tbuckley/cabot-search huggingface dataset:
American Society of Clinical Oncology 2001 Presidential Initiative: Impact of Regulatory Burdens on Quality Cancer Care
Authors: Lawrence H. Einhorn, Jenifer Levinson, Susan Li, Laurie Lamar, Deborah Kamin, Dan Mendelson
Journal: Journal of Clinical Oncology (2002)

PURPOSE: This study was conducted as part of the American Society of Clinical Oncology (ASCO) 2001 Presidential Initiative to assess the administrative burden of payer documentation requirements and their impact on oncology practice. METHODS: The study consisted of a physician questionnaire and an activity log. Site visits were conducted to support survey data. Analysis included 2,493 questionnaires and 1,115 activity logs; data were also collected from site visits to 10 oncology practices. RESULTS: Increased documentation was the greatest concern among respondents, greater even than the stress of dealing with death and dying. More than 97% of survey respondents reported an increase in documentation (averaging 1.4 h/d) and 77% reported an increase in work hours because of documentation in the past 5 years. As a result, more than 40% of respondents reported decreases in key aspects of patient care and decreases in teaching (48%) and research (39%). Site visit data demonstrate similar trends. CONCLUSION: It is critical to find ways to decrease physician burden without decreasing the ability to prevent fraud and abuse. Reforms include provisions in a recently passed bill in the United States House of Representatives to streamline Medicare regulation and increase physician education. To address oncology-specific concerns, changes also should be made to supervision requirements for residents and fellows and evaluation and management documentation for oncology follow-up visits.
Time to legalise assisted dying?: Doctors cannot simultaneously be patient centred and reject assisted suicide
Authors: Hazel Smith, Richard Smith
Journal: BMJ (2005)

EDITOR—You can't aspire to be patient centred and simultaneously reject assisted suicide.1 That's the discomfort that afflicts the Royal College of General Practitioners and other doctors who reject assisted suicide. They cling to a world where “doctor knows best,” a world that is as dead as “politicians know best and so be respectful and follow what we do.”

Of course, assisted suicide …
Differential Uptake of Tl-201 by Small-Cell Lung Cancer in a Patient With Pneumoconiosis-Related Pulmonary Nodules
Authors: NORIYUKI SHUKE, NORIHISA TONAMI, HIROMOTO SHINTANI, TOMIAKI KAMEYAMA, NAOTO WATANABE, KUNIHIKO YOKOYAMA, SEIGO KINUYA, KENICHI NAKAJIMA, TAKATOSHI MICHIGISHI, TAMIO ABURANO
Journal: Clinical Nuclear Medicine (1999)

A 68-year-old man with pneumoconiosis was thought to have small-cell lung cancer based on the results of a biopsy of a bone tumor. Three pulmonary nodules were observed on a chest radiograph. Compared with a chest radiograph taken 4 months earlier, one of the nodules had grown. It was difficult to differentiate this nodule from pneumoconiosis-related benign pulmonary nodules from the appearance on the chest radiograph and CT. Ga-67 scintigraphy and Tl-201 lung SPECT were performed to characterize these nodules. Tl-201 SPECT showed differential high uptake in the enlarged nodule, whereas Ga-67 scintigraphy showed equally intense up-take in all these nodules. Transbronchial biopsy of the nodule that showed high Tl-201 uptake revealed cancer cell nests against a background of interstitial fibrosis. The pathologic diagnosis was small-cell lung cancer that had developed in lung scar tissue. This case suggests the utility of Tl-201 in scintigraphic assessments of pneumoconiosis-related pulmonary nodules when lung cancer is suspected.
General practice 8 till 8
Authors: D. Spence
Journal: BMJ (2013)

<b>Objective</b> To assess the efficacy of two different high doses of intravenous methylprednisolone (IVMP) for the treatment of relapses in MS. <b>Background</b> NMP is the treatment of choice for MS relapses, but it is unknown whether its effects are dose related. <b>Methods</b> We conducted a double-blind, randomized study. Follow-up included serial clinical and MRI recordings at baseline and at 7, 15, 30, and 60 days after the beginning of treatment. Outcome measures were the number of brain and cervical spinal cord MRI contrast-enhancing lesions, and the Expanded Disability Status Scale score. <b>Results</b> Both treatment regimens improved clinical scores and reduced the number of MRI enhancing lesions during the follow-up period. The higher dose of IVMP was significantly more effective than the lower dose in reducing the number of MRI contrast-enhanced lesions at 30 and 60 days, mainly by decreasing the rate of new lesion formation. <b>Conclusions</b> The higher dosage of IVMP has a more powerful and prolonged action in maintaining blood-brain barrier integrity after a clinical relapse.
United States issues guidelines on embryo cell research
Authors: F. Charatan
Journal: BMJ (1999)

The US National Institutes of Health is proposing, for the first time, to allow funding of research into human pluripotent stem cells. It has just issued draft guidelines for such research and has proposed establishing a research group to ensure that its final guidelines are strictly followed.

The guidelines apply to research applications or proposals for National Institutes of Health funding that entail the use of human pluripotent stem cells …
Cochrane reviews <i>v</i> industry supported meta-analyses: Has Cochrane really achieved its goals?
Authors: Marko Tostad
Journal: BMJ (2006)

EDITOR—I am amazed that the BMJ chose to publish this review, given its small sample size yet broad conclusions.1 I believe that if the results had been in the other direction it would be less likely to have been published.

It is true that Cochrane reviews report specific items more thoroughly than journal based reviews. However, much of this is due to the …
Incidental Detection of Obstructive Uropathy during Scrotal Imaging
Authors: ABDELHAMID H. ELGAZZAR, MARIANO FERNANDEZ-ULLOA, RICHARD R. BLACK, EDWARD B. SILBERSTEIN
Journal: Clinical Nuclear Medicine (1988)

The customary method for radionuclide imaging in patients with testicular pain is to image the scrotal region using Tc-99m pertechnetate. Acute obstructive uropathy was found to be the cause of the testicular pain in three adult patients with normal testicular perfusion using Tc-99m DTPA. Tc-99m DTPA is recommended for testicular imaging with concomitant imaging of the kidneys and ureters, particularly in the adult patient.
Immunologic thrombocytopenia followed by thrombotic thrombocytopenic purpura in two HIV<sub>1</sub> patients
Authors: Jean‐Pierre Routy, Raymond Beaulieu, Marc Monte, Jean Saint‐Louis, Guy Sauvageau, Emil Toma
Journal: American Journal of Hematology (1991)

Abstract Two homosexual HIV 1 ‐positive male patients with thrombotic thrombopenic purpura (TTP) were found to have past history of immune thrombocytopenia (ITP). The first patient had ITP 10 months prior to TTP and was successfully treated by splenectomy. The second patient had ITP 32 months before TTP. No specific treatment was given for his asymptomatic ITP. Association of HIV infection to TTP seems to be frequent. These two types of purpura have different pathogenic mechanisms but share a common altered immune response to antigenic challenge. The occurrence of ITP and TTP in HIV‐positive patients may lead to errors in diagnosis and therapy.
Inaccuracy of House Staff in Reading Throat Cultures
Authors: Roger Glass
Journal: JAMA (1978)

The low prevalence of streptococcal pharyngitis in our pediatric clinic during a normally high-prevalence period encouraged us to examine the accuracy of throat culture readings made by the house staff. Six pediatric residents processed 256 cultures, which were then reinterpreted by a microbiologist. The residents consistently underread the cultures, failing to identify 68 (60%) of 112 with beta-hemolysis and 23 (58%) of 40 with a zone of bacitracin inhibition. This inaccuracy in interpretation of throat cultures emphasizes the physician's need to periodically reassess these skills.
A Limited Form of Proteus Syndrome With Bilateral Plantar Cerebriform Collagenomas and Varicose Veins Secondary to a Mosaic<i>AKT1</i>Mutation
Authors: Jamie S. Wee, Peter S. Mortimer, Marjorie J. Lindhurst, Heung Chong, Leslie G. Biesecker, Colin A. Holden
Journal: JAMA Dermatology (2014)

Proteus syndrome is an extremely rare disorder of mosaic postnatal overgrowth affecting multiple tissues including bone, soft tissue, and skin. It typically manifests in early childhood with asymmetric and progressive skeletal overgrowth that leads to severe distortion of the skeleton and disability. The genetic basis has recently been identified as a somatic activating mutation in the AKT1 gene, which encodes an enzyme mediating cell proliferation and apoptosis.We present a 33-year-old man who developed plantar cerebriform collagenomas on the soles of both feet and varicose veins in early childhood, in the absence of any skeletal or other connective tissue abnormality. Although the patient did not meet the diagnostic criteria for Proteus syndrome, he was found to have the c.49G>A, p.Glu17Lys AKT1 mutation in lesional skin but not in his blood.To our knowledge, this is the mildest molecularly confirmed case of Proteus syndrome, occurring in the absence of the characteristic skeletal overgrowth. These findings extend the spectrum of Proteus syndrome pathological characteristics and suggest that somatic mutations late in development and restricted in distribution cause subtle clinical presentations that do not meet the published clinical criteria.
DISCOLORATIO UNGUIUM: (1) LEUCOPATHIA UNGUIUM; (2) UNGUES FLAVI
Authors: W. KNOWSLEY SIBLEY
Journal: British Journal of Dermatology (1911)

Journal Article DISCOLORATIO UNGUIUM: (1) LEUCOPATHIA UNGUIUM; (2) UNGUES FLAVI Get access W. KNOWSLEY SIBLEY, M.A., M.D., B.C., M.R.C.P. W. KNOWSLEY SIBLEY, M.A., M.D., B.C., M.R.C.P. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 23, Issue 9, 1 September 1911, Pages 281–291, https://doi.org/10.1111/j.1365-2133.1911.tb16683.x Published: 01 September 1911
Doctor is struck off after practising anaesthetics "as she would in Spain"
Authors: C. Dyer
Journal: BMJ (2014)

A specialty doctor in anaesthetics who justified her unsafe methods by telling concerned colleagues that this “was how she practised in Spain” has been struck off by the Medical Practitioners Tribunal Service.

Maria Esther Ramos De Los Santos, who trained in Spain, was found to have provided substandard care to 10 different patients at Hillingdon Hospital, west London, in 2011. Her failings alarmed colleagues and …
Capturing the essence of decision making should not be oversimplified
Authors: Ewa Joanna Godzińska, Andrzej Wróbel
Journal: Behavioral and Brain Sciences (2014)

Abstract Bentley et al. propose a thought-provoking approach to the question of causal factors underlying human choice behavior. Their map model is interesting, but too simplified to capture the essence of decision making. They disregard, among other matters, qualitative differences between various subcategories of social influences, and the role of neurobiological factors engaged in interdependent individual and social decision-making processes.
Should stroke medicine be a separate subspecialty?
Authors: P. Bath, K. Lees, M. Dennis, D. Smithard, I. Bone, D. Grosset, J. Macdonald, S. Pollock
Journal: BMJ (1997)

The three facets of the management of cerebrovascular disease—prevention, acute care, and rehabilitation—have in the past been poorly coordinated. Stroke was regarded less as a preventable disorder than a predictable and often terminal consequence of old age. During the past 20 years, however, active management strategies have been shown to influence outcome. Half of all strokes need never happen with better identification and management of risk factors. Effective secondary prevention strategies include warfarin (in patients with atrial fibrillation) or aspirin (in others), and carotid endarterectomy (in patients with severe ipsilateral carotid stenosis) for patients with ischaemic stroke.

Acute stroke management is changing: early thrombolysis and aspirin may improve outcome while most patients should have computed tomography to differentiate ischaemic stroke from primary haemorrhage and to identify other intracranial pathologies. Early complications are reduced by swallowing assessment to prevent aspiration and graduated compression stockings to prevent thromboembolism. Patients with expanding infratentorial haemorrhage may require immediate surgical evacuation.

Although there remains a need for domiciliary care, most patients should be admitted to hospital, and ideally to an acute stroke unit offering resuscitation and stabilisation, investigation and diagnosis, initial treatment, and prevention of complications. Patients should then be rehabilitated, preferably in a stroke rehabilitation unit; such units have been shown to reduce mortality and morbidity, and probably length of stay in hospital, through interdisciplinary rehabilitation, and also promote secondary prevention and provide a …
Comparative Effectiveness Research on Robotic Surgery
Authors: Joel S. Weissman, Michael Zinner
Journal: JAMA (2013)

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
Distribution and anomalies of coronary arteries in tetralogy of fallot.
Authors: R P Dabizzi, G Caprioli, L Aiazzi, C Castelli, G Baldrighi, L Parenzan, V Baldrighi
Journal: Circulation (1980)

The surgical management of tetralogy of Fallot (TF) may be complicated by anomalies in the course and distribution of coronary arteries. Selective coronary angiography was performed in 119 cases of TF in order to prevent injury of aberrant vessels. In 11 patients, anomalies in the origin of coronary branches were revealed (five patients with a single coronary ostium, five with the anterior descending coronary artery arising from the right coronary artery or right sinus of Valsalva, and one with the circumflex artery arising from the right coronary artery). Other findings include anastomoses between coronary and bronchial arteries, small fistulas between coronary arteries and the pulmonary artery or right atrium, and hypoplasia of the coronary tree. The onset of left anterior hemiblock after total correction of TF could possibly be explained, in cases with a dominant left pattern, by injury to the coronary system after closure of the interventricular septal defect, rather than by injury to the conduction system.
TCT-18 Clinical and Procedural Predictors and Consequences of Stent Thrombosis Following Drug-eluting Stents for Acute Coronary Syndromes: Results From the ADAPT-DES Study
Authors: Ankit Garg, Bruce R. Brodie, Thomas Stuckey, Ke Xu, Ajay J. Kirtane, Bernhard Witzenbichler, Giora Weisz, Michael J. Rinaldi, Franz-Josef Neumann, D. Christopher Metzger, Timothy D. Henry, David Cox, Peter L. Duffy, Ernest L. Mazzaferri, Roxana Mehran, Gregg Stone
Journal: Journal of the American College of Cardiology (2013)
BMA vows to push for changes to health reform bill
Authors: C. White
Journal: BMJ (2011)

The BMA has said it will step up its opposition to the most damaging parts of the UK government’s Health and Social Care Bill, after intense and detailed debate about the changes that it will bring to the health service at its special representatives meeting in London on 15 March.

The BMA Council, which met the following day to discuss how to act on the strong opposition to the bill voiced by the representatives at the meeting, said it would continue to demand major changes to controversial proposals for reform of the NHS in England. A key concern is …
Driving after repair of groin hernia
Authors: P. K Amid
Journal: BMJ (2000)

It is usually safe after a week with repairs that do not put tissues under tension 

Papers p 1056 

Surgeons have traditionally advised patients recovering from groin hernia repairs not to drive for a month or two. This is based on the concern that postoperative pain could prolong reaction times and, to a lesser degree, that there is a risk of early recurrence as a result of the inertial forces that occur during a sudden impact or stop. However, preclusion from driving, particularly in the major cities around the globe, can have socioeconomic consequences.

Fortunately, by alleviating traditional concerns (and restrictions) about driving, the modern method of hernia repair is improving not only patients' physical wellbeing but their social and psychological recovery as well.

The pain that follows the repair of hernias in the groin is caused by mechanical and chemical stimulation of large, myelinated nerve fibres (A-α fibres) or small, …
Serum-Induced Thrombosis
Authors: STANFORD WESSLER, LEOPOLD REINER, DAVID G. FREIMAN, STANLEY M. REIMER, MORLEY LERTZMAN
Journal: Circulation (1959)

A simple, reproducible, physiologic technic is delineated for the production and study of thromboembolism. The method is based on the observation that the infusion of serum, in striking contrast to plasma, induces massive thrombosis in vascular segments containing stagnant blood far removed from the site of infusion. Data are presented on the nature of the thrombosis-inducing activity of canine and human serum, on the effect of serum infusions on recipient animals, and on the morphology of the induced thrombus. The adaptability of this method to the study of a variety of thromboembolic phenomena in man is described.
Prophylactic Antibiotics-Reply
Authors: William E. Scheckler
Journal: JAMA (1983)

In Reply.—  Dr Miller makes an important point. The available literature always must be reviewed in the context of one's own practice experience. The patient population studied and described in the literature must be compared with one's own patient population in making judgments about the applicability of reported findings to one's own practice. There have been numerous recent reviews in the literature of the appropriateness in selected settings of prophylactic antibiotic use. I think the most useful single resource in this area is the recent guidelines coming from the Centers for Disease Control in Atlanta. Of particular value is the Guidelines for Prevention of Surgical Wound Infections , published in March 1982. 1 This guideline does discuss prophylactic antibiotics and includes a useful bibliography in the whole area of surgical wound infection prevention and control.
Disorders of Renal Amino Acid Transport
Authors: Stanton Segal
Journal: New England Journal of Medicine (1976)

During the past several decades our conception of plasma-cell membranes and their functions has undergone considerable change. No longer do we accept the old anatomic concept that the cell membrane is an inert lipid envelope surrounding the cell, serving merely to delimit the cell from its external environment. The membrane is now regarded as a dynamic structure organized to transport soluble, hydrophilic substances across its "lipid sea."1 In cells with a specialized transport (absorption) function, such as those of the intestinal mucosa and proximal renal tubule, the membrane has been further differentiated into a mass of fingerlike projections, the microvilli, . . .
A comparison of liver ultrasound with liver biopsy histology in psoriatics receiving long-term methotrexate therapy
Authors: I.H. COULSON, J. MCKENZIE, V.S. NEILD, A.E. JOSEPH, R.A. MARSDEN
Journal: British Journal of Dermatology (1987)

A comparison of liver ultrasound and liver biopsy histology was made on 54 paired investigations from 28 patients about to receive or already receiving methotrexate for severe psoriasis. Ultrasound scans were reported as normal, or abnormal showing either fatty change or fibrosis. Eighteen of the scans were reported as normal and in no instance did the simultaneously-obtained liver biopsy show significant fibrosis. Thirty-one of the scans were reported as showing fatty change without fibrosis; in 12 cases the liver histology showed mild but significant fibrosis and in four cases fibrosis was of sufficient severity to necessitate methotrexate withdrawal. Five of the scans were reported as showing fibrosis and in all the biopsy showed significant fibrosis. This was of sufficient degree to necessitate methotrexate withdrawal in two cases. No patient with a normal ultrasound scan showed significant fibrosis and thus we concluded that such patients may be spared liver biopsy and safely continue with methotrexate therapy. Ultrasound cannot reliably distinguish between fatty change and fibrosis, so all patients with abnormal scans require liver biopsy.
Recent Trends in Violence-Related Behaviors Among High School Students in the United States
Authors: Nancy D. Brener
Journal: JAMA (1999)

Violence-related behaviors such as fighting and weapon carrying are associated with serious physical and psychosocial consequences for adolescents.To measure trends in nonfatal violent behaviors among adolescents in the United States between 1991 and 1997.Nationally representative data from the 1991, 1993, 1995, and 1997 Youth Risk Behavior Surveys were analyzed to describe the percentage of students in grades 9 through 12 who engaged in behaviors related to violence. Overall response rates for each of these years were 68%, 70%, 60%, and 69%, respectively. To assess the statistical significance of time trends for these variables, logistic regression analyses were conducted that controlled for sex, grade, and race or ethnicity and simultaneously assessed linear and higher-order effects.Self-reported weapon carrying, physical fighting, fighting-related injuries, feeling unsafe, and damaged or stolen property.Between 1991 and 1997, the percentage of students in a physical fight decreased 14%, from 42.5% (95% confidence interval [CI], 40.1%-44.9%) to 36.6% (95% CI, 34.6%-38.6%); the percentage of students injured in a physical fight decreased 20%, from 4.4% (95% CI, 3.6%-5.2%) to 3.5% (95% CI, 2.9%-4.1%); and the percentage of students who carried a weapon decreased 30%, from 26.1% (95% CI, 23.8%-28.4%) to 18.3% (95% CI, 16.5%-20.1%). Between 1993 and 1997, the percentage of students who carried a gun decreased 25%, from 7.9% (95% CI, 6.6%-9.2%) to 5.9% (95% CI, 5.1%-6.7%); the percentage of students in a physical fight on school property decreased 9%, from 16.2% (95% CI, 15.0%-17.4%) to 14.8% (95% CI, 13.5%-16.1 %); and the percentage of students who carried a weapon on school property decreased 28%, from 11.8% (95% CI, 10.4%-13.2%) to 8.5% (95% CI, 7.0%-10.0%). All of these changes represent significant linear decreases.Declines in fighting and weapon carrying among US adolescents between 1991 and 1997 are encouraging and consistent with declines in homicide, nonfatal victimization, and school crime rates. Further research should explore why behaviors related to interpersonal violence are decreasing and what types of interventions are most effective.