-1ra. Endothelial-cell specific staining demonstrated an enhancement of reendothelialisation by eEPCs 24 hours after vascular injury. After 2 weeks a reduction of Ki67+ proliferating cells from 37.0 ± 8.5 Ki67+ cells in the control group to 11.67 ± 2.85 Ki67+ cells after eEPC transplantation (P=0.03) was found. Yet, no additional anti-proliferative effects were observed after transplantation of eEPC IL-1ra. Thus, enhancement of reendothelialization through local delivery of eEPCs may be sufficient for the inhibition of neointima generation since additional anti-inflammatory treatment using eEPC IL-1ra had no beneficial effect. Conclusion : Local delivery of blood-derived expanded endothelial progenitor cells after vascular injury contributes to endothelial regeneration, inhibits neointimal smooth muscle cell proliferation and reduces neointima generation. Autologous cell transplantation after vascular injury may be a feasible strategy for promotion of reendotheli-alisation and improvement of vascular regeneration.
A CASE OF ANEURYSM OF THE LEFT VENTRICLE.
Authors: ERNEST B. SANGREE
Journal: JAMA (1898)

Recently Dr. W. H. Witt, Demonstrator of Anatomy, found in the body of a colored woman of about 25 years, the cardiac aneurysm shown in Fig. 1. The surface of the heart was covered with shaggy fibrin of a recent pericarditis, but whether or not this was the cause of death we have been unable to learn, as the body was of the "resurrected" variety and we have not succeeded in tracing it so as to get a clinical history. The aneurysmal pouch when opened contained soft black clots, showing no attempt on the part of nature to fill it up with laminated clot. The pouch communicated with the cavity of the left ventricle by a large opening just below the attachment of the anterior segment of the mitral valve. This opening is two and three-fourths centimeters long by one and one-fourth broad (see Fig. 2). The opening easily admits
Medicamina Faciei Femineae: Roman Skin Care
Authors: Faisal R. Ali, James Fox, Alexander E. T. Finlayson
Journal: JAMA Dermatology (2013)

Written 2 millennia ago, Ovid's Medicamina Faciei Femineae (Cosmetics for the Female Face) provides a unique insight into Roman dermatological practices and attitudes toward beauty. Born in Sulmo (east of Rome) in 43 BC, Ovid trained as an orator before crafting his art as one of the canonical poets of Latin literature.
Accountable Care Organizations
Authors: Elliott S. Fisher, Stephen M. Shortell
Journal: JAMA (2010)

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
FOOD STAGNATION FROM ALL CAUSES.
Authors: CHARLES G. STOCKTON
Journal: JAMA (1905)

When the stomach fails to empty itself within a reasonable time after the taking of food, this condition is termed food stagnation. It differs in degree, depending, in part, on the character of the food taken, still more on the morbid state giving rise to the condition. Semi-liquid or pultaceous food should leave the stomach in four or five hours, and if it is retained longer there is a certain degree of stagnation. An ordinary meal composed of a variety of foods is the proper test for food stagnation. With this meal the stomach should be emptied, according to Riegel, within seven hours, and the presence of contents beyond that time is evidence of food stagnation. There are conditions, however, in which the liquid food is retained for a much longer period than five hours, and solid foods are retained for twenty-four hours or longer. Under such circumstances, we have
Unsupervised overnight closed loop insulin delivery during free living: analysis of randomised cross-over home studies in adults and adolescents with type 1 diabetes
Authors: Hood Thabit, Daniela Elleri, Lalantha Leelarathna, Janet Allen, Alexandra Lubina-Solomon, Marietta Stadler, Emma Walkinshaw, Ahmed Iqbal, Pratik Choudhary, Malgorzata Wilinska, Katharine Barnard, Simon Heller, Stephanie Amiel, Mark Evans, David Dunger, Roman Hovorka
Journal: The Lancet (2015)
Fabrication of homogeneously cross-linked, functional alginate microcapsules validated by NMR-, CLSM- and AFM-imaging
Authors: H Zimmermann, M Hillgärtner, B Manz, P Feilen, F Brunnenmeier, U Leinfelder, M Weber, H Cramer, S Schneider, C Hendrich, F Volke, U Zimmermann
Journal: Biomaterials (2003)
FINDING OF NON CALCIFIED PLAQUES IN CORONARY ARTERIES USING COMPUTED TOMOGRAPHY IS A BETTER PREDICTOR OF HIGH RISK OF MAJOR CARDIAC EVENTS THAN CALCIFIED PLAQUES AND LUMINAL STENOSIS: A STUDY WITH A MEDIAN OF 80 MONTHS FOLLOW-UP, ESPECIALLY IN SUBJECTS WITH DIABETES MELLITUS
Authors: Hiroyuki Takaoka, Nobusada Funabashi, Masae Uehara, Yoshio Kobayashi
Journal: Journal of the American College of Cardiology (2012)
Targeted Therapies Take Aim Against Lung Cancer and Melanoma
Authors: Mike Mitka
Journal: JAMA (2010)

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
Lymph Node Evaluation in Colon Cancer
Authors: Sandra L. Wong
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
Sir John Mandeville: Alias John (with the Beard) de Bourgogne
Authors: Robert W. Buck
Journal: New England Journal of Medicine (1961)

IN the year MCCCLXXII [1372] there died in Liége, on November 12, a man of distinguished birth who was content to be known by the name Jehan de Bourgogne, also called à la Barbe (with the Beard). However, on his death bed he revealed himself to his companion and testamentary executor Jehan d'Oultremeuse, and in fact in the summary of his will he gave his name as Messire Jehan de Mandeville, knight, Earl of Montfort in England and Lord of the Island of Campdi and of Castle Perouse. Having had the bad luck in his own country to kill an . . .
EVALUATION OF CHEST PAIN IN THE EMERGENCY ROOM USING A 2 HOUR SENSITIVE TROPONIN I (CTNI)
Authors: Shahriar Dadkhah, Zakaria Almuwaqqat, Harsh A. Rawal, Samian Sulaiman, Husein Husein, Nadia Elhangouche, Brian Huettl, Addis Afsaw, Kushal Naha
Journal: Journal of the American College of Cardiology (2015)