tbuckley/cabot-search huggingface dataset:
Birth weight from pregnancies dated by ultrasonography in a multicultural British population.
Authors: M Wilcox, J Gardosi, M Mongelli, C Ray, I Johnson
Journal: BMJ (1993)

OBJECTIVE--To produce standard curves of birth weight according to gestational age validated by ultrasonography in the British population, with particular reference to the effects of ethnic origin. DESIGN--Retrospective analysis of computerised obstetric database. SETTING--Three large maternity units associated with Nottingham University with over 16,000 deliveries a year. PATIENTS--41,718 women with ultrasound dated singleton pregnancies and delivery between 168 and 300 days9 gestation. MAIN OUTCOME MEASURES--Length of gestation, ethnic origin, parity, maternal height and weight at booking, smoking during pregnancy; the effect of these variables on birth weight. RESULTS--Birth weights from ultrasound dated pregnancies have a higher population mean and show less flattening of the birthweight curve at term than those of pregnancies dated from menstrual history. Significant differences were observed in mean birth weights of babies of mothers of European origin (3357 g), of Afro-Caribbean origin (3173 g), and from the Indian subcontinent (3096 g). There were also significant interethnic differences in length of gestation, parity, maternal height, booking weight, and smoking habit which affected birth weight. The ethnic differences in birth weight were even greater when the effect of smoking was excluded. CONCLUSIONS--Birthweight standards require precise dating of pregnancy and should describe the population from which they were derived. In a heterogeneous maternity population the accurate assessment of an individual baby9s weight needs to take the factors which affect birthweight standards into consideration.
Canada supports agency criticised as an "AIDS denier"
Authors: D. Spurgeon
Journal: BMJ (2003)

A Canadian agency that has been supported financially by the Canadian government has come under strong criticism for being an “AIDS denier.” The agency carries claims on its website that HIV is neither necessary nor sufficient to cause AIDS and that the number of AIDS cases worldwide has been manipulated and is really decreasing rather than increasing.

The views on the website of InterPares (www.interpares.ca), a non-governmental agency, run counter to those stated on the Canadian federal health department's own website (www.hc-sc.gc.ca).

InterPares describes itself as supporting “social justice work” in more than 20 countries in Africa, Asia, and Latin America. In 2002, it received $C5m (£2.2m; $3.8m; €;3.2m) from the Canadian International Development Agency (CIDA).

Dr Mark Wainberg, director of the AIDS Centre at McGill University, Montreal, and formerly president of the International AIDS Society, …
Semisynthetic Human Insulin: Biologic and Immunologic Activity in Newly Treated Diabetic Subjects During a Six-month Follow-up
Authors: M Iavicoli, U DI Mario, G A Coronel, A M Dawud, P Arduini, M Leonardi
Journal: Diabetes Care (1984)

Biologic and immunogenic activities of semisynthetic human monocomponent insulins were examined in insulin-dependent diabetic patients (group 1). Patients treated with porcine monocomponent (group 2) and conventional (group 3) insulins were studied for control purposes. The patients were examined before the beginning of insulin treatment and for a 6-mo follow-up period. The data collected during the study show that insulin antibody levels were significantly lower in group 1 than in groups 2 and 3. Furthermore, the prevalence of immune complexes assays with the C1q solid phase technique failed to reveal any differences between the three groups. When the conglutinin binding test was used, the prevalence of immune complexes showed a slight but not significant reduction in group 1 and a significant increase in group 3. The metabolic control was similar in the three groups during follow-up and the insulin requirement was lower, but not significantly, in group 1 than in groups 2 and 3. These data suggest that with human monocomponent insulins equivalent glycemic control may be achieved at similar doses than those required with porcine monocomponent insulins. Furthermore, human insulinis the least immunogenic of the present available insulins.
New Drug for HIV Infection
Authors: Jane E. Henney
Journal: JAMA (2000)

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
Clinical negligence lawyers told to improve their performance
Authors: R. Dobson
Journal: BMJ (2002)

Fifty of the 200 British law firms involved in clinical medical negligence cases have been told to improve their performance.

The companies have been told to make a series of improvements, including better vetting of cases before they are taken on.

A letter from the Lord Chancellor's Department said that research was also looking at whether the practice of “no win, no fee” could be used …
Electrocardiography in Women
Authors: Peter M. Okin
Journal: Circulation (2006)

n the just over 100 years since the first ECG was performed, 1 the ECG has become the most extensively used noninvasive diagnostic and prognostic tool in cardiology.Used both at rest and during provocative exercise, the 12-lead ECG has impressive, if imperfect, utility for rhythm analysis, detection of ischemic and hypertrophic heart disease, and outcome prediction in a variety of clinical settings, with a large body of literature that illustrates and supports these applications.The first observation of gender differences in the ECG was published 85 years ago by Bazett, 2 demonstrating that women have significantly longer QT intervals than men despite having higher heart rates.However, despite a growing body of literature demonstrating significant gender differences in QRS amplitudes and duration, 3-6 QT intervals, 5,7,8 ST-segment deviation, 9,10 and novel, computer-based measurements of T-wave complexity, 8,11 few ECG criteria routinely use gender-specific diagnostic criteria, and there has been a relative paucity of data on the prognostic performance of ECG variables in women. Articles pp 473 and 481Two studies in the current issue of Circulation by Rautaharju and colleagues 12,13 provide a wealth of new findings and impetus for further study of the ECG in women.Using well-validated computerized ECG methodology, the authors examined the value of a number of ECG variables for predicting incident coronary heart disease and its mortality, incident congestive heart failure, and total mortality in more than 38 000 women participating in the dietary modification trial of the Women's Health Initiative.Although both studies reconfirm the predictive value of ECG evidence of prior Q-wave myocardial infarction (MI), the principle new findings are the strong predictive value of various ECG measures of repolarization, and in particular of the QRS/T angle, 12,13 a measure of the spatial angle between mean QRS and T vectors.In the single-ECG multivariable models that adjusted for standard demographic and clinical risk factors, nearly all T-wave and ST-segment variables and the QRS/T angle, as well as novel measures of repolarization derived from singular value decomposition of the derived vectorcardiogram, were significant predictors of outcome.
Cyclic adenosine monophosphate-mediated protection against bile acid-induced apoptosis in cultured rat hepatocytes
Authors: Cynthia R.L. Webster, Sawkat M. Anwer
Journal: Hepatology (1998)

Cyclic adenosine monophosphate (cAMP) has been shown to modulate apoptosis. To evaluate the role of cAMP in bile acid-induced hepatocyte apoptosis, we studied the effect of agents that increase cAMP on the induction of apoptosis by glycochenodeoxycholate (GCDC) in cultured rat hepatocytes. GCDC induced apoptosis in 26.5% ± 1.1% of hepatocytes within 2 hours. Twenty-minute pretreatment of hepatocytes with 100 μmol/L 8-(4-chlorothiophenyl) cAMP (CP-cAMP) resulted in a reduction in the amount of apoptosis to 35.2% ± 3.8% of that seen in hepatocytes treated with GCDC alone. Other agents that increase intracellular cAMP, including dibutyryl cAMP (100 μmol/L), glucagon (200 nmol/L), and a combination of forskolin (20 μmol/L) and 3-isobutyl-1-methylxanthine (20 μmol/L), also inhibited GCDC-induced apoptosis to a similar extent. Pretreatment with the protein kinase A (PKA) inhibitor, KT5720, prevented the protective effect of CP-cAMP and inhibited CP-cAMP-induced activation of PKA activity. Inhibitors of phosphatidylinositol 3-kinase (PI3K), wortmannin (50 nmol/L), or Ly 294002 (20 μmol/L) also prevented the cytoprotective effect of cAMP. PI3K assays confirmed that wortmannin (50 nmol/L) inhibited PI3K activity, while CP-cAMP had no effect on the activity of this lipid kinase. GCDC increased mitogen-activated protein kinase (MAPK) activity, but had no effect on stress-activated protein kinase (SAPK) activity in hepatocytes. cAMP decreased basal and GCDC-induced MAPK activity and increased SAPK activity. The MAPK kinase inhibitor, PD 98059, inhibited both GCDC-mediated MAPK activation and GCDC-induced apoptosis. In conclusion: 1) agents that increase intracellular cAMP protect against hepatocyte apoptosis induced by hydrophobic bile acids; 2) activation of MAPK by GCDC may be involved in bile acid-induced apoptosis; and 3) cAMP-mediated cytoprotection against bile acid-induced apoptosis appears to involve PKA, MAPK, and PI3K.
Postprandial Myocardial Perfusion in Healthy Subjects and in Type 2 Diabetic Patients
Authors: Roldano Scognamiglio, Christian Negut, Saula Vigili De Kreutzenberg, Antonio Tiengo, Angelo Avogaro
Journal: Circulation (2005)

Background— In diabetic patients, postprandial hyperglycemia is a more powerful risk factor for cardiovascular disease than fasting hyperglycemia itself. A negative influence of acute hyperglycemia on systemic endothelial function (brachial artery) has been shown. However, myocardial perfusion during postprandial hyperglycemia has not been investigated. Methods and Results— We evaluated the effects of a standardized mixed meal on myocardial perfusion in 20 healthy subjects and 20 consecutive patients with type 2 diabetes mellitus without macrovascular or microvascular complications. Myocardial perfusion was assessed in fasting and postprandial states by myocardial contrast echocardiography. Fasting myocardial flow velocity (β, 0.65±0.27 versus 0.67±0.24; P =NS), myocardial blood volume (MBV; 8.3±1.2 versus 8.4±2; P =NS), and myocardial blood flow (5.4±1.5 versus 5.6±2; P =NS) did not differ between control subjects and diabetic patients. In the postprandial state, β (0.67±0.24 versus 0.92±0.35; P &lt;0.01), MBV (8.4±2 versus 10.9±2.7; P &lt;0.01), and myocardial blood flow (5.6±2 versus 9.9±2.8; P &lt;0.01) increased significantly in control subjects. In diabetic patients, β increased (0.65±0.27 versus 0.8±0.24; P &lt;0.01) but MBV (8.3±1.2 versus 4.3±1.3; P &lt;0.01) and myocardial blood flow (5.4±1.5 versus 3.4±0.9; P &lt;0.01) decreased significantly. Changes in MBV (expressed as [(MBV postprandial −MBV fasting )/MBV fasting ]×100) were significantly correlated with postprandial glycemia levels in diabetic patients. Conclusions— Postprandial hyperglycemia determines myocardial perfusion defects in type 2 diabetic patients. They are secondary to deterioration in microvascular function causing a decrease in MBV. In diabetic patients without microvascular or macrovascular complications, postprandial myocardial perfusion defects may represent an early marker of the atherogenic process in the coronary circulation; hence, its reversal constitutes a potential goal of treatment.
Learned control of blood pressure in patients with high blood pressure.
Authors: D A Kristt, B T Engel
Journal: Circulation (1975)

Five patients with documented histories of essential hypertension of at least ten years' duration participated in a triphasic study of training to control systolic blood pressure (SBP). Phase 1 was a seven week period during which patients took their BP (systolic and diastolic) at home and mailed these data to us daily. Phase 2 was a three week period during which patients were taught to control SBP using a noninvasive technique: patients were trained to raise, to lower and to alternately lower and raise SBP. Phase 3 was a three month period during which patients again took their BP at home and mailed these data to us daily. Results: (1) all patients learned SBP control: average increas 15%; average decrease 11%; (2) during SBP control heart rates, breathing rates, triceps brachii muscle tension and EEG activity did not change; (3) follow-up tests at one and three months showed evidence of retained SBP control; (4) baseline SBP fell from 153 mm Hg during laboratory training to 135 mm Hg at the three month follow-up; (5) phase 3 home BPs fell 18/8 mm Hg from phase 1 levels; (6) at home patients also were able to reduce SBP from 141 mm Hg (average) to 125 mm Hg (average) by means of the lowering technique learned in the laboratory.
Letter: Drugs for rheumatoid arthritis.
Authors: P J Rooney, A C Dick, A C Kennedy, R D Sturrock, W W Buchanan, J A Anderson
Journal: BMJ (1974)

Dr. Godfrey described the increased in- hibition of bronchoconstriction after 60 mg indoramin compared with 50 mg taken by the same patient on a different occasion as a "quite extraordinary dose-related phen- omenon."Admittedly the dose-response curve in this one patient appears to be steep, nevertheless the result is consistent with what one would expect of a drug with antagonist activity.Many more experiments with patients receiving several doses of indoramin seem necessary to determine that this dose relationship is unusual.Professor Bianco and his colleagues claimed that indoramin prevented specific airway conductance falling below the pretreatment con- trol level in all cases.This is inconsistent, however, with the results published for cases 2, 3, 9, and 10 in their table III.Fortunately, these inconsistencies do not detract from the authors' overall condlusions.From our analysis of their work we would conclude that under the limitations imposed by their methodology the evidence is consistent with indoramin preventing exercise-induced bronchoconstriction in five patients, decreas- ing it in five, and not leading to any im- provement in one.It would be of interest to learn from the investigators how the patients' symptomatology was affected by alpha-blockade.For it could be argued that if indoramin abolished the asthmatic symp- toms it prevented exercise-induced "asthma" while only partially antagonizing exercise- induced "bronchoconstriction."-We are, etc.,
Analysis of 12-Lead T-Wave Morphology for Risk Stratification After Myocardial Infarction
Authors: Markus Zabel, Burak Acar, Thomas Klingenheben, Michael R. Franz, Stefan H. Hohnloser, Marek Malik
Journal: Circulation (2000)

The stratification of post-myocardial infarction (MI) patients at risk of sudden cardiac death remains important. The aim of the present study was to assess the prognostic value of novel T-wave morphology descriptors derived from resting 12-lead ECGs.In 280 consecutive post-MI patients, a 12-lead ECG was recorded before discharge, optically scanned, and digitized. For the present study, 5 T-wave morphology descriptors were automatically calculated after singular value decomposition of the ECG signal. The total cosine R-to-T (TCRT [describes the global angle between repolarization and depolarization wavefront]) and the T-wave loop dispersion were univariately associated (P:=0.0002 and P:<0.002, respectively, U: test) with 27 prospectively defined clinical events in 261 patients (mean follow-up 32+/-10 months). Kaplan-Meier event probability curves for strata above and below the median confirmed the strong risk discrimination by TCRT and T-wave loop dispersion (P:<0.003 and P:<0.001, respectively, log-rank test). On Cox regression analysis, with the entering of age, left ventricular ejection fraction, heart rate, QRS width, reperfusion therapy, beta-adrenergic-blocker treatment, and standard deviation of R-R intervals on 24-hour Holter monitoring, TCRT (P:<0.03) yielded independent predictive value, whereas T-wave loop dispersion was of borderline independence (P:=0.064). Heart rate (P:<0.02), left ventricular ejection fraction (P:<0.02), and reperfusion therapy (P:<0.02) also remained in the final model.Computerized T-wave morphology analysis of the 12-lead resting ECG permits independent assessment of post-MI risk and an improved risk stratification when combined with other risk markers.
Congenital Factor X Deficiency and Incomplete Transverse Paralysis
Authors: Yasuyuki Endo
Journal: JAMA (1981)

AN UNUSUAL case of congenital factor X deficiency with hematomyelia was treated at the Akita University School of Medicine during October 1978. The 27-year-old man displayed an incomplete transverse paralysis due to hemorrhage into the spinal cord. Although hemorrhage into the CNS is not unusual, hemorrhage into the spinal cord in hemophilia and related disorders is rare. To our knowledge, only 20 similar afflictions with congenital factor X deficiencies have been reported since 1956, and none of these showed any evidence of hematomyelia.<sup>1,2</sup> <h3>Report of a Case</h3> At age 17 years, the patient's ailment had been diagnosed as congenital factor X deficiency having familial traits. He was admitted to our hospital because of a gait disturbance and the suppression of urine and stools following severe back pains. While under our care, he had recurrent intramuscular hemorrhages in the right thigh as well as two episodes of tooth extractions. Although
Chronic Ulcerative Colitis, Skin Necrosis, and Cryofibrinogenemia
Authors: GENE V. BALL
Journal: Annals of Internal Medicine (1976)

Necrotizing skin lesions developed in a man with chronic ulcerative colitis. No evidence of intrinsic disease of medium or small-sized vessels was found. A circulating cryofibrinogen was thought to be responsible for in situ thrombosis leading to skin infarctions. Sodium warfarin in a daily dose of 2.5 to 5 mg appears to have thwarted progression of developing lesions and the occurrence of new ones.
Scintigraphic Study of Propylthiouracil Induced Submassive Hepatic Necrosis
Authors: AMOLAK SINGH, RAJIV THAKUR
Journal: Clinical Nuclear Medicine (1995)

Drug induced hepatitis is a rare complication of thiourea antithyroid drugs. In some patients, the hepatotoxicity may be severe and lead to submassive hepatic necrosis (SHN). Submassive hepatic necrosis is a potentially fatal complication which is usually recognized on the liver biopsy and histological examination or autopsy. In the case presented here, SHN was identified on Tc-99m SC liver images. Sharply defined intrahepatic photopenic abnormalities without significant colloid shift were noted. SPECT images were most remarkable and exhibited extensive liver necrosis. Resolution of hepatic abnormalities correlated with clinical and biochemical resolution of SHN. in patients with propyithiouracil hepatotoxiclty, serial liver SPECT images with Tc-99m SC appear helpful for the diagnosis and follow up of SHN and, in an appropriate clinical context, may obviate the need for liver biopsy.
Ombudsman appoints clinical advisers BMA wants coordinator for partnership campaign Seventeen million fewer forms for GPs Commissioning GPs set out national standards University employers want more money for academics BMA supports GMSC election changes Correction
Authors: L. Beecham
Journal: BMJ (1996)

# Ombudsman appoints clinical advisers {#article-title-2}

The health service ombudsman, Sir William Reid, has appointed four medical and nursing advisers to help him deal with complaints about the clinical decisions of doctors, nurses, and other health professionals.The ombudsman's jurisdiction was extended this year to cover complaints about family practitioner services and clinical competence.

The new advisers are Dr Elizabeth Bingham, general practitioner in Reading and an examiner for the Royal College of General Practitioners;Dr Hugh Thelwall-Jones, former consultant obstetrician and group medical director, BUPA, 1990-5; Dr Richard Waldram, former consultant and clinical director, North Hampshire Hospital; and Dr Lyn Martin, former nursing officer, Department of Health, and principal, Bloomsbury and Islington College of Nursing and Midwifery, 1990-5.

Sir Williams says that the advisers will maintain high investigating standards and will help to appoint independent assessors to advise on professional matters.

# BMA wants coordinator for partnership campaign {#article-title-3}

General practitioners want a full time national coordinator appointed to facilitate local initiatives and provide materials to keep up the momentum of the doctor and patient partnership campaign.

The health secretary and the chairman of the General Medical Services Committee launched the patient education campaign earlier this year and £750 000 has been spent on advertising in the national press. Each health authority and health board has been allocated a further £20 000 to spend locally during 1996-7 in publicising out of hours initiatives and encouraging …
Leukaemia on myeloma.
Authors: S L Cohen, H Dodsworth, A G Whitelaw
Journal: BMJ (1971)

In a recent study of 1,263 children with acute leukaemia at the Children's Cancer Research Foundation in Boston we observed two patients with undifferentiated leukaemia and multiple neurofibromatosis.5This fre- quency is not significantly higher than the estimated incidence of neurofibromatosis in the general population (one case per 2,500- 3,300 births).2The association of neuro- fibromatosis with leukaemia has occurred in two other children in the same clinic (not in our series) and has been described in three case reports from France.3-5In one instance the combination of diseases affected siblings.4The eight reported cases of neurofibroma- tosis and childhood leukaemia are of great interest, but the evidence is not sufficient as yet to indicate that the high cancer risk in neurofibromatosis extends to leukaemia.-Iam, etc.,