tbuckley/cabot-search huggingface dataset:
Changes for VA Residencies?
Authors: Joan Stephenson
Journal: JAMA (1996)

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
Case of Ventral Hernia: Treated Successfully by Pressure
Authors: T. Guy
Journal: BMJ (1843)

Thursday.Going on well; abdomen soft, and free from pain; discharge ratherscanty; pulse 98; feels weak and low.Friday, 13.No bad symptom; express herself very comfortable; bowels relieved since yesterday;pulse 92 ; no tenderness on pressure; discharge still scanty and ozfenive.Saturday morning, four o'clock.I was called up to her, and found her with puerperal fever
Intravenous Hexamethonium Sensitivity and Responses to Oral Treatment
Authors: D. M. GREEN, EUGENE J. ELLIS
Journal: Circulation (1954)

This study represents an effort to distinguish between neurogenic and humoral vasoconstrictive factors in a representative group of hypertensive patients by the response to hexamethonium ganglionic blockade. The correlation between intravenous hexamethonium sensitivity and subsequent treatment response was also determined.
AO Manual of Fracture Management: Elbow and Forearm
Authors: Young W. Kwon
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
What the educators are saying
Authors: Brian Jolly
Journal: BMJ (2006)

Most doctors are regarded by their patients as experts. But what is expertise? If we knew more about it, we might be able to cultivate it more efficiently. An article summarises recent progress. Expertise can be seen as (a) a set of discrete skills, together with perspicacity about when to use each skill; (b) the application of theory and general principles; (c) critical analysis, using a framework for examining and interpreting situations or events; or (d) as a continuing interaction between analysis and action, in which experience is used to increase expertise. Universities tend to focus on (b) and (c), with a particular emphasis on creating theory, developing applicable rules, and generating knowledge. In the professions, though, where that knowledge comes from and how best it is learnt have been at the heart of major controversy.

Within the interactive notion of expertise, a further distinction could be made between “experts,” “experienced non-experts,” and “routine experts.” Experts solve problems that increase expertise. Experienced non-experts work in environments that …
Dictionaries and Usage
Authors: Lester S. King
Journal: JAMA (1973)

Modern education conditions us to regard a dictionary with reverence. It serves as a point of stability, a standard in a world of constant change. A few years ago a great tumult arose when the new edition of W<i>ebster's Third International Dictionary</i>retreated from the position of setting rigid standards, contenting itself with reporting the actual usages, what<i>is</i>rather than what<i>ought</i>to be. Medical dictionaries generally do not have to contend with this problem. New terms come into being and naturally are included in new editions. At the same time, obsolete terms get eliminated. Only rarely, however, do medical terms undergo a major change in usage. This problem, nevertheless, so common in ordinary speech, is becoming intrusive into medicine with a recent<i>JAMA</i>publication [Meyerowitz et al, 225:408, 1973] that dealt with an excision of a massive abdominal fold. The authors were not entirely consistent in their
Inversion injuries of the ankle: clinical assessment and radiographic review.
Authors: S C Brooks, B T Potter, J B Rainey
Journal: BMJ (1981)

Inversion injuries of the ankle are a common cause of referral and presentation to accident units. They impose a load on radiographic services. A prospective trial was carried out to determine the accuracy of clinical examination. All patients were assessed clinically then examined radiographically, the clinical assessment missed 5% of the fractures. These, however, were all minor avulsion fractures or crush fractures and Tubigrip support was sufficient. Clinical examinations is, therefore, accurate and the need for most x-ray examination is questionable. X-ray examination should be reserved for patients with continuing pain or those who clinically have a fracture requiring immobilisation. This would produce a large saving in NHS resources.
Feasibility of Improved Blood Glucose Control in Patients With Insulin-Dependent Diabetes Mellitus
Authors: Charles M Peterson, Robert L Jones, Andre Dupuis, Barbara S Levine, Richard Bernstein, Michael O'Shea
Journal: Diabetes Care (1979)

An attempt was made to improve the control of blood glucose in patients with insulin-dependent diabetes mellitus. Ten patients were studied over a period exceeding 8 mo in the outpatient department. Each patient was taught to monitor his or her own blood glucose concentration and was enrolled in an exercise program. In addition, they were taught to calibrate insulin, food, and exercise in terms of the response of the blood glucose. After 3 mo of study, there was a significant decrease in hemoglobin A1c (Hb A1c) values from a mean concentration of 10.3 to 7.6%. Hb A1c values correlated well with mean blood glucose levels (r = 0.86). Dietary analysis revealed that the patients selected a diet consisting of 25% protein, 44% fat, and 31% carbohydrate, but there was a wide range in caloric distribution. There was no correlation between blood glucose control as measured by Hb A1c and caloric distribution. Systolic blood pressures decreased greater than 10 mm Hg. Serum alkaline phosphatase also decreased in each patient as control of blood glucose improved. Three of the patients with abnormalities of nerve conduction measurement at the beginning of the study had a complete return to normal at 8 mo. An outpatient program such as this may be cost effective through the avoidance of diabetes-related hospitalizations and may provide a mechanism whereby larger studies can be designed to define further the relationship of glycemia to the sequelae of diabetes.
Knockout of <i>Adamts7</i> , a Novel Coronary Artery Disease Locus in Humans, Reduces Atherosclerosis in Mice
Authors: Robert C. Bauer, Junichiro Tohyama, Jian Cui, Lan Cheng, Jifu Yang, Xuan Zhang, Kristy Ou, Georgios K. Paschos, X. Long Zheng, Michael S. Parmacek, Daniel J. Rader, Muredach P. Reilly
Journal: Circulation (2015)

Background— Genome-wide association studies have established ADAMTS7 as a locus for coronary artery disease in humans. However, these studies fail to provide directionality for the association between ADAMTS7 and coronary artery disease. Previous reports have implicated ADAMTS7 in the regulation of vascular smooth muscle cell migration, but a role for and the direction of impact of this gene in atherogenesis have not been shown in relevant model systems. Methods and Results— We bred an Adamts7 whole-body knockout mouse onto both the Ldlr and Apoe knockout hyperlipidemic mouse models. Adamts7 −/− / Ldlr −/− and Adamts7 −/− / Apoe −/− mice displayed significant reductions in lesion formation in aortas and aortic roots compared with controls. Adamts7 knockout mice also showed reduced neointimal formation after femoral wire injury. Adamts7 expression was induced in response to injury and hyperlipidemia but was absent at later time points, and primary Adamts7 knockout vascular smooth muscle cells showed reduced migration in the setting of tumor necrosis factor-α stimulation. ADAMTS7 localized to cells positive for smooth muscle cell markers in human coronary artery disease lesions, and subcellular localization studies in cultured vascular smooth muscle cells placed ADAMTS7 at the cytoplasm and cell membrane, where it colocalized with markers of podosomes. Conclusions— These data represent the first in vivo experimental validation of the association of Adamts7 with atherogenesis, likely through modulation of vascular cell migration and matrix in atherosclerotic lesions. These results demonstrate that Adamts7 is proatherogenic, lending directionality to the original genetic association and supporting the concept that pharmacological inhibition of ADAMTS7 should be atheroprotective in humans, making it an attractive target for novel therapeutic interventions.
Mixed Hepatocellular–Cholestatic Liver Injury after Pioglitazone Therapy
Authors: Louis D. May, Jay H. Lefkowitch, Michael T. Kram, David E. Rubin
Journal: Annals of Internal Medicine (2002)

Background: Pioglitazone is an oral hypoglycemic agent in the thiazolidinedione class. Only one case of hepatotoxicity related to this agent has previously been reported. Objective: To report the clinical course of a patient with hepatitis after therapy with pioglitazone. Design: Case report. Setting: A community hospital. Patient: A 49-year-old diabetic man taking pioglitazone, 30 mg/d. Intervention: Discontinuation of pioglitazone therapy. Measurements: Serum aminotransferase and bilirubin levels, standard blood tests for causes of hepatitis and cirrhosis other than drug toxicity, and liver biopsy. Results: After 6 months of pioglitazone therapy, significant hepatic dysfunction developed. Blood tests excluded viral, metabolic, and autoimmune disorders. Liver biopsy showed mixed hepatocellular–cholestatic injury compatible with drug toxicity. After treatment with pioglitazone was discontinued, liver enzyme values returned to normal. Conclusion: Patients receiving pioglitazone may develop serious liver injury and should be observed for evidence of hepatitis.
MSD "regrets" tactics used to silence doctor over prescription advice
Authors: F. Turone
Journal: BMJ (2014)

The drug company Merck Sharp and Dohme has said that it “regrets” the intimidating tactics adopted by its Italian branch to silence a public health doctor who had criticised the prescription of the cholesterol lowering drug ezetimibe. 

Alberto Donzelli, the head of education, appropriateness, and …
Prognosis of the Ramsay Hunt syndrome.
Authors: K W Heathfield, A S Mee
Journal: BMJ (1978)

Thirty-six cases of herpes zoster complicated by facial paralysis (the Ramsay Hunt syndrome) seen over 10 years were reviewed to determine the subjective degree of recovery (ascertained by questionnaire) and residual disability (ascertained by re-examination). Eighteen patients made a full recovery, most within three months; 14 patients were left with only mild residual signs. In only four patients was the final result regarded as unsatisfactory. Outcome was not adversely influenced by age. The facial paralysis of the Ramsay Hunt syndrome thus carries a generally favourable prognosis.
CXC chemokine ligand 4 (Cxcl4) is a platelet‐derived mediator of experimental liver fibrosis†
Authors: Mirko Moreno Zaldivar, Katrin Pauels, Philipp von Hundelshausen, Marie‐Luise Berres, Petra Schmitz, Jörg Bornemann, M. Anna Kowalska, Nikolaus Gassler, Konrad L. Streetz, Ralf Weiskirchen, Christian Trautwein, Christian Weber, Hermann E. Wasmuth
Journal: Hepatology (2009)

Liver fibrosis is a major cause of morbidity and mortality worldwide. Platelets are involved in liver damage, but the underlying molecular mechanisms remain elusive. Here, we investigate the platelet-derived chemokine (C-X-C motif) ligand 4 (CXCL4) as a molecular mediator of fibrotic liver damage. Serum concentrations and intrahepatic messenger RNA of CXCL4 were measured in patients with chronic liver diseases and mice after toxic liver injury. Platelet aggregation in early fibrosis was determined by electron microscopy in patients and by immunohistochemistry in mice. Cxcl4−/− and wild-type mice were subjected to two models of chronic liver injury (CCl4 and thioacetamide). The fibrotic phenotype was analyzed by histological, biochemical, and molecular analyses. Intrahepatic infiltration of immune cells was investigated by fluorescence-activated cell sorting, and stellate cells were stimulated with recombinant Cxcl4 in vitro. The results showed that patients with advanced hepatitis C virus–induced fibrosis or nonalcoholic steatohepatitis had increased serum levels and intrahepatic CXCL4 messenger RNA concentrations. Platelets were found directly adjacent to collagen fibrils. The CCl4 and thioacetamide treatment led to an increase of hepatic Cxcl4 levels, platelet activation, and aggregation in early fibrosis in mice. Accordingly, genetic deletion of Cxcl4 in mice significantly reduced histological and biochemical liver damage in vivo, which was accompanied by changes in the expression of fibrosis-related genes (Timp-1 [tissue inhibitor of matrix metalloproteinase 1], Mmp9 [matrix metalloproteinase 9], Tgf-β [transforming growth factor beta], IL10 [interleukin 10]). Functionally, Cxcl4−/− mice showed a strongly decreased infiltration of neutrophils (Ly6G) and CD8+ T cells into the liver. In vitro, recombinant murine Cxcl4 stimulated the proliferation, chemotaxis, and chemokine expression of hepatic stellate cells. Conclusion: The results underscore an important role of platelets in chronic liver damage and imply a new target for antifibrotic therapies. (HEPATOLOGY 2010.)
Selective expression of a normal action of the 1,25-dihydroxyvitamin D3 receptor in human skin fibroblasts with hereditary severe defects in multiple actions of that receptor.
Authors: J Barsony, W McKoy, D A DeGrange, U A Liberman, S J Marx
Journal: Journal of Clinical Investigation (1989)

We evaluated three actions of 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] in human skin fibroblasts to test for heterogeneity in hormone-response coupling. In fibroblasts from normal subjects the 1,25-(OH)2D3 concentrations for half-maximal effect (EC50) were: for mitogenic effect 0.0001-0.0005 nM, for antimitogenic effect 1 nM, and for induction of 25-OHD3 24-hydroxylase (24-OHase) 5 nM. To evaluate the effects of mutations presumed to be in the gene for the 1,25-(OH)2D3 receptor we examined cell lines representing four kindreds with hereditary resistance to 1,25-(OH)2D3 ("mutant" cell lines). In one mutant cell line all three 1,25-(OH)2D3 actions were severely abnormal. In one mutant cell line 24-OHase induction and mitogenic action were undetectable, but EC50 and maximal effect were normal for antimitogenic action of 1,25-(OH)2D3. In two mutant cell lines 24-OHase induction and antimitogenic actions were undetectable or severely impaired but mitogenic action were undetectable or severely impaired but mitogenic action was normal in EC50 and normal or increased in maximal effect. The mitogenic and antimitogenic actions in normal cells showed a similar profile of potency ratios for 1,25-(OH)2D3 and six analogues. Whenever a mutant cell showed a normal or even an abnormal mitogenic or antimitogenic effect of 1,25-(OH)2D3, these effects showed potency ratios similar to wild type, suggesting mediation by a similar 1,25-(OH)2D3 receptor. We conclude that three 1,25-(OH)2D3 actions show important differences in hormone response coupling indicated by differences in EC50 for 1,25-(OH)2D3 and by different consequences of receptor mutations.
Does the patient know best?
Authors: S. P Devane
Journal: BMJ (1992)

their general practitioner.Taking into considera- tion the points already made about possible reasons for their visit to the department and the general nature of the question asked, the figure does not seem to differ from that found in other studies.2The study asked a vague general question about consultations with a general practitioner before the visit to the accident and emergency department and consequently got vague general data, from which no conclusions can be drawn.Perhaps more disturbing is the implied criticism of general practitioners' diagnostic ability.I hope that I am being hypersensitive after my second 120 hour week this month and that no such criticism was meant.
The First 100 Consecutive, Robot-assisted, Intracorporeal Ileal Conduits: Evolution of Technique and 90-day Outcomes
Authors: Faris S. Azzouni, Rakeeba Din, Shabnam Rehman, Aabroo Khan, Yi Shi, Andrew Stegemann, Mohammad Sharif, Gregory E. Wilding, Khurshid A. Guru
Journal: European Urology (2012)
Donor insemination: report of a two-year study.
Authors: G W Pennington, S Naik
Journal: BMJ (1977)

In the past few years the more liberal attitude to therapeutic abortion and the widespread use of the oral contraceptive pill have led to a decrease in the number of babies available for adoption. Donor artificial insemination (AID) has been prac tised in Britain for some years, mainly in the private sector. Owing to a change in the influence of legal, ethical, and theolo gical considerations it is now an accepted method of treating the infertile couple when there is a history of azoospermia, severe oligospermia, rhesus incompatability, or the presence of genetic disorders. We report a two-year study of AID as practised within the National Health Service.
Cytokine modulation of basophil histamine release in wasp‐venom allergy
Authors: M. Radermecker, R. Louis, M. Leclercq, Th. Weber, J. L. Corhay, Th. Bury
Journal: Allergy (1994)

We report the effect of interleukin-3 (IL-3) and of other cytokines on antigen-induced basophil histamine release in wasp-venom-allergic subjects. Leukocytes from 12 patients with documented anaphylactic sensitivity to wasp venom were preincubated in the presence or absence of IL-3, granulocyte/macrophage-colony stimulating factor (GM-CSF), IL-5, IL-8, or stem cell factor (SCF). Washed cells were then exposed to venom and to other secretagogues, and histamine release in the supernatant was measured fluorometrically. Preincubation of leukocytes with IL-3, GM-CSF, or IL-5 (0.02-2 ng/ml), but not with IL-8 and SCF, caused a dose-dependent enhancement of antigen-induced basophilic histamine release in all subjects tested. Mean maximum increase was about 100% for IL-3, IL-5, and GM-CSF. The priming effect of IL-3 was rapid, persisted up to 12 h, and was not accompanied by a change in cellular histamine. IL-3 had a comparable enhancing effect when basophils were triggered with anti-IgE or N-formylmethionylphenylalanine (FMP). By contrast, IL-3 had no effect on substance-P-induced histamine release. The significant enhancement of basophil releasability to antigen in wasp-venom allergy by very low concentrations of IL-3, GM-CSF, and IL-5 suggests that cytokines in the basophil (mast-cell?) microenvironment could be critical factors in determining the variability of sting reactions in Hymenoptera-venom-allergic subjects.
A tight squeeze
Authors: B. T Maurer
Journal: BMJ (2003)

Although most pathology in paediatrics is psychosocial, once in a while a constellation of clinical signs triggers a dim recollection of something learned long ago. Staring through the glass darkly, you suddenly see the light.

It was a slow afternoon on a brilliant summer day. A father walked in with his four year old son for an appointment. The only problem was that he had come to the wrong place. Although the boy was our patient, his mother had made an appointment for his physical examination elsewhere, as he needed a physical before starting kindergarten and we couldn't fit him in before then. The office manager said we could squeeze the boy in, and so it was that I saw him after all.

Our newest and youngest medical assistant took his vital signs and escorted him and his father to an examination room. I recognised the name when I saw the chart. A bit of a tragic situation: the boy and his elder brother had both shown severe behavioural problems at young …
Long-term lamivudine monotherapy (LAM) in patients with HBeAg-negative HBV related chronic liver disease [HBeAg(−)CLD]: predictors of virological (VBTs) and biochemical (BBTs) breakthroughs
Authors: George Papatheodoridis, Evangelini Dimou, Andreas Laras, Vasilios Papadimitropoulos, Stephanos Hadziyannis
Journal: Journal of Hepatology (2002)
Preclinical Modeling of a Phase 0 Clinical Trial: Qualification of a Pharmacodynamic Assay of Poly (ADP-Ribose) Polymerase in Tumor Biopsies of Mouse Xenografts
Authors: Robert J. Kinders, Melinda Hollingshead, Sonny Khin, Larry Rubinstein, Joseph E. Tomaszewski, James H. Doroshow, Ralph E. Parchment
Journal: Clinical Cancer Research (2008)

Abstract Purpose: The National Cancer Institute has completed a first-in-human clinical pharmacodynamic trial of the targeted agent ABT-888, a poly (ADP-ribose) polymerase (PARP) inhibitor, under the auspices of the U.S. Food and Drug Administration's Exploratory Investigational New Drug Application. Performance of the study design, needle biopsy procedure, and validated pharmacodynamic assay were evaluated in human tumor xenograft models. Experimental Design: A validated ELISA was used to quantify PAR, a product of the PARP 1/2 enzyme activity. Sampling variability from tumor heterogeneity was determined by comparing PAR content in multiple tumors, and in different areas of the same tumor in a particular animal, collected under anesthesia by needle biopsy or resection before and after administration of nontoxic doses of ABT-888. The degree of PARP inhibition following single-dose treatment was evaluated in the time frame anticipated for biopsy in humans. Results: Sampling variability around the mean (∼50%) for untreated and vehicle-treated animals was random and due to specimen heterogeneity. PAR levels in initial and repeat tumor biopsies, separated by 1 week, were not altered by the stress induced by daily handling of the animals. A single ABT-888 dose (3 or 12.5 mg/kg) reduced intratumor PAR levels by &amp;gt;95%. ABT-888 (1.56-25 mg/kg) significantly decreased PAR levels at 2 h post-dosing. Conclusion: The detailed methodologies developed for this study facilitated the design of a phase 0, first-in-human clinical trial of ABT-888 and could serve as a model for developing proof-of-principle clinical trials of molecularly targeted anticancer agents.