tbuckley/cabot-search huggingface dataset:
ONE THOUSAND UNSUCCESSFUL CAREERS
Authors: A. WARREN STEARNS, ALBERT D. ULLMAN
Journal: American Journal of Psychiatry (1949)

Since time immemorial society has dealt with the problem of poverty on a moral basis. Success has been honorific and failure ignominious, and so handicapped persons failing to make the social grade have been judged by the method of moral evaluation. The terms "lazy," "improvident," "vicious" have been used as terms of reproach. Each advance in civilization has led to a changed technique in dealing with human failures; but in general, all have tended to attribute the squalid condition of the poor to individual qualities. Latterly there has been a change in attitude. There has been more solicitude for the common man and his welfare and less willingness to allow avarice and greed to go unchecked. The tendency has been away from scrutiny of the individual and toward scrutiny of social organization. Sociologists in particular have attributed the plight of handicapped classes to social disorganization, and vast plans have been made for their relief, with very little information concerning the personality of the individuals involved. Medicine has a place in the social sciences and psychiatry is, in a way, the social wing of the medical profession. For this reason it seemed important to make a critical survey of a substantial number of welfare recipients with a view to determining what their personal qualities and their personal problems were. Our study involved 1,000 admissions to a large state institution, formerly called a workhouse, latterly called a hospital. It has been a reconnaissance study and therefore exact measurements did not seem applicable. At any rate, the preliminary study was made by examination of the natural history of the organism; that is, what has been the record in functional terms of the trajectories of these persons' lives? The results are simple. The individuals show an excess of immigrants; a deficit in formal education, in occupational skill, and in marital success. We do not find a preponderance of catastrophic illness, but we do find alcohol to have been an important factor in the failure of these individuals to make a successful adaptation. Our experience indicates the need of further psychiatric inquiry into this field, as the techniques of psychiatry seem to be peculiarly applicable. The data suggest the possibility of poverty often being secondarily economic and primarily either due to chronic illness or behavior disorder.
Smoking habits and inflammatory bowel disease: effect on nutrition.
Authors: A D Harries, L Jones, R V Heatley, J Rhodes
Journal: BMJ (1982)

cyclophosphamide had any beneficial effect in the treatment of lupus nephritis.It would seem unjustifiable, therefore, to continue its use in this condition.In other autoimmune conditions and malignant disease we suggest carefully controlled trials of cyclophosphamide, assessing its benefits in each condition, and taking into account the long-term risks before it is accepted as standard treatment.Follow-up of patients who have already received the drug should be of long duration.Symptoms of cystitis-frequency and dysuria, with or without haematuria or bacteriuria-should be taken seriously, as they are common presenting features of carcinoma of the bladder and assume even more importance in patients who have received cyclophosphamide.A skeleton regimen with individual variations would include six- monthly visits with urological history, urine microscopy, culture, and cytology.If there is a positive response intravenous urography should be performed and, when indicated, cystoscopy.The patient should be advised not to await the next six-monthly appointment if symptoms develop but to report at the earliest opportunity.
Long-Term Prostacyclin for Pulmonary Hypertension With Associated Congenital Heart Defects
Authors: Erika Berman Rosenzweig, Diane Kerstein, Robyn J Barst
Journal: Circulation (1999)

Background —Although long-term prostacyclin (PGI2) has been shown to improve hemodynamics, quality of life, and survival in patients with primary pulmonary hypertension, its use in patients with pulmonary hypertension (PHT) and associated congenital heart defects (CHD) has not been evaluated. Methods and Results —Twenty patients (15±14 years) with PHT and associated CHD (9 atrial septal defect, 7 ventricular septal defect, 4 transposition of the great vessels, 3 patient ductus arteriosus, 3 partial anomalous pulmonary venous return, and 1 aortopulmonary window) who failed conventional therapy (including digitalis; diuretics; oxygen; warfarin; calcium channel blockade, if indicated; and surgery, if operable) were treated with chronic PGI2. Eleven patients had previous cardiac surgery at a median age of 3 years (range, 5 days to 47 years). Eleven of 20 patients had residual systemic to pulmonary shunts. Hemodynamics, NYHA functional class, and exercise capacity were measured at baseline and after 1 year of PGI2 therapy. None of the patients acutely responded to PGI2 administration. Despite lack of an acute response, mean pulmonary artery pressure decreased 21% on chronic PGI2: 77±20 to 61±15 mm Hg ( P &lt;0.01, n=16). Cardiac index and pulmonary vascular resistance also improved on long-term PGI2: 3.5±2.0 to 5.9±2.7 L · min −1 · m −2 ( P &lt;0.01, n=16), and 25±13 to 12±7 U · m 2 ( P &lt;0.01, n=16), respectively. NYHA functional class improved from 3.2±0.7 to 2.0±0.9 ( P &lt;0.0001, n=19). Exercise capacity increased from 408±149 to 460±99 m ( P =0.13, n=14) on long-term PGI2. Conclusions —Chronic PGI2 improves hemodynamics and quality of life in patients with PHT and associated CHD who fail conventional therapy. As previously demonstrated in patients with primary pulmonary hypertension, long-term PGI2 may have an important role in the treatment of patients with PHT and associated CHD.
Commentary: Risks of doing as the Romans do
Authors: M. Tremblay
Journal: BMJ (2009)

Garattini and Chalmers (doi:10.1136/bmj.b1025) make four suggestions to improve the evaluation of drugs—involve patients in establishing research priorities, improve the transparency of drug evaluations and studies, fund independent drug evaluations, and require evidence that new drugs have added clinical value. Although controversial, many of their proposals would benefit patients. However, their suggestion to follow the Italian approach to funding independent clinical trials is unlikely to be a good idea.

In 2003, Italy decided to establish a tax on the drug industry of 5% of their medicines advertising budget. This money is used by the state medicines agency, AIFA, to fund clinical research on the efficacy of orphan drugs, comparisons of drugs for the same indication, observational outcome studies, and pharmacovigilance.1 2

We …
Aggravation of Diabetic Hyperglycemia by Chlordiazepoxide
Authors: Barnett Zumoff
Journal: JAMA (1977)

The administration of chlordiazepoxide hydrochloride, 40 mg daily, aggravated the hyperglycemia in an insulin-dependent, maturity-onset diabetic woman, raising the fasting blood glucose values from 220 mg/100 ml to 380 mg/100 ml. Review of the literature shows that virtually all psychoactive drugs affect diabetes; most tranquilizers aggravate diabetic hyperglycemia, while most antidepressants ameliorate it. The effect described in this communication is of clinical importance because of the widespread use of the benzodiazepine tranquilizers. (<i>JAMA</i>237:1960-1961, 1977)
Screening is effective in early detection of ovarian cancer
Authors: J. Wise
Journal: BMJ (2009)

Population screening for ovarian cancer is feasible and can detect tumours at an early stage, preliminary results from a large randomised controlled UK trial show ( Lancet Oncology 2009 Mar 11, doi:10.1016/S1470-2045(09)70026-9). However, the screening tests missed about 10% of cases of ovarian cancer, and some women had surgery for suspected cancer when they were, in fact, healthy.

The UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) involves more than 200 000 women. The full mortality results will not be released until 2014, but the results of the preliminary screening have been published. 

The preliminary screening detected 84 primary ovarian and three tubal cancers. Almost half of the cancers detected were at an early stage (I or II). However, 13 ovarian cancers were missed and were diagnosed clinically in the ensuing year.

Ian Jacobs, director of UKCTOCS and of the University College London Institute for Women’s Health, said, “We have shown that it is possible to detect the majority of women with ovarian cancer before they show symptoms of the disease. This is …
Graduate Medical Education, 2011-2012
Authors: Sarah E. Brotherton, Sylvia I. Etzel
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
Trex1 regulates lysosomal biogenesis and interferon-independent activation of antiviral genes
Authors: Maroof Hasan, James Koch, Dinesh Rakheja, Asit K Pattnaik, James Brugarolas, Igor Dozmorov, Beth Levine, Edward K Wakeland, Min Ae Lee-Kirsch, Nan Yan
Journal: Nature Immunology (2012)
Role of nitric oxide in hematosuppression and benzene-induced toxicity.
Authors: D L Laskin, D E Heck, C J Punjabi, J D Laskin
Journal: Environmental Health Perspectives (1996)

It is becoming increasingly apparent that nitric oxide plays a multifunctional role in regulating inflammatory processes in the body. Although nitric oxide and its oxidation products are cytotoxic toward certain pathogens, they can also cause tissue injury and suppress proliferation. Cytokines and growth factors released at sites of inflammation or injury stimulate both immune and nonimmume cells to produce nitric oxide. Nowhere in the body is this more detrimental than in the bone marrow, for the continuous production of hematopoietic precursors is essential for normal blood cell maturation. Our laboratories have discovered that, in response to inflammatory mediators, bone marrow cells readily produce nitric oxide. Nitric oxide production is enhanced by hematopoietic growth factors including interleukin-3, macrophage colony stimulating factor, and granulocyte-macrophage colony-stimulating factor. When bone marrow cells produce nitric oxide, hematopoiesis is impaired, an effect that is potentiated by colony-stimulating factors. Treatment of mice with benzene, which suppresses bone marrow cell development, was found to markedly enhance the ability of bone marrow cells to produce nitric oxide in response to inflammatory mediators alone and in combination with hematopoietic growth factors. Taken together, these data suggest that nitric oxide may be an important mediator of benzene-induced bone marrow suppression.
Abstract P3-10-17: The Fractal Analysis of Tumor Histology Is an Independent Prognostic Factor in Breast Cancer Patients
Authors: A Magliocco, M Eliasziw, M Tambasco
Journal: Cancer Research (2010)

Abstract Background: Despite the usefulness of standard clinical prognosticators for breast cancer patients, recommendations for systemic adjuvant therapy are not entirely straightforward. Hence, there is a need for a more accurate independent prognosticator that provides additional information to improve risk assessment and associated therapeutic decisions. Methods: We used fractal dimension analysis to quantitatively assess the morphologic complexity of breast epithelium. To investigate the relationship between fractal dimension and patient survival we applied fractal analysis to pan-cytokeratin stained tissue microarray (TMA) cores derived from a series of 408 patients with over 10 years follow up, and analyzed three TMA cores for each patient. A data-oriented approach was used to stratify patients according to low (&amp;lt;1.56), intermediate (1.56-1.75), and high (&amp;gt;1.75) fractal dimension. Univariate statistical analyses were performed to show the relationship between outcome and fractal dimension, tumour size, tumour grade, lymph node status, estrogen receptor status, and HER-2/neu status. Multivariate analysis was performed to assess the relative effect of these prognosticators on disease-specific and overall survival. Results: Patients with higher fractal score had significantly lower disease-specific 10-year survival (69.4%, 56.4%, and 25.0%, for low, intermediate, and high fractal dimension, respectively, P&amp;lt;0.001). Overall 10-year survival showed a similar association with fractal dimension. Cox regression analysis showed fractal dimension, lymph node status, and grade to be the only significant (P&amp;lt;0.05) independent predictors for both disease-specific and overall survival. Fractal dimension had the highest hazard ratio for overall survival 2.7(95% confidence interval (CI)=1.6-4.7); P&amp;lt;0.001), and the second highest for disease-specific survival 2.6(95% CI=1.4-4.8; P=0.002) versus 3.1(95% CI=1.9-5.1; P&amp;lt;0.001) for lymph node status. Discussion: Except for lymph node status, morphologic complexity of breast epithelium as measured by fractal dimension is more strongly and significantly associated with disease-specific and overall survival than standard clinical prognosticators. Furthermore, it is independent of standard prognosticators, and unlike tumour grade, it provides prognostic information that can be objectively assessed from TMA cores. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-17.
Aid for essential services for world's one billion slum dwellers should be scaled up, Red Cross says
Authors: J. Zarocostas
Journal: BMJ (2010)

Governments and aid groups need to scale up support for the world’s one billion people who live in urban slums, says a report from the International Federation of Red Cross and Red Crescent Societies. These people are at high risk of diseases as a result of poor access to health and other basic services.

“Acute respiratory infections, dysentery and diarrhoea, largely under control in high-income countries, continue to exact a significant toll on the health and well-being of a disproportionate number of those who live in the sprawling slums of the developing world,” it says.

It adds that unhealthy living …
GMC drops charges against paediatrician in Climbié case
Authors: Clare Dyer
Journal: BMJ (2004)

A consultant paediatrician who failed to diagnose sores and scars on the severely abused Victoria Climbie's 8 year old body as intentional injuries had charges of serious professional misconduct against her dropped by the UK General Medical Council last week.

Dr Ruby Schwartz's failure to alert social services to signs of abuse led to the child's return to the abusers who killed her.

Victoria had been taken to the Central Middlesex Hospital in July 1999 after waking up crying out with pain at her childminder's home in north London. Sores on her face and fingers oozed pus.

Dr Schwartz's diagnosis of scabies was decisive in discouraging police and …
How to set up a coronary rehabilitation programme.
Authors: H. J. Bethell
Journal: BMJ (1988)

How to do it Set up a coronary rehabilitation programme H J N Bethell Supervised rehabilitation for patients who are recover- ing from coronary illness or coronary surgery could and should be provided by every district general hospital.It would not be expensive to do so, but requires the hospital cardiologists and physicians to initiate, encourage, and nurture the programmes. Why do it?Coronary rehabilitation, which is popular in many
Vacuolar Myopathy: SLE or Chloroquine?
Authors: Charles F. Merwin
Journal: JAMA (1965)

To the Editor:—  Lang et al in their interesting report Vacuolar Myopathy in Lupus Erythematosus ( JAMA  191 :49 [Jan 4] 1965) neglected to mention a second possible cause for the myopathy noted in their patient with systemic lupus erythematosus. This patient had been receiving chloroquine phosphate in apparently continuous dosage for approximately four years prior to the onset of her weakness.  Whisnant et al in Chloroquine Neuromyopathy ( Proc Mayo Clin  38 :501 [Nov 6] 1963) reported four cases and mentioned three others with a very similar picture of generalized muscle weakness, with accentuation of weakness in the proximal muscle groups developing in those patients who had taken chloroquine for extended periods. Neck flexor weakness was observed and the muscle-stretch reflexes were weak to absent in the extremities. There were no sensory abnormalities. The serum glutamic oxaloacetic transaminase was elevated in their case 1. The histological changes in skeletal muscle in
Abstract 3789: Induction of autophagy increases the radiation sensitivity of head and neck cancer cells via growth arrest
Authors: Hae Yun Nam, Yoon Sun Lee, Hyang Ju Lee, I-Rang Im, Jihye Kwak, Seong Who Kim, Sang Yoon Kim
Journal: Cancer Research (2011)

Abstract Autophagy is frequently activated in cancer cells resistant to various apoptotic stimuli such as ionizing radiation, which supports the premise of enhancing the efficiency of radiotherapy by interventional means of autophagy regulation. In this study, we investigated whether autophagy pathway mediates the radio-sensitizing effect in head and neck cancer cells, and how the mechanism underlying the enhanced sensitivity works in cancer cells. The cellular responses following the ionizing radiation were examined by cell morphologic change, cell proliferation, clonogenic survival, cell cycle distribution, and expression level of several corresponding marker proteins in head and neck cancer HN-9 cells. Induction of autophagy was performed by down-regulating the mTOR signaling pathway using mTOR inhibitors such as rapamycin and PP242. Also, autophagy was inhibited by blocking the formation of autophagic vacuole (3-MA) or by disturbing the autophagosome maturation (bafilomycin A1, pepstatin A/E-46d). The change of autophagic flux was evidenced by the level of autophagy-related proteins and the morphological manifestation of autophagy. Upon exposure to radiation, the number of autophagic vacuoles was increased greatly in radiation dose- and time-dependent manners; however, the increase of apoptotic cells was not observed even in cells exposed to 12 Gy. In the meanwhile, the initial inhibition of cell cycle was maintained at slightly enhanced G1 phase. In some of the cases, it was restored to normal states, which implied that HN-9 cells adopted the mode of autophagy as a survival strategy against radiation. However, unexpectedly, further augmentation of autophagy pathway through the combination of either rapamycin or PP242 and radiation toward HN-9 cells hindered rather than enhanced clonogenic survival and cell proliferation, accompanying prolonged G1 arrest. Taken together, these results suggest that either induction of autophagy could serve as a therapeutic strategy to enhance radio-sensitivity, which is possibly due to irreversible cell cycle arrest following the excessive activation of autophagy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3789. doi:10.1158/1538-7445.AM2011-3789
Intravenous Diazepam Administration
Authors: R. Carter Davis
Journal: JAMA (1973)

To the Editor.—  With reference to recentLettersregarding the intravenous diazepam administration previously mentioned in the article by Langdon et al (223:184, 1973) and letter by Friedenberg and Barker (224: 901, 1973), a special technique for injection of diazepam was mentioned. The use of a scalp vein needle to inject diazepam directly into the vein may be an alternate method of giving the drug and one that could probably cut down incidence of phlebitis. I have been routinely doing this now on my last 150 endoscopic examinations and have given diazepam slowly, directly through the scalp vein needle with further dosage increases by mounting a new filled syringe attached to the tubing and injecting the amount needed. I have not flushed the syringes with saline or heparin sodium solution and have only drawn back and used the patient's own blood. At the present time, I have had approximately 60
Clinical effectiveness of a silk fabric in the treatment of atopic dermatitis
Authors: G. Ricci, A. Patrizi, B. Bendandi, G. Menna, E. Varotti, M. Masi
Journal: British Journal of Dermatology (2004)

In children with atopic dermatitis (AD), eczema is easily aggravated by contact with irritant factors (e.g. aggressive detergents, synthetic and woollen clothes, climatic factors).To evaluate the effectiveness of a special silk fabric (MICROAIR DermaSilk) in the treatment of young children affected by AD with acute lesions at the time of examination.Forty-six children (mean age 2 years) affected by AD in an acute phase were recruited: 31 received special silk clothes (group A) which they were instructed to wear for a week; the other 15 served as a control group (group B) and wore cotton clothing. Topical moisturizing creams or emulsions were the only topical treatment prescribed in both groups. The overall severity of the disease was evaluated using the SCORAD index. In addition, the local score of an area covered by the silk clothes was compared with the local score of an uncovered area in the same child. All patients were evaluated at baseline and 7 days after the initial examination.At the end of the study a significant decrease in AD severity was observed in the children of group A (mean SCORAD decrease from 43 to 30; P = 0.003). At the same time, the improvement in the mean local score of the covered area (from 32 to 18.6; P = 0.001) was significantly greater than that of the uncovered area (from 31 to 26; P = 0.112).The use of special silk clothes may be useful in the management of AD in children.