tbuckley/cabot-search huggingface dataset:
From War Zone to Contact Zone: Culture and Refugee Mental Health Services
Authors: Stevan Weine
Journal: JAMA (2001)

Convention Relating to the Status of Refugees-as somebody who, "owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country." 1 Recent estimates suggest that there are approximately 50 million displaced persons worldwide, including internally displaced persons (who have not crossed international borders) and refugees. 2 Health care professionals engage with these populations in numerous ways, ranging from personal, clinical encounters with refugee patients to participation in international medical interventions.Good intentions and sound medical knowledge, however, are not sufficient to provide the health care required by this community of patients.With their history of displacement, persecution, fragmentation of cultural and familial structures, and violation of human rights, displaced persons have a more complicated biopsychosocial profile than most patients in the United States. 3 By becoming more aware of the various issues that affect members of displaced communities, health care providers may become better at confronting their acute and long-term health problems.Furthermore, the health care issues that apply to these populations may also apply to others who do not exactly fit the United Nations definition.Illegal residents or immigrants, those who have been internally displaced, and asylees who do not yet have official refugee status, for example, may benefit from the approaches and perspectives described for refugees.This issue of MS JAMA examines the special problems faced by refugees and displaced persons.Richard Mollica provides a model for how to incorporate the patient's trauma story into the primary care medical interview, so that this essential part of this story is not missed.Health care professionals must take into account the complicated perspectives of culture, human rights, and the ethical problems of international intervention.Stevan Weine proposes a more active engagement with the ramifications of culture in health care interventions, particularly as it pertains to the patient's family and local physicians.Alejandro Moreno and colleagues review the epidemiology of human rights violations in displaced populations and suggest how these might be addressed through the education of physicians and an awareness of human rights violations in the clinical encounter.Gina Jae interviews Philip Gourevitch, the author of We Wish to Inform You That Tomorrow We Will Be Killed With Our Families, a powerful and critical analysis of the genocide and refugee crises in Rwanda in 1994.Ferid Agani examines the mental health system of Kosova after the war and NATO interventions of 1999, focusing on the importance of recognizing local institutions in the rebuilding that goes on after such crises.
Secret detention violates human rights and should be banned, say UN experts
Authors: J. Zarocostas
Journal: BMJ (2010)

United Nations human rights experts have called for an end to the use of secret detention in connection with counterterrorism activities, including during states of emergency and in armed conflict. 

Their study on secret detentions in 66 nations found that detainees were often tortured and in some instances were examined by medical doctors, who allowed the abuses to continue.

Secret detention and related activities—including so called “proxy detention” and “rendition” or “extraordinary rendition”—have increased in numerous states over the nine years since 11 September 2001, say two independent UN experts on counterterrorism and torture and two UN expert bodies on arbitrary detention and enforced or involuntary disappearances. 

Violations carried out during secret detention breach international humanitarian law and the practice should be prohibited, they say in a report.

“If resorted to in a widespread or systematic manner, …
Phase I Trial of Temozolomide and Protracted Irinotecan in Pediatric Patients with Refractory Solid Tumors
Authors: Lars M. Wagner, Kristine R. Crews, Lisa C. Iacono, Peter J. Houghton, Christine E. Fuller, M. Beth McCarville, Robert E. Goldsby, Karen Albritton, Clinton F. Stewart, Victor M. Santana
Journal: Clinical Cancer Research (2004)

Abstract Purpose: The purpose is to estimate the maximum-tolerated dose (MTD) of temozolomide and irinotecan given on a protracted schedule in 28-day courses to pediatric patients with refractory solid tumors. Experimental Design: Twelve heavily pretreated patients received 56 courses of oral temozolomide at 100 mg/m2/day for 5 days combined with i.v. irinotecan given daily for 5 days for 2 consecutive weeks at either 10 mg/m2/day (n = 6) or 15 mg/m2/day (n = 6). We assessed toxicity, the pharmacokinetics of temozolomide and irinotecan, and the DNA repair phenotype in tumor samples. Results: Two patients experienced dose-limiting toxicity (DLT) at the higher dose level; one had grade 4 diarrhea, whereas the other had bacteremia with grade 2 neutropenia. In contrast, no patient receiving temozolomide and 10 mg/m2/day irinotecan experienced DLT. Myelosuppression was minimal and noncumulative. No pharmacokinetic interaction was observed. Drug metabolite exposures at the MTD were similar to exposures previously associated with single-agent antitumor activity. One complete response, two partial responses, and one minor response were observed in Ewing’s sarcoma and neuroblastoma patients previously treated with stem cell transplant. Responding patients had low or absent O6-methylguanine-DNA methyltransferase expression in tumor tissue. Conclusions: The MTD using this schedule was temozolomide (100 mg/m2/day) and irinotecan (10 mg/m2/day), with DLT being diarrhea and infection. Drug clearance was similar to single-agent values, and clinically relevant SN-38 lactone and MTIC exposures were achieved at the MTD. As predicted by xenograft models, this combination and schedule appears to be tolerable and active in pediatric solid tumors. Evaluation of a 21-day schedule is planned.
Haemodynamic Effects of Carotid Artery Stenosis
Authors: J. G. Brice, D. J. Brice, R. D. Lowe
Journal: BMJ (1964)

and for the detection of causal associations among these complex conditions.At the same time the study underlines the need to extend and refine available techniques of measurement.Even with carefully defined criteria of illness the wide variation between practitioners' prevalence rates points to two potent groups of factors.The first of these relates to the ecological differences between practices and can be offset by paying regard to the size and representativeness of the sample of participating doctors.The second relates to the doctor, his attitudes, and his interactions with his patients ; for psychiatric illness, as we have shown, they constitute a major source of variation. SummaryThis paper reports on a general practice survey of psychiatric morbidity carried out in the Greater London area.The sick- ness experience of nearly 15,000 patients on the lists of 80 practitioners was studied over a period of one year.It was shown that minor psychiatric disorders, classified according to a predetermined schema, were diagnosed in 14% of the population at risk.Neurotic illness was most prevalent among middle-aged females and proved to be an important cause of chronic illness.The reasons for interpractice variation in recorded morbidity are discussed.We are grateful to the following general practitioners, whose co- operation made this study possible.
Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study
Authors: D. D. Dunlop, J. Song, P. A. Semanik, L. Sharma, J. M. Bathon, C. B. Eaton, M. C. Hochberg, R. D. Jackson, C. K. Kwoh, W. J. Mysiw, M. C. Nevitt, R. W. Chang
Journal: BMJ (2014)

<b>Objective</b> To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. <b>Design</b> Prospective multisite cohort study from September 2008 to December 2012. <b>Setting</b> Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. <b>Participants</b> Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. <b>Main outcome measures</b> Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. <b>Results</b> Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. <b>Conclusion</b> These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of the knee or risk factors for knee osteoarthritis. An increase in daily physical activity time may reduce the risk of disability, even if the intensity of that additional activity is not increased.
Oesophageal motility in the irritable bowel syndrome.
Authors: P J Whorwell, C Clouter, C L Smith
Journal: BMJ (1981)

Oesophageal motility was assessed in 30 patients with the irritable bowel syndrome and controls matched for age and sex. Lower oesophageal sphincter pressure was significantly lower in the patients than their controls (mean pressures 13.8 and 23.8 cm H2O respectively), and the same degree of difference between patients and controls was maintained in all age groups. In addition, spontaneous activity, repetitive contractions, and the presence of variable-amplitude and simultaneous waves were significantly more common in the patients, who were also more likely to have more than one abnormal pattern of motility. There was no difference in upper oesophageal sphincter pressure between the two groups. These findings may help to explain why patients with the irritable bowel syndrome may complain of upper gastrointestinal symptoms, including heartburn and dysphagia. The results suggest that the syndrome may be a more widespread disorder of smooth muscle, or its innervation, than was previously thought.
Organ Transplantation: A Clinical Guide
Authors: David Axelrod
Journal: JAMA (2012)

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
Thermoregulation of exercising men in the morning rise and evening fall phases of internal temperature.
Authors: M Torii, H Nakayama, T Sasaki
Journal: British Journal of Sports Medicine (1995)

The purpose of this study was to compare the thermoregulatory responses during exercise in the morning rise (0900 h) and evening fall phases (2000 h) in circadian variation of body temperature. Five healthy volunteers performed bicycle exercises at 30% and 60% of maximal aerobic power (VO2max) at 26 degrees C with a relative humidity of 50%. Whole-body sweat rate (SR), rectal (Tre), mean skin (Tsk) and mean body (Tb) temperature, pulmonary ventilation (VE), oxygen uptake (VO2), and carbon dioxide output (VCO2) and heart rate (HR) were measured during the experimental period. SR during exercise at 30% VO2max was significantly higher at 2000 h than at 0900 h. However, the circadian variation of SR during exercise was not observed at 60% VO2max. At the two experimental times, there were also no significant differences in VO2, VCO2, VE and Tsk in both workloads. In HR, Tb and Tre circadian effects were demonstrated as well as in workload levels. As Tb was plotted against SR during exercise, positive correlations were observed. The data showed that there was a parallel shift in the SR to Tb relationship during exercise in the morning and evening. This rightward shift indicated that there was an increased Tb threshold for the onset of sweating in the evening. Resting Tb at 2000 h was significantly higher when compared with Tb at 0900 h. The present results suggest that the circadian influence on the thermoregulatory response to exercise may be evident only at low workloads.
Gadolinium chelate with DO3A conjugated 2-(diphenylphosphoryl)-ethyldiphenylphosphonium cation as potential tumor-selective MRI contrast agent
Authors: Prashant Chandrasekharan, Cai-Xian Yong, Zihan Poh, Tao He, Zhengjie He, Shuang Liu, Edward G. Robins, Kai-Hsiang Chuang, Chang-Tong Yang
Journal: Biomaterials (2012)
Intense F-18 FDG Accumulation in Stomach in a Patient with Hodgkin Lymphoma: Helicobacter pylori Infection as a Pitfall in Oncologic Diagnosis With F-18 FDG PET Imaging
Authors: Ilknur Ak, Zafer G??lba??
Journal: Clinical Nuclear Medicine (2004)

Helicobacter pylori is a Gram-negative, spiral rod that has been proved to be responsible for chronic antral gastritis. H. pylori infection is the most common chronic infection in humans and is the major cause of gastritis worldwide. This infection is also accepted as the etiologic factor of the majority of peptic ulcers, and has been associated with atrophic gastritis, gastric carcinoma and nonulcer dyspepsia. The authors present F-18 FDG images in a patient with stage IV anaplastic large cell-like Hodgkin lymphoma (HL) that show intense accumulation of F-18 FDG in the stomach that is likely to indicate a malignant disease of the stomach. Histopathologic examination of gastric biopsy specimens obtained by endoscopy revealed chronic atrophic gastritis. The presence of H. pylori was determined histologically. There was no evidence of involvement of HL in the stomach.
A Statistical Characterization of Consistent Patterns of Human Immunodeficiency Virus Evolution Within Infected Patients
Authors: Scott Williamson, Steven M. Perry, Carlos D. Bustamante, Maria E. Orive, Miles N. Stearns, John K. Kelly
Journal: Molecular Biology and Evolution (2004)

Within-patient HIV populations evolve rapidly because of a high mutation rate, short generation time, and strong positive selection pressures. Previous studies have identified "consistent patterns" of viral sequence evolution. Just before HIV infection progresses to AIDS, evolution seems to slow markedly, and the genetic diversity of the viral population drops. This evolutionary slowdown could be caused either by a reduction in the average viral replication rate or because selection pressures weaken with the collapse of the immune system. The former hypothesis (which we denote "cellular exhaustion") predicts a simultaneous reduction in both synonymous and nonsynonymous evolution, whereas the latter hypothesis (denoted "immune relaxation") predicts that only nonsynonymous evolution will slow. In this paper, we present a set of statistical procedures for distinguishing between these alternative hypotheses using DNA sequences sampled over the course of infection. The first component is a new method for estimating evolutionary rates that takes advantage of the temporal information in longitudinal DNA sequence samples. Second, we develop a set of probability models for the analysis of evolutionary rates in HIV populations in vivo. Application of these models to both synonymous and nonsynonymous evolution affords a comparison of the cellular-exhaustion and immune-relaxation hypotheses. We apply the procedures to longitudinal data sets in which sequences of the env gene were sampled over the entire course of infection. Our analyses (1) statistically confirm that an evolutionary slowdown occurs late in infection, (2) strongly support the immune-relaxation hypothesis, and (3) indicate that the cessation of nonsynonymous evolution is associated with disease progression.
HEMORRHAGIC PAPILLARY NECROSIS OF THE KIDNEY
Authors: H. T. Tamaki
Journal: JAMA (1952)

Acute renal papillary necrosis is a relatively infrequently encountered condition. A perusal of the literature reveals the condition to be most commonly found in diabetic patients, with a few cases reported in older persons with some type of obstructive uropathy. The majority of patients in which this pathological condition was found were in the sixth or seventh decade. The youngest patient we encountered was an 18-year-old girl, in whom the lesion developed postpartum. 1 Careful search of the American literature failed to disclose an occurrence in infants. The purpose of this paper is to report a case of hemorrhagic papillary renal necrosis in a 2-month-old infant.  Most writers consider the condition to be a form of pyelonephritis. The striking predominance of its occurrence among diabetics was emphasized in a report by Robbins and co-workers. 2 Of 26 cases of necrotizing papillitis found at autopsy, 19 were in diabetics. The remainder
Sternocostoclavicular Hyperostosis: Painful Swelling of the Sternum, Clavicles, and Upper Ribs
Authors: H. KÖHLER
Journal: Annals of Internal Medicine (1977)

Five patients had persistent, pulling pain in the sternum, clavicles, and upper ribs that was exacerbated by cold and dampness. Clublike, symmetrical enlargement of the clavicles was seen and, in two patients, venous congestion of the upper half of the body. All patients had a constantly elevated erythrocyte sedimentation rate. Radiologically there was symmetrical hyperostosis of the sternal and middle portions of the clavicles, synostosis of the sternoclavicular joints, a widened and thickened sternum, and varying degrees of involvement of the upper ribs. X-ray findings did not change over several years. Phlebography showed bilateral subclavian vein occlusion in three patients and unilateral occlusion in one. Biopsies of the clavicles showed a characteristic hyperostotic sclerosis of the spongiosa. The cause of this sternocostoclavicular hyperostosis is unknown, but clinical, radiologic, and histologic findings indicate that it may represent a distinct, hitherto undescribed entity.
Differential Effects of Anticoagulants on the Activation of Platelets Ex Vivo
Authors: David J. Schneider, Paula B. Tracy, Kenneth G. Mann, Burton E. Sobel
Journal: Circulation (1997)

Background Because activation of platelets and of the coagulation system are interdependent mediators of thrombosis, platelet activation was characterized in whole blood in the presence of anticoagulants used to assess platelet function in vitro or as treatment for patients with occlusive arterial disease. Methods and Results Blood was anticoagulated alone or in combination with citrate, ethylenediaminetetraacetatic acid, corn trypsin inhibitor (CTI, an inhibitor of activated factor XII), heparin, enoxaparin, recombinant tick anticoagulant peptide (rTAP), or recombinant hirudin. Platelet activation in response to adenosine diphosphate (ADP) or collagen was detected by assay of P-selectin on the platelet surface delineated by flow cytometry. Although minimal activation was seen without ADP, the fraction of platelets expressing P-selectin in response to ADP was greatest in blood anticoagulated with citrate compared with CTI and all other anticoagulants. ADP-induced platelet activation was greater in blood anticoagulated with heparin compared with an equipotent anti-Xa concentration of enoxaparin. More variable results were seen with collagen, but platelet activation in the presence of citrate was greater than that with CTI. Conclusions Interpretation of assays of inhibition of platelet activation by potentially therapeutic agents in vitro requires consideration of the effects of anticoagulants used. In addition, anticoagulants other than standard heparin may potentiate efficacy of antiplatelet drugs.
MRCP (UK) part II
Authors: J. Crofton, F. Anderson, C. A Clarke
Journal: BMJ (1975)

Recognized risk factors for metrizamide myelography are seizure disorder, seizurethreshold-lowering drugs, dehydration, and possibly age. After observing serious neurologic complications in diabetic patients after routine metrizamide myelography, a retrospective study was conducted to determine if diabetes should be considered another independent and important risk factor. Forty-one diabetic patients who had lumbar metrizamide myelograms were compared with a control group of 110 nondiabetic patients. A significantly higher incidence was found of severe vomiting (15% vs. 3%, <i>P</i> &lt; 0.01) and neurologic complications (20% vs. 2%, <i>P</i> &lt; 0.001) in the diabetic population. Neurologic complications included one case each of seizure, severe encephalopathy, auditory and visual hallucinations, and prolonged somnolence and four cases of confusion-anxiety. Four of the diabetic patients had major transient elevations of blood pressure. These findings suggest that diabetics are a high-risk population for metrizamide myelography. The dose of metrizamide should be minimized, whenever possible. The new nonionic myelographic agents may prove to be safer in this population, but caution and careful follow-up should be exercised in the initial trials with these patients.