tbuckley/cabot-search huggingface dataset:
Recent advances: Neurosurgery
Authors: M. Powell
Journal: BMJ (1999)

Neurosurgery changes constantly. Recent years have seen important organisational changes in the way units are run, such as the proliferation of subspecialisation among consultants and the use of a multidisciplinary team approach to problems. Inevitably, however, it is new equipment that catches the eye of the public, and in recent years exciting new technology has expanded and refined the discipline of neurosurgery.
Relative systemic hypertension in patients with sickle cell disease is associated with risk of pulmonary hypertension and renal insufficiency
Authors: Victor R. Gordeuk, Vandana Sachdev, James G. Taylor, Mark T. Gladwin, Gregory Kato, Oswaldo L. Castro
Journal: American Journal of Hematology (2007)

We analyzed entry data from 163 adult hemoglobin SS and Sbeta(0) thalassemia patients enrolled in the prospective Sickle Cell Pulmonary Hypertension Screening Study and stratified their ECHO-determined tricuspid regurgitant jet velocity (TRV) and serum creatinine concentration according to three systemic blood pressure categories. TRV was >or= 2.5 m/sec in 27% of the patients with systolic blood pressure (SBP) <120 mmHg and diastolic blood pressure (DBP) <70 mmHg, in 37% with SBP 120-139 mmHg or DBP 70-89 mmHg, and in 93% with SBP 140 mmHg or DBP 90 mmHg or higher (P<0.0005 for trend). Serum creatinine concentration was 1.0 mg/dL or higher in 7% of patients with SBP <120 mmHg and DBP <70 mmHg, in 17% with SBP 120-139 mmHg or DBP 70-89 mmHg and 50% with SBP 140 mmHg or DBP 90 mmHg or higher (P<0.0005 for trend). Over 2 years of follow-up, there were trends for more frequent progression to elevated TRV (P=0.073) or creatinine (P=0.037) values according to the higher systemic blood pressure categories. Our findings suggest that systemic SBP 120-139 mmHg or DBP 70-89 mmHg defines a category of relative systemic hypertension in patients with sickle cell disease that is associated with increased risk for pulmonary hypertension and renal dysfunction. Whether antihypertensive and/or nitric oxide donor therapy in sickle cell disease patients with relative hypertension prevents these and other complications should be determined by clinical trials.
Division and Differentiation of Abnormal Cells
Authors: F. J. C. Roe
Journal: BMJ (1971)

<b>Background:</b> According to the combined statement of ERS and ATS, diagnosis of PCD relies on multiple test modalities. The diagnosis is sometimes delayed due to low yield of some of the tests. This can result in lung health decline. Nasal brush biopsy is one of the tests in which ciliated epithelium is looked at under electron microscope. It’s a crude procedure and can sometimes produce low quality specimen without any diagnostic yield. We did bronchial brush biopsies for children admitted due to an exacerbation where diagnosis had been delayed despite best efforts. <b>Methods:</b> Biopsy specimen were taken from right main stem bronchus under general anaesthesia. Nasal brush biopsy specimen were taken simultaneously. Age appropriate Olympus flexible bronchoscopes were used and specimen were stored in glutaraldehyde solution.Cytosoft cytology brush was used for nasal scrapping from the inferior turbinate. <b>Results:</b> Ten patients (7 females,3 males) were included in this retrospective analysis.TEM (transmission electron microscopy) analysis of 6 bronchial wall biopsy specimen yielded normal results. Corresponding nasal brush biopsy specimen also produced normal results on TEM. Two bronchial specimen were abnormal with no central microtubules.Similar results were seen in corresponding nasal brush biopsies. However, remaining two bronchial wall biopsies reported reduced number(low density) of cilia and outer dyenin arm defects on EM.Nasal brush samples for these patients were normal. <b>Conclusions:</b> Nasal brush biopsy in an outpatient setting is technically challenging and can result in inadequate specimen.Bronchial wall biopsy produces good sample volume which has a sensitivity of 100% for ciliary ultrastructural defects.
Levosimendan vs Dobutamine for Patients With Acute Decompensated Heart Failure
Authors: Alexandre Mebazaa, Markku S. Nieminen, Milton Packer, Alain Cohen-Solal, Franz X. Kleber, Stuart J. Pocock, Roopal Thakkar, Robert J. Padley, Pentti Põder, Matti Kivikko, for the SURVIVE Investigators
Journal: JAMA (2007)

Because acute decompensated heart failure causes substantial morbidity and mortality, there is a need for agents that at least improve hemodynamics and relieve symptoms without adversely affecting survival.To assess the effect of a short-term intravenous infusion of levosimendan or dobutamine on long-term survival.The Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support (SURVIVE) study was a randomized, double-blind trial comparing the efficacy and safety of intravenous levosimendan or dobutamine in 1327 patients hospitalized with acute decompensated heart failure who required inotropic support. The trial was conducted at 75 centers in 9 countries and patients were randomized between March 2003 and December 2004.Intravenous levosimendan (n = 664) or intravenous dobutamine (n = 663).All-cause mortality at 180 days.All-cause mortality at 180 days occurred in 173 (26%) patients in the levosimendan group and 185 (28%) patients in the dobutamine group (hazard ratio, 0.91; 95% confidence interval, 0.74-1.13; P = .40). The levosimendan group had greater decreases in B-type natriuretic peptide level at 24 hours that persisted through 5 days compared with the dobutamine group (P<.001 for all time points). There were no statistical differences between treatment groups for the other secondary end points (all-cause mortality at 31 days, number of days alive and out of the hospital, patient global assessment, patient assessment of dyspnea at 24 hours, and cardiovascular mortality at 180 days). There was a higher incidence of cardiac failure in the dobutamine group. There were higher incidences of atrial fibrillation, hypokalemia, and headache in the levosimendan group.Despite an initial reduction in plasma B-type natriuretic peptide level in patients in the levosimendan group compared with patients in the dobutamine group, levosimendan did not significantly reduce all-cause mortality at 180 days or affect any secondary clinical outcomes.clinicaltrials.gov Identifier: NCT00348504.
A fat cell in a bone marrow aspirate
Authors: Barbara J. Bain
Journal: American Journal of Hematology (2010)

Fat cells or adipocytes are easily recognised in bone marrow fragments. There is less awareness of the morphology of detached single fat cells. This image is of a typical fat cell, showing voluminous weakly staining cytoplasm and an oval nucleus with a delicate chromatin pattern and ill-defined nucleoli. Fat cells have sometimes been confused with storage cells or tumor cells. Recognition of the typical appearance of a fat cell that has become detached from a fragment can avoid confusion.
The effects of albuterol on the lung function of hospitalized patients with cystic fibrosis.
Authors: N L Hordvik, P H Sammut, C G Judy, S J Strizek, J L Colombo
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Twenty-four hospitalized patients with cystic fibrosis were enrolled into a 2-d, double-blind, placebo-controlled, randomized crossover trial comparing albuterol inhalation aerosol with a saline placebo. Aerosols were administered with the first three of four chest physiotherapy sessions given 4 h apart. Spirometry was measured before and 45 min after 7:00 A.M. and 3:00 P.M. therapy and before therapy at 7:00 P.M. and 7:00 A.M. the next morning. The mean percent change in FVC, FEV1, and FEF25-75% at 7:00 A.M. was 10.7, 14.8, and 19.6% with albuterol versus 2.4, 1.0, and -0.8% with placebo (p = 0.0012, < 0.0001, and = 0.003, respectively). A greater than 8% change in FEV1 separated changes with albuterol versus placebo with 96% specificity and occurred in 75% of all patients with albuterol; 71% at 7:00 A.M. versus 24% at 3:00 P.M. The reduction in response at 3:00 P.M. (p < 0.01) was presumably due to prolonged effects of morning therapy ( > 4 h). Individual changes in spirometry were significantly more positive and homogeneous with albuterol versus placebo at both 7:00 A.M. and 3:00 P.M. The mean percent change for the FVC, FEV1, and FEF25-75 across the day (7:00 A.M. pretherapy to 7:00 P.M. pretherapy) was 8.1, 10.1, and 9.7% with albuterol versus 3.9, 3.5 and 2.6% with placebo (p = 0.029, 0.036, and 0.232, respectively). The more positive and homogeneous changes in spirometry with albuterol, along with greater changes in these measures across the day when compared with placebo, suggest that albuterol improves pulmonary function in a majority of hospitalized patients with cystic fibrosis.
Independent data for patients
Authors: T. L. Alves, T. Reed
Journal: BMJ (2009)

<h3>Background and importance</h3> In November 2016 a pharmacy resident arrived in the emergency ward to implement clinical pharmacy. A year and a half later, we wanted to measure the satisfaction of caregivers on this presence because few data are available on this issue. However, it seems important to better understand the expectations of staff and to target pharmaceutical activities to help improve the management of patients admitted to the emergency department. <h3>Aim and objectives</h3> Our objectives were to collect caregivers’ opinions on the role of the pharmacy intern as well as on the clinical pharmacy, regarding reorganisation of the pharmacies in international non-proprietary name (INN). <h3>Material and methods</h3> A questionnaire was submitted to the 52 day nurses during a 10 day period in April 2018. The questionnaire had two parts: one concerning the activities of the pharmacy resident and their relevance to the improvement in patient care and another about the new pharmacy organisation and the role of the pharmaceutical team in helping caregivers to use it. <h3>Results</h3> A total of 71% of day nurses answered the questionnaire: 92% were strongly satisfied with the pharmaceutical team’s availability for answering their questions or helping them with treatments; 86% were strongly satisfied with the information given about the new organisation in INN and the equivalence table developed; 80% agreed that storing drugs based on INN was better even if it was harder; 100% strongly agreed that clinical pharmacy activities (medication reconciliation, pharmaceutical analysis) improve patient safety; and 96% thought strongly or very strongly that the pharmaceutical presence allowed better continuity of treatment. Regarding transmission of information from the pharmacy (medicine shortages, new references) only 46% were very satisfied, and 8% were unsatisfied. Opinions were more divided for reporting side effects related to care or drugs: only 35% were strongly satisfied, 8% not enough and 19% did not have an opinion. <h3>Conclusion and relevance</h3> The satisfaction of caregivers on the relevance of the presence of a pharmacy resident on the emergency ward was good overall. However, they considered that the transmission of information from the central pharmacy and the reporting of iatrogenic events were insufficient. The next step is to work on this to keep improving nurses’ satisfaction. <h3>References and/or acknowledgements</h3> No conflict of interest.
Compression of Venous Ulcers
Authors: Robert S. Kirsner
Journal: JAMA Dermatology (2014)

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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Dermatology journal
Colonoscopic surveillance in ulcerative colitis
Authors: G GARAS
Journal: Gut (1999)

cacy of combining these drugs might be of great help.Presently, the data in the three meta-analyses constitutes a sound, objective basis on which to tackle therapeutic decisions.The statement endorsed by the working party seems to reflect the common belief shared by leading authorities in this field that these agents are ineVective in the treatment of acute pancreatitis.This may be because the drugs are believed to act through their antisecretory or protease inhibitory activity.However, other relevant properties of somatostatin and octreotide, namely the haemodynamic eVects on reducing splanchnic blood flow, the stimulation of the hepatic reticuloendothelial system, and the modulation of the cytokine cascade, are usually forgotten.It has been hypothesised that the eYcacy of somatostatin and octreotide in acute pancreatitis might be better explained by all these properties rather than its capability of inhibiting pancreatic secretion.
Hepatic messenger ribonucleic acid activity profiles in experimental azotemia in the rat. Relationship to food intake and thyroid function.
Authors: W B Kinlaw, H L Schwartz, C N Mariash, C Bingham, F E Carr, J H Oppenheimer
Journal: Journal of Clinical Investigation (1984)

We have studied the hepatic messenger RNA (mRNA) activity profile in chronically azotemic rats and sought to determine whether the observed changes could be mediated either by reduced food intake or diminished thyroid function at the tissue level. mRNA activity profiles were produced by two-dimensional gel electrophoretic separation of radioactively labeled products of an in vitro reticulocyte lysate system which had been programmed by hepatic RNA. Of the approximately 240 translational products identified in this system, seven sequences were consistently altered in azotemia. In pair-fed animals six of these also decreased, but the alterations in three were depressed to a significantly lesser extent in the pair-fed group. Moreover, analysis of covariance suggested that food intake could account for the differences in only one sequence. The possibility that the mRNA activity profile in azotemia could represent the effects of diminished thyroid function was minimized by the finding that the reductions in plasma thyroxine (T4) and triiodothyronine (T3) levels observed were due largely to reduced plasma protein binding, with maintenance of the mean free T4 and free T3 concentrations within the normal range. The changes in only one mRNA sequence could be related to free T3 levels alone. Our findings, therefore, indicate that although diminished food intake and reduced thyroid function may contribute to some of the observed changes in the mRNA activity profiles, the bulk of alterations in azotemia appear to be mediated by other mechanisms. The striking overlap between the sequences affected by azotemia and pair-feeding raises the speculation that altered gene expression in azotemia may reflect an impaired hepatic response at the pretranslational level to metabolic signals associated with food intake.
Influence of fiber posts on the fracture resistance of endodontically treated premolars with different dental defects
Authors: Qian-Qian Hou, Yi-Ming Gao, Lei Sun
Journal: International Journal of Oral Science (2013)

This study aimed to evaluate the influence of quartz fiber post placement on the fracture resistance of endodontically treated premolars with different dental defects under dynamic loading. Fifty extracted single-rooted mandibular premolars were randomized into five groups. Each group was prepared according to numbers of residual walls ranged from 0 to 4. Then each group was divided into two subgroups with one restored with quartz fiber posts and the other without posts. In no-post groups, gutta percha point 2 mm below cemento-enamel junction was removed. Composite resin was adapted to the well and used to shape the core directly. Each tooth was restored with a complete metal crown. Dynamic loading was carried out in a masticatory simulator with a nominal load of 50 N at 2 Hz for 300 000 loading cycles. Then a quasi-statically load was applied in a universal testing machine 30° to the long axis with a crosshead speed of 1 mm⋅min−1 until fracture. Data were analyzed with one-way analysis of variance and pairwise comparison (P<0.05). No specimens failed during dynamic loading. The fracture resistance enhanced with the increase of numbers of coronal walls and the differences were significant (P<0.05). Placement of fiber posts had a significant effect when fewer than two walls remained (P<0.05), but it had no significant influence in groups with two, three or four walls (P>0.05). Fiber post did not change failure mode, and the fracture pattern was mainly favorable. More dentin walls need to be retained in clinic. When no less than two walls remained, a fiber post is not always necessary. Restoration with fiber posts can help reinforce a tooth's structural integrity in some root canal surgery patients, which shows research from China. The structural properties of these posts make them well suited for fracture prevention, but the universality of these benefits remains unclear. A root canal procedure can leave a treated tooth with some portions of the dentin 'wall' surrounding the pulp intact. Yi-Ming Gao and colleagues at Shanghai Jiao Tong University examined how this wall affects the efficacy of post implantation. They used an in vitro simulation of chewing force to test fracture prevention in implanted versus non-implanted teeth with varying amounts of remaining dentin. They found that posts specifically improved fracture resistance in teeth with no remaining dentin or with a single dentin wall, and generally did not affect the likelihood that fractures could subsequently be repaired.
Points from letters: Valuable drugs
Authors: A Macdonald
Journal: BMJ (1976)

part-time consultant" is, if successful, always available to his patients and colleagues because the tradition of mixed medical practice has always meant availability as required, a true "whole-time doctor."I realise that I am perhaps over-emphasising the difference, but my reason for this is honourable and refers to a previous letter from my colleagues and myself (8 February, 1975, p 336).There is a difference between a profession and a trade.
355 APPLYING HEPATITIS B GUIDELINES IN EUROPE: HOW EXPENSIVE IS A STATE-OF-THE ART MANAGEMENT OF HBV INFECTION?
Authors: H. Becker, J. Stahmeyer, S. Heidelberger, K. Deterding, C. Krauth, M. Cornberg, M.P. Manns, H. Wedemeyer
Journal: Journal of Hepatology (2011)
Cerebriform nodular amelanotic metastases of malignant melanoma: a challenge in differential diagnosis of a rare variant
Authors: A. Assmann, B. Farthmann, O. Burkhardt, E. Dippel, C.E. Orfanos, U. Blume-Peytavi
Journal: British Journal of Dermatology (2000)

High variability of the clinical appearance of malignant melanoma (MM) and its metastases render the differential diagnosis of solid amelanotic tumours difficult. We report a 71-year-old woman with several unusual cutaneous tumours of cerebriform morphology, suggesting skin metastases from occult internal cancer. Histopathological findings and thorough investigations, however, revealed a late-stage metastatic MM. We discuss the differential diagnosis of skin metastases of various origin and underline the difficulties for early detection of MM.
Conflict and health: Public health and humanitarian interventions: developing the evidence base
Authors: N Banatvala, A B Zwi
Journal: BMJ (2000)

This is the first of four articles 

Worldwide, millions of people are annually affected by conflict and over $2bn was spent on non-food emergency aid each year between 1991 and 1997.1 Recently, 30 million people were estimated to be internally displaced and 23 million to be refugees (seeking refuge across international borders), the vast majority of whom were fleeing conflict zones.2 More agencies than ever are working in relief activities; over 200 humanitarian agencies responded to the Rwandan genocide and population displacement.3

Populations affected by armed conflict experience severe public health consequences as a result of food insecurity, population displacement, the effects of weapons, and the collapse of basic health services. 4 5 Though most conflicts after the second world war took place in Africa, the Middle East, Asia, and Latin America, since the end of the Cold War and break up of the Soviet Union we have also witnessed conflicts in Europe and the former Soviet Union, notably in Tajikistan, Chechnya, former Yugoslavia, and Nagorno-Karabakh.6 Increasingly, with relatively few exceptions, conflicts are internal rather than waged between states.

This article argues that the evidence base for humanitarian health interventions should be actively developed and explores mechanisms for its promotion.

#### Summary points

Humanitarian interventions are increasingly complex and are difficult and costly to resource

Research to identify effective and efficient approaches to the delivery of aid warrants additional investment

Data on the public health effects of war and on delivery of public health in settings affected by conflict are increasingly being assembled, but the effectiveness of many humanitarian initiatives has not been adequately evaluated

Evaluation of the effectiveness of intervention in conflict settings needs to make explicit the humanitarian principles on which interventions are based

Generating knowledge and promoting an evidence based culture will require collaborative initiatives between …
A randomized, placebo-controlled trial of enoxaparin after high-risk coronary stenting: the ATLAST trial
Authors: Wayne B. Batchelor, Kenneth W. Mahaffey, Peter B. Berger, Ezra Deutsch, Susan Meier, Vic Hasselblad, Edward T. Fry, Paul S. Teirstein, Allan M. Ross, Cynthia A. Binanay, James P. Zidar
Journal: Journal of the American College of Cardiology (2001)
Improving patient confidentiality
Authors: P Barlow
Journal: BMJ (1994)

EDITOR, - The moves by the BMA and others to push for legislation to improve patient confidentiality are welcome but slightly hypocritical.1 There are two types of situation in which the medical profession itself is technically guilty of large scale breaches of confidentiality, and perhaps it should examine its own practice and guidelines before tackling the government. The first situation concerns adult, mentally competent patients found to have a serious illness; it still …
Infection and Pheochromocytoma
Authors: Martin G. Myers
Journal: JAMA (1977)

A urinary tract infection with possible septicemia and endocarditis developed in a 36-year-old man. The illness was complicated by pulmonary embolism, thrombocytopenia, hematemesis, hepatic dysfunction, paralytic ileus and accelerated hypertension. The latter finding suggested pheochromocytoma. Treatment with antibiotics and phenoxybenzamine hydrochloride was associated with notable clinical improvement. A chromaffin cell tumor was surgically removed above the lift kidney. Conclusively, a pheochromocytoma may mimic and be present in association with infection.