tbuckley/cabot-search huggingface dataset:
Reconfiguration of surgical, emergency, and trauma services
Authors: Patrick M Trust
Journal: BMJ (2004)

Screening without evidence of efficacy Thyroid ultrasonography is another exampleEditor-I agree with Law's view of screening, that screening of unproved value should not be advocated. 1 As a clinical endocrinologist I often have to deal with patients' anxieties about non-palpable incidental findings on thyroid ultrasonography, often performed for wrong or unjustified reasons.Sometimes patients arrive with already established surgical complications after unnecessary thyroid operations.Although a substantial number of incidental thyroid nodules may be histologically malignant, 2 their clinical importance has never been proved.A recent preliminary study indicates that the progression rate of non-palpable proved thyroid malignant nodules to clinically significant lesions may be very low. 3 Thyroid ultrasonography is an additional example of an often used, often non-efficacious screening modality that may lead to "cascade iatrogenesis." 4
A Theme Issue on Infectious Disease and Immunology—Call for Papers
Authors: Gianna Zuccotti
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
Effect of Propranolol on Exercise Tolerance of Patients with Atrial Fibrillation
Authors: R. W. Brown, A. J. Goble
Journal: BMJ (1969)

Six patients with atrial fibrillation who were taking digitalis were exercised before and after 30 mg. of propranolol twice daily. Though there was a lower pulse rate at rest and on exercise in all patients, three suffered deterioration of exercise tolerance. It is concluded that propranolol does not improve the exercise tolerance of patients with atrial fibrillation whose resting ventricular rate is controlled with digitalis.
General practice obstetrics in Bradford
Authors: J. Danby, K. Simmons
Journal: BMJ (1990)

SIR,-As two general practitioners in Bradford who are actively concerned in providing maternity care we would like to comment on the paper by Dr F C Bryce and colleagues on general practitioner obstetrics in Bradford.'We have worked in Bradford in different practices for two years and one year respectively.We both have experience of schemes of community antenatal care in Hackney and Tower Hamlets that are looselv based on the Sighthill model.2We are convinced that such schemes succeed because of cooperation between hospital and community staff, which results from the development and implementation of agreed protocols for maternity care.In contrast we found that the lack of any such protocols in Bradford and the poor communication among colleagues created a sense of isolation among general practitioner obstetricians.We were first aware of the paper by Dr Brvce and colleagues in September 1989, when an earlier draft was circulated to local general practitioners.There was no general practitioner or midwife participation in the preparation of the paper.Its tone was felt by many general practitioners to be admonitory and divisive.Trhere was an immediate response bv general practitioners in Bradford, manv of whom wrote letters to the local medical committee, which prepared a paper in response.No further communication occurred until the obstetricians' paper, slightly modified, appeared in the BM7, almost six months after we had first seen it.As far as we are aware no account had been taken of the large response from general practitioners that it had generated.The thrust of our response to the original paper was that the key to better maternity care in Bradford is good communication and cooperation among all those concerned: consumers, midwives, general practitioners, and consultants.We regret the style of the paper and would question its scientific validity in view of the small numbers studied.Nevertheless, we welcome the opening up of the debate and hope that it may be possible to move the discussion out of the hospital and into the community.Specifically, we propose that consul- tants should come into the community clinics on a regular basis.This would lead to improved communication.Consultants would share their expertise and provide continuing clinical advice and education.Midwives and general practitioners would benefit from the support provided by such contact, and, above all, the women of Bradford would benefit from expert, well planned, locally based maternity care.
INTUBATION IN PRIVATE PRACTICE. AND ITS PERFECTION.
Authors: J. TRUMPP
Journal: JAMA (1901)

You probably know that intubation was formerly received in Europe with great reserve, and also that the ingenious operation of O'Dwyer is practiced at the present time only by our clinicians. The reason why our practitioners have not much inclination for the endo-laryngeal method is, that, being so conservative, they in this case apprehend that intubation is an operation immensely difficult to learn, and accompanied by a great number of dangers. One who is experienced in the matter knows that these apprehensions are exaggerated, that intubation is not at all more dangerous than tracheotomy, and that its sphere ought not to be limited to the hospital. But prejudices of that kind, if they once exist, will not be removed by the reports of single persons, however splendid they might be, but only by extensive, thoroughly authenticated statistics. In the summer of 1899 I took the trouble to procure data concerning
Irish ombudsman chides doctors on poor record keeping
Authors: D. Payne
Journal: BMJ (2001)

The Irish ombudsman has given doctors a stinging rebuke over poor record keeping and lack of cooperation over patients' complaints.

Kevin Murphy, testifying recently before a legislative committee, singled out dismissive doctors and missing notes in his tackling of complaints. He said he found that doctors and consultants “do not engage wholeheartedly with patients' complaints” and that medical record keeping was sometimes “atrocious,” with notes not written up until his office began an investigation.

“Complaint-handling is invariably seen by medical staff as very …
Get Set to Jet
Authors: G. G. Liddle
Journal: JAMA (1972)

To the Editor.—  There you are, flying first class from here to there at some unbelievable altitude and speed. Why first class? Because you know you like first class. It's more comfortable, better serviced, and, being with your wife, you can sit without the intrusion of a stranger. Your wife enjoys talking to strangers; you don't.  After two miniatures of your favorite tonic comes a delectable dinner served, as usual, on a doggie dish. Oh, the steak's a little dry—no sauce Bordelaise, and the essence has been soaked up by an underlying sliver of rye bread. Otherwise, the meal is sumptuous—more than you can or dare eat.  Of course, it's not like travel used to be when there were no pressurized jets. Then there were trains, and what trains they were! Remember the Capitol Limited, Baltimore to Chicago, but not first rate until the main section was added at Washington—
Raw Single-Wall Carbon Nanotubes Induce Oxidative Stress and Activate MAPKs, AP-1, NF-κB, and Akt in Normal and Malignant Human Mesothelial Cells
Authors: Maricica Pacurari, Xuejun J. Yin, Jinshun Zhao, Ming Ding, Steve S. Leonard, Diane Schwegler-Berry, Barbara S. Ducatman, Deborah Sbarra, Mark D. Hoover, Vincent Castranova, Val Vallyathan
Journal: Environmental Health Perspectives (2008)

Single-wall carbon nanotubes (SWCNTs), with their unique physicochemical and mechanical properties, have many potential new applications in medicine and industry. There has been great concern subsequent to preliminary investigations of the toxicity, biopersistence, pathogenicity, and ability of SWCNTs to translocate to subpleural areas. These results compel studies of potential interactions of SWCNTs with mesothelial cells.Exposure to asbestos is the primary cause of malignant mesothelioma in 80-90% of individuals who develop the disease. Because the mesothelial cells are the primary target cells of asbestos-induced molecular changes mediated through an oxidant-linked mechanism, we used normal mesothelial and malignant mesothelial cells to investigate alterations in molecular signaling in response to a commercially manufactured SWCNT.In the present study, we exposed mesothelial cells to SWCNTs and investigated reactive oxygen species (ROS) generation, cell viability, DNA damage, histone H2AX phosphorylation, activation of poly(ADP-ribose) polymerase 1 (PARP-1), stimulation of extracellular signal-regulated kinase (ERKs), Jun N-terminal kinases (JNKs), protein p38, and activation of activator protein-1 (AP-1), nuclear factor kappaB (NF-kappaB), and protein serine-threonine kinase (Akt).Exposure to SWCNTs induced ROS generation, increased cell death, enhanced DNA damage and H2AX phosphorylation, and activated PARP, AP-1, NF-kappaB, p38, and Akt in a dose-dependent manner. These events recapitulate some of the key molecular events involved in mesothelioma development associated with asbestos exposure.The cellular and molecular findings reported here do suggest that SWCNTs can cause potentially adverse cellular responses in mesothelial cells through activation of molecular signaling associated with oxidative stress, which is of sufficient significance to warrant in vivo animal exposure studies.
Delayed Postconditioning in the Mouse Heart In Vivo
Authors: François Roubille, Alicia Franck-Miclo, Aurélie Covinhes, Chrystel Lafont, Frédéric Cransac, Stéphane Combes, Anne Vincent, Pierre Fontanaud, Catherine Sportouch-Dukhan, Christelle Redt-Clouet, Joël Nargeot, Christophe Piot, Stéphanie Barrère-Lemaire
Journal: Circulation (2011)

Background— Reperfusion during acute myocardial infarction remains the best treatment for reducing infarct size. Postconditioning, applied at the onset of reperfusion, reduces myocardial infarction both in animals and humans. The objective of this study was to identify the time delay to apply postconditioning at reperfusion, allowing preservation of cardioprotection in the mouse myocardium. This is a major issue in the management of acute myocardial infarction patients. Methods and Results— Mice were subjected to 40 minutes of ischemia and 60 minutes of reperfusion (IR 60′ ). Postconditioning protocols corresponding to repetitive ischemia (3 cycles of 1 minute of ischemia and 1 minute of reperfusion) were applied during early reperfusion at various time durations (Δt) after reopening of the coronary artery (Δt=10 seconds, 1, 5, 10, 15, 20, 30, and 45 minutes; PostC Δt ). Infarct size/area at risk was reduced by 71% in PostC Δ1 compared with IR 60′ mice ( P =5×10 −6 ). There was a linear correlation ( r 2 =0.91) between infarct size and Δt, indicating that the cardioprotective effect of delayed postconditioning was progressively attenuated when Δt time increased. The protective effect of PostC Δ1 and PostC Δ15 was still effective when the duration of reperfusion was prolonged to 24 hours (IR 24 hours ; PostC Δ1 and PostC Δ15 versus IR 24 hours , P =0.001). Similar results were obtained for internucleosomal DNA fragmentation and lactate dehydrogenase release. Conclusions— This study in our in vivo mouse model of myocardial IR shows for the first time that delaying the intervention of postconditioning to 30 minutes does not abrogate the cardioprotective effect of postconditioning. This finding provides evidence that the time window of protection afforded by postconditioning may be larger than initially reported.
CONGENITAL MEGACOLON WITH ABSENCE OF VAGINA
Authors: H. Hartley
Journal: BMJ (1925)

PANNICULITIS.r THF BRITI 451 affected, and, if both sides are attacked, the left is generally the worse), the costal margins, the abdomeni, and over the fascia lata.Very occasionally patches may be found in otlher localities, but, apart from the fascia lata, as a ruile they are confined to the trunk.Stockmaui's descriiption of the imiicroscopical appearance is as follows:" Tlle fibrous tissue is fouind to be thicker and denser than
Stellate Nonhereditary Idiopathic Foveomacular Retinoschisis
Authors: Michael D. Ober, K. Bailey Freund, Manthan Shah, Shareef Ahmed, Tamer H. Mahmoud, Thomas M. Aaberg, David N. Zacks, Hua Gao, Krishna Mukkamala, Uday Desai, Kirk H. Packo, Lawrence A. Yannuzzi
Journal: Ophthalmology (2014)
Abstract 432: Differences in molecular background of colorectal liver and lung metastases
Authors: Nikki Knijn, Simone van Lin, Elisa Vink-Borger, Shannon van Vliet, Leonie Mekenkamp, Sietske Riemersma, Maria Tebar, Marjolein Klomp, Jos Meijer, Steven Teerenstra, Kees Punt, Iris Nagtegaal
Journal: Cancer Research (2012)

Abstract BACKGROUND: Mutations in the KRAS oncogene occur in 30-60% of the patients with colorectal cancer (CRC). Constitutively activation of the KRAS protein leads to growth, proliferation, and survival of CRC cells. KRAS mutation is an early event during colorectal carcinogenesis, therefore all tumor cells including metastatic cells are expected to have the same mutation status. We investigated the KRAS mutation status in primaries and metastatic tissue of patients with liver and lung metastasis. METHODS: Patients with histological confirmed CRC who underwent surgical resection of the primary tumor and biopsy or surgical resection of the corresponding liver (n = 304) or lung metastasis (n = 90) were included. KRAS mutation analysis was performed for codons 12 and 13 using sequencing analysis. We used Next Generation Sequencing (NGS) to further evaluate a patient with a discordance in KRAS mutation status between the primary and metastasis. RESULTS: KRAS mutations were detected in 35.3% of the 304 primary tumors with liver metastases. In 11 cases (3.6%), we found a discordance between primary tumor and metastasis: 5 primary tumors had a KRAS mutation with a wild-type metastasis, 1 primary tumor was wild type with a KRAS mutation in the metastasis, and in 5 cases the primary tumor and the metastasis had a different KRAS mutation. NGS of the patient with a wild type primary tumor and a KRAS mutation in the liver metastases revealed a KRAS mutation in 7.5% of the primary tumor cells. KRAS mutations were detected in 46.7% of the 90 primary tumors with lung metastases. The KRAS mutation frequency in lung metastases was 55.6%. A discordance in KRAS mutation status between primary tumors and metastasis was observed in 8 cases (8.9%). In all these patients the primary tumors had a KRAS wild-type while the lung metastasis showed a KRAS mutation. CONCLUSION: We observed a higher KRAS mutation frequency in primary CRC with lung metastases compared to primary CRC with liver metastases (p=0.038). Increased discordance in the lung metastases might indicate that these originate in very small subclones of the primary. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 432. doi:1538-7445.AM2012-432
Poor People and the Medical-Care Crises
Authors: James J. Callahan
Journal: New England Journal of Medicine (1972)

The current crisis in medical care is described usually in terms of lack of access, fragmented services, maldistribution of facilities and personnel, and escalating costs. Proposed solutions discussed include health-maintenance organizations, economic incentive systems, manpower development and national health insurance. The dialogue, or shouting match, generated by these issues includes health providers, academics, and governmental bureaucrats.Each health-provider group seeks to expand its influence over new developments and to protect its vital interests. The academic group attempts to introduce research and rationality into the discussion, as well as to expand its opportunities for health research. The governmental bureaucrats strive to . . .
Clinical significance of cardiac troponins I and T in acute heart failure
Authors: Tuomo Ilva, Johan Lassus, Krista Siirilä‐Waris, John Melin, Keijo Peuhkurinen, Kari Pulkki, Markku S. Nieminen, Harri Mustonen, Pekka Porela, Veli‐Pekka Harjola
Journal: European Journal of Heart Failure (2008)
Stability is not intrinsic
Authors: D. C. Dennett, C. F. Westbury
Journal: Behavioral and Brain Sciences (1999)

A pure vehicle theory of the contents of consciousness is not possible. While it is true that hard-wired tacit representations are insufficient as content vehicles, not all tacit representations are hardwired. O'Brien &amp; Opie's definition of stability for patterns of neural activation is not well-motivated and too simplistic. We disagree in particular with the assumption that stability in a network is purely intrinsic to that network. Many complex forms of stability in a network are apparent only when interpreted by something external to that network. The requirement for interpretation introduces a necessary functional element into the theory of the contents of consciousness, suggesting that a pure vehicle theory of those contents will not succeed.
Serum carbohydrate-deficient transferrin: Mechanism of increase after chronic alcohol intake
Authors: Yan Xin, Jerome M. Lasker, Charles S. Lieber
Journal: Hepatology (1995)

Carbohydrate-deficient transferrin (CDT) is now considered to be the most sensitive and specific biological marker of alcohol abuse. However, the mechanism by which chronic alcohol consumption causes an elevation of CDT levels in serum is still not understood. Therefore, we fed eight pairs of male rats a nutritionally adequate liquid diet containing either alcohol (36% of energy) or isocaloric dextrose (control) for 4 weeks, after which blood and liver samples were obtained. Serum CDT content in alcohol-treated rats increased by 45% (P < .05) in ethanol-fed animals compared with their corresponding controls. In contrast, in rats fed ethanol, the activities of sialyltransferase (ST), galactosyltransferase (GT), and N-acetylglucosamine transferase (N-AGT), which are glycosyltransferases involved in transferrin carbohydrate side chain synthesis, were diminished by 24% and 40% (P < .05), 23% and 51% (P < .05, .001), and 20% and 26% (P < .05) in total liver homogenates and Golgi fraction (GF) 1, respectively, when expressed as units/100 g body weight. These enzymes were also significantly less active in hepatic GFs 2 and 3. The depression of the transferase activities in ethanol-fed rats appeared to be due, at least in part, to enzyme inactivation by acetaldehyde, whereas ethanol itself was without effect. Similar results were obtained in humans: five alcohol abusers were found to exhibit a 23% decrease in hepatic sialyltransferase and a 41% increase in sialidase activities, respectively, when compared with three nondrinking subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Reviews and Notes: The Erosion of Autonomy in Long-Term Care
Authors: Frederick R. Abrams
Journal: Annals of Internal Medicine (1994)

Literature of Medicine15 January 1994Reviews and Notes: The Erosion of Autonomy in Long-Term CareFrederick R. Abrams, MDFrederick R. Abrams, MDUniversity of Colorado, Denver, CO 80206Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-2-199401150-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Erosion of Autonomy in Long-Term CareCharles W. Lidz, Lynn Fischer, and Robert M. Arnold. 195 pages. New York: Oxford University Press; 1992. $37.95.The autonomy of persons admitted to long-term care facilities is often diminished by the very need to seek institutional lodging. Indeed, this is usually less than an autonomous choice. Through their depiction of institutional life, the authors of this book show further erosion of autonomy. They describe a research project that examines the fate of patients in nursing homes and independent residents of one such facility, scrutinizing the factors influencing autonomy.What is autonomy and ... Author, Article, and Disclosure InformationAffiliations: University of Colorado, Denver, CO 80206 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1994Volume 120, Issue 2Page: 173-174KeywordsBehaviorElderlyHealth promotionLong-term careMedical staffNursing homesSafety ePublished: 15 August 2000 Issue Published: 15 January 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Learning-based prediction of gestational age from ultrasound images of the fetal brain
Authors: Ana I.L. Namburete, Richard V. Stebbing, Bryn Kemp, Mohammad Yaqub, Aris T. Papageorghiou, J. Alison Noble
Journal: Medical Image Analysis (2015)

We propose an automated framework for predicting gestational age (GA) and neurodevelopmental maturation of a fetus based on 3D ultrasound (US) brain image appearance. Our method capitalizes on age-related sonographic image patterns in conjunction with clinical measurements to develop, for the first time, a predictive age model which improves on the GA-prediction potential of US images. The framework benefits from a manifold surface representation of the fetal head which delineates the inner skull boundary and serves as a common coordinate system based on cranial position. This allows for fast and efficient sampling of anatomically-corresponding brain regions to achieve like-for-like structural comparison of different developmental stages. We develop bespoke features which capture neurosonographic patterns in 3D images, and using a regression forest classifier, we characterize structural brain development both spatially and temporally to capture the natural variation existing in a healthy population (N=447) over an age range of active brain maturation (18–34 weeks). On a routine clinical dataset (N=187) our age prediction results strongly correlate with true GA (r=0.98,accurate within±6.10days), confirming the link between maturational progression and neurosonographic activity observable across gestation. Our model also outperforms current clinical methods by ±4.57 days in the third trimester—a period complicated by biological variations in the fetal population. Through feature selection, the model successfully identified the most age-discriminating anatomies over this age range as being the Sylvian fissure, cingulate, and callosal sulci.