tbuckley/cabot-search huggingface dataset:
ABC of palliative care: Constipation and diarrhoea
Authors: M. Fallon, B. O'Neill
Journal: BMJ (1997)

Prevalence of constipationConstipation can be defined as the passage of small hard faeces infrequently and with difficulty.Constipation is more common in patients with advanced cancer than in those with other terminal diseases, and many of the associated symptoms may mimic features of the underlying disease.About half of patients admitted to specialist palliative care units report constipation, but about 80% of patients will require laxatives. Assessment of constipation HistoryAn accurate history is essential for effective management.Inquiry should be made about the frequency and consistency of stools, nausea, vomiting, abdominal pain, distention and discomfort, mobility, diet, and any other symptoms.In patients with a history of diarrhoea, care should be taken to distinguish true diarrhoea from overflow due to faecal impaction.Careful questioning about access to a toilet or commode is important.Limited mobility may mean that using the toilet or commode is avoided.Other issues, such as lack of privacy or the need for nurses or carers to help with toileting, can exacerbate constipation. ExaminationA constipated patient may have malodorous breath, or the smell of faecal leakage may be obvious.Bacterial degradation of hard stools can result in leakage, of which the patient has no warning.General observation may reveal that a patient is in pain, confused or disorientated, or unable to reach the toilet.Abdominal distension, visible peristalsis, and borborygmi can suggest obstruction.Palpation may reveal an easily palpable colon with indentable and mobile (and rarely tender) faecal masses.In contrast, tumour masses are usually hard, not indentable, fixed, and often tender.In constipation complicated by obstruction, auscultation of the abdomen may reveal high pitched tinkling bowel sounds, although the abdomen can also be silent.Digital examination of the rectum or stoma is crucial if constipation is suspected-this will immediately reveal hard stools, tumour masses, or concomitant disease such as haemorrhoids, an anal fissure, or perianal ulceration.The rectum or stoma can be empty in constipation-hard or even impacted stools can lie higher in the bowel.Constipation may herald a spinal cord compression.If a neurological deficit is suspected a full neurological examination is essential, including assessment of sphincter tone and rectal sensation.Referral, if appropriate, should be made as an emergency.
MI Survivors Who Quit Using Snuff Add Years to Their Lives
Authors: Anita Slomski
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
EFFICACY OF VARENICLINE THERAPY IN THE &amp;ldquo;BOARD THE BUS AND QUIT&amp;rdquo; SMOKING CESSATION PROGRAM: ONE YEAR RESULTS
Authors: Piero Clavario, Cristina Barbara, Laura Casalino, Tiziana Zappulla, Gelsomina Cavallero, Sabrina Benvenuto
Journal: Journal of the American College of Cardiology (2012)
Occupational dermatoses from warm dry air
Authors: R.J.G. RYCROFT
Journal: British Journal of Dermatology (1981)

Journal Article Occupational dermatoses from warm dry air Get access R.J.G. RYCROFT R.J.G. RYCROFT St John's Hospital for Diseases of the Skin and Employment Medical Advisory Service, London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 105, Issue s21, 1 September 1981, Pages 29–34, https://doi.org/10.1111/j.1365-2133.1981.tb01305.x Published: 01 September 1981
Ureteroileostomy, an Efficacious Method of Urinary Diversion
Authors: George R. Read, Alfred Hurwitz
Journal: New England Journal of Medicine (1955)

THE multiplicity of surgical procedures proposed1 to divert the urinary stream after total cystectomy shows that there has been no satisfactory solution to the major problems of obstruction, infection and hyperchloremic acidosis.Nephrostomy and cutaneous ureterostomy are not usually efficacious because they require intubation, which almost always leads to progressive pyelonephritis.In 1911 Coffey2 advocated tunneling of the ureter through the sigmoid wall to prevent reflux of bowel contents. Stricture of the anastomosis tended to occur, leading to obstruction and ascending infection. A long-term follow-up study on 144 ureterosigmoidostomies of this type for exstrophy of the bladder3 at the Mayo . . .
The Neuroendocrinology of Chronic Fatigue Syndrome
Authors: Anthony J. Cleare
Journal: Endocrine Reviews (2003)

Abstract Chronic fatigue syndrome (CFS) is a common and disabling problem; although most likely of biopsychosocial origin, the nature of the pathophysiological components remains unclear. There has been a wealth of interest in the endocrinology of this condition, which will be reviewed in this article. Most studied has been the hypothalamic-pituitary-adrenal (HPA) axis; although the quality of many studies is poor, the overall balance of evidence points to reduced cortisol output in at least some patients, with some evidence that this is linked to symptom production or persistence. There is evidence for heightened negative feedback and glucocorticoid receptor function and for impaired ACTH and cortisol responses to a variety of challenges. However, there is no evidence for a specific or uniform dysfunction of the HPA axis. Given the many factors that may impinge on the HPA axis in CFS, such as inactivity, sleep disturbance, psychiatric comorbidity, medication, and ongoing stress, it seems likely that HPA axis disturbance is heterogeneous and of multifactorial etiology in CFS. Studies assessing GH, dehydroepiandrostenedione and its sulfate, melatonin, leptin, and neuroendocrine-monoamine interactions are also reviewed. There is some evidence from these studies to suggest alterations of dehydroepiandrostenedione sulfate function and abnormal serotonin function in CFS, but whether these changes are of functional importance remains unclear. To obtain a clearer assessment of the etiological and pathophysiological relevance of endocrine changes in CFS, it is suggested that more prospective cohort studies be undertaken in groups at high risk for CFS, that patients with CFS are followed up into recovery, and that multidimensional assessments are undertaken to unravel the influence of the various confounding factors on the observed endocrine changes in CFS.
Treatment of acquired factor X inhibitor by plasma exchange with concomitant intravenous immunoglobulin and corticosteroids
Authors: Cyrus C. Hsia, Mike Keeney, Annmarie A. Bosco, Anargyros Xenocostas
Journal: American Journal of Hematology (2007)

Abstract A patient with spontaneous hemorrhage from multiple body sites was found to have markedly prolonged international normalized ratio (INR) and activated partial thromboplastin times (aPTT) with incomplete correction of aPTT on mixing studies using normal plasma. The cause of this severe hemorrhage was due to a specific factor X inhibitor. No underlying or associated diseases were found. Initial treatment with fresh frozen plasma, vitamin K, and recombinant activated factor VII (rFVIIa) was unsuccessful. However, therapy utilizing plasma exchange with concomitant intravenous immunoglobulin and corticosteroids resulted in a rapid and sustained normalization of factor X levels with a clinical hemostatic response. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.
STUDIES ON IMMUNITY TO SWINE INFLUENZA
Authors: Richard E. Shope
Journal: The Journal of Experimental Medicine (1932)

Of the two etiological components of swine influenza, only the filtrable virus possessed immunizing properties. H. influenzae suis, while essential to the production of the disease, played only a secondary and contributory rôle and, alone, conferred no immunity. Serum of swine convalescent from the filtrate disease neutralized the swine influenza etiological complex of organism and virus. Intramuscularly administered swine influenza virus was incapable of inducing illness but did render hogs immune to swine influenza. It is suggested that a specific relationship, as regards infectivity, exists between the swine influenza virus and the tissues of the respiratory tract.
NIH Panel Says More Study Is Needed to Assess Marijuana's Medicinal Use
Authors: Rebecca Voelker
Journal: JAMA (1997)

IN 1988, Paul Palmberg, MD, PhD, was treating a glaucoma patient who did not respond to any of the conventional treatments. So his patient, Elvy Mussika, obtained marijuana from a federal government compassionate use program in hopes that it would lower her intraocular pressure. Last month, Palmberg told his fellow members of a panel specially convened by the National Institutes of Health (NIH) in Bethesda, Md, that marijuana was the only agent that helped Mussika, who spoke during an activist-sponsored news conference at the meeting. "There may be a residual group of people for whom marijuana is essential. We ought to find out," Palmberg, professor of ophthalmology at the University of Miami School of Medicine in Miami, Fla, told the panel. After a day and a half of hearing expert testimony and patients' testimonials, panel members said they believe sufficient rationale exists to conduct additional studies on the therapeutic use
P2-177: A multicenter phase II study of carboplatin plus gemcitabine followed by concomitant chemoradiation in patients with non-resectable stage III non-small-cell-lung cancer: preliminary report of the Cher@Nos trial
Authors: Paul R. Germonpré, Annelies Janssens, Lut Van Moorter, Dirk Verresen, Danny Galdermans, Roger Devogelaere, Hugo Ottevaere, Yves Mentens, Christel De Pooter, Chris Goor
Journal: Journal of Thoracic Oncology (2007)
Purification of macrophage deactivating factor.
Authors: S Srimal, C Nathan
Journal: The Journal of Experimental Medicine (1990)

Macrophage deactivation factor (MDF) in P815 tumor cell-conditioned medium was assayed by its suppression of the ability of activated mouse peritoneal macrophages to release hydrogen peroxide. MDF displayed properties of a soluble protein(s) associated with both low (8-25,000) and high (greater than 450,000) Mr fractions. MDF was purified 6,140-fold by a seven-step procedure: extraction with acid-ethanol; precipitation with ether; and fractionation on gel filtration, anion-exchange, diphenyl reversed-phase and C4 reversed-phase HPLC columns, the last column twice. The final preparation contained two species: (a) a approximately 13,000 Mr band on reducing or nonreducing SDS-PAGE and on autoradiograms after radioiodination with chloramine T, and (b) a 66,000 Mr species ranging from approximately 5% to approximately 50% of the protein detectable by silver strain. The 66,000 Mr species was identified as albumin from its NH2-terminal amino acid sequence. However, no amino acid sequence could be obtained for the approximately 13,000 Mr species, either in fluid phase or after electroelution of the corresponding SDS-PAGE band. Thus, approximately 13,000 Mr MDF associates tightly with albumin through a variety of separation techniques, and may have a blocked NH2 terminus. Purified MDF afforded 50% inhibition of activated macrophage H2O2 releasing capacity at a concentration of 1-10 nM. Separation of MDF from most higher Mr moieties was associated with disproportionately small increases in specific activity, suggesting MDF might be partially inactivated by purification. As purified, MDF was approximately 1,000-fold less potent at deactivating macrophages than TGF-beta. Antibodies that neutralized the macrophage-deactivating effect of TGF-beta did not inhibit deactivation by MDF.
Mobile Mass in a Pulmonary Cavity or Air Meniscus Sign
Authors: Maurice M. Reeder
Journal: JAMA (1974)

In introducing the "Gamut"<sup>1,2</sup>as a regular feature ofTopics in Radiology, it is hoped that each case will prove challenging to the radiologist and clinician alike, since only by working together can the correct diagnosis be established in difficult cases. The gamut approach to roentgenographic diagnosis rests on the following triangulation concept. Successful roentgenographic interpretation begins with a detailed analysis of all the indexes of disturbed morphology and pathophysiology seen on the roentgenogram. The radiologist can usually fit the visualized abnormalities into a specific pattern of disturbed morphology, such as "honeycomb" lung, "bull's-eye" lesion of the gastrointestinal tract, or solitary epiphyseal lesion of bone. For each pattern there is a specific gamut or comprehensive list of differential possibilities. This list can be narrowed to one or several reasonable possibilities for a given patient, based on age, symptoms, and knowledge of pertinent clinical and laboratory data
The anaesthetic roundabout and its effect on behaviour at work
Authors: P. A. Ward
Journal: BMJ (2013)

Cooper and Faragher’s editorial on the impact of the workplace on health was made all the more pertinent by the recent death of Bank of America Merill Lynch’s summer intern, attributed to pulling eight “all-nighters” in two weeks to impress bosses.1 2 Clearly the NHS has evolved beyond the “magic roundabout” city culture, in which shifts start early and finish 24 hours later with a …
The National Cholesterol Education Program
Authors: James I. Cleeman, Claude Lenfant
Journal: JAMA (1998)

The National Cholesterol Education Program (NCEP) is a prime example of the role the National Heart, Lung, and Blood Institute has played, in its 50 years of existence, as a catalyst for translating research advances into improved clinical and public health practices. Since its inception in 1985, the NCEP has adhered to 2 principles in mounting educational campaigns for professionals and the public: building on a strong science base and working in partnership with other organizations. In slightly more than a decade, the NCEP has made significant progress toward its goal of reducing the prevalence of high blood cholesterol. The impact of cholesterol education is clearly visible in 4 major trends: increasing professional and public cholesterol awareness; declining dietary intakes of saturated fat, total fat, and cholesterol; falling serum cholesterol levels; and a continuing decline in coronary heart disease (CHD) mortality rates. Nevertheless, cholesterol levels are still being undertreated, especially in patients with CHD, and substantial scientific and educational challenges remain. As it looks forward to the 21st century, the NCEP plans to make continued progress by using emerging scientific developments and pursuing the powerful combination of cholesterol lowering in CHD patients and in primary prevention.
Clinical Aspects of Cardiomyopathy
Authors: J. F. Goodwin, H. Gordon, A. Hollman, M. B. Bishop
Journal: BMJ (1961)

The term " cardiomyopathy " has come into use to describe disorders of the heart not due primarily to rheumatic, hypertensive, coronary-artery, thyroid, or congenital disease.It is often assumed that cardiomyopathies are rare diseases; but, while this is true of some, recent work has tended to suggest that a number of cardiomyopathies may be commoner than previously thought.Nevertheless, despite increased awareness of the condition, we remain extremely ignorant of the causation of most of the cardiomyopathies.No definition of the cardiomyopathies is entirely satisfactory, but the following is proposed as being generally useful."Cardiomyopathy-a subacute or chronic disorder of heart muscle of unknown or obscure aetiology, often with associated endocardial, and some- times with pericardial, involvement, but not atherosclerotic in origin."Cardiomyopathy may be classified in many ways.The object of the present communication is to suggest a general classification for cardiomyopathy and to emphasize especially the methods of clinical presentation of this condition, basing conclusions on data derived from patients studied personally.So far as is possible the pathology has been correlated with the clinical presentation, with electrocardiography and radiology, and with the results of special investigations, such as angiocardiography and cardiac catheterization.No attempt has been made to give a full classification of * 2 with cardiac infarct.I with anomalous coronary artery.cardial fibroelastosis; in the other 5 the myocardial changes were non-specific.In the third group of 7 JAN.14, 1961
Bronchodilator Therapy: The Basis of Asthma and Chronic Obstructive Airways Disease Management
Authors: Gordon L. Snider
Journal: JAMA (1986)

This book comprises 11 chapters and three appendixes by 14 contributors, ten from the United Kingdom, three from New Zealand, and one from Israel. Because of differences in regulatory practices, many more agents are available in the United Kingdom than in the United States. Metered-dose inhaler and power-nebulizer administration of bronchodilator aerosols is much more widely used in the UK than in the United States, and, not surprisingly, a clear picture of UK practices in the use of these drugs emerges from the pages of this book. The much wider range between therapeutic efficacy and toxicity of aerosol administration of sympathomimetic amines as compared with their oral use is made very clear. As might be expected, the material on theophylline therapy is much less authoritative than that on sympathomimetic amines and anticholinergic agents such as ipratropium bromide, since there has been much less experience with theophylline in the UK than
Access to antimalarial therapy: accurate diagnosis is essential to achieving long term goals
Authors: H. Hopkins, C. Asiimwe, D. Bell
Journal: BMJ (2009)

Increased attention to and funding for malaria promises to improve access to effective treatment, but <b>Heidi Hopkins</b>, <b>Caroline Asiimwe</b>, and <b>David Bell</b> argue that without diagnostic testing much of this effort will be wasted
Heme oxygenase-1 mediates the anti-inflammatory effect of molecular hydrogen in LPS-stimulated RAW 264.7 macrophages
Authors: Hong-Guang Chen, Ke-Liang Xie, Huan-Zhi Han, Wei-Na Wang, Da-Quan Liu, Guo-Lin Wang, Yong-Hao Yu
Journal: International Journal of Surgery (2013)
Multicenter Study of the Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in the Urban Brazilian Population Aged 30–69 yr
Authors: Domingos A Malerbi, Laercio J Franco
Journal: Diabetes Care (1992)

OBJECTIVE To assess the prevalence of diabetes and IGT in the urban adult Brazilian population. RESEARCH DESIGN AND METHODS We used a two-stage, multicenter, cross-sectional survey in a random sample of 21,847 individuals aged 30–69 yr from nine large cities. Subjects were first screened by FCG. All positive screenees (FCG ≥ 5.6 mM/L) and every sixth consecutive negative screenee were administered a 75 g OGTT and classified as diabetic, IGT, or normal (nondiabetic) according to WHO recommendations. OGTT findings from the negative screenees were extrapolated to all negative screenees after adjustments for potential biases. RESULTS The overall rates were 7.6 and 7.8% for diabetes and IGT, respectively. Men (7.5%) and women (7.6%) had similar rates of diabetes. Similar rates resulted with whites (7.8%) and nonwhites (7.3%). Diabetes prevalence increased from 2.7% in the 30–39-yr age-group to 17.4% in the 60–69-yr age-group. Diabetes was more prevalent among less educated people, but this difference disappeared after adjusting for age. Family history of diabetes was associated with a twofold increase in diabetes prevalence (12.5 vs. 5.8%); the same increase occurred with obesity (11.6 vs. 5.2%). Undiagnosed diabetes accounted for 46% of the total prevalence. Among previously diagnosed cases, 22.3% were not under treatment, 7.9% were on insulin, 40.7% were on oral agents, and 29.1% were on dietary treatment only. Self-reported diabetes prevalence was 0.1, 3.2, and 11.6% in the age groups &amp;lt; 30, 30–69, and &amp;gt; 70 yr, respectively. CONCLUSIONS The prevalence of diabetes in Brazil is comparable with that of more developed countries, where it is considered a major health problem.
Influence of Severity of Myocardial Injury on Distribution of Macromolecules: Extravascular Versus Intravascular Gadolinium-Based Magnetic Resonance Contrast Agents
Authors: Juerg Schwitter, Maythem Saeed, Michael F. Wendland, Nikita Derugin, Emmanuelle Canet, Robert C. Brasch, Charles B. Higgins
Journal: Journal of the American College of Cardiology (1997)
Diagnostic utility of flumazenil in coma with suspected poisoning.
Authors: D W Hodgkinson, P Driscoll
Journal: BMJ (1991)

Diagnostic utility of flumazenil in coma with suspected poisoning SIR, -There have been a number of worrying case reports when flumazenil treatment has been used in mixed poisoning with tricyclic antidepressants. 2 Dr Jonas Hojer and colleagues3 quite correctly state that a normal electrocardiogram recorded before giving flumazenil to an unconscious patient will imply a minimal risk of adverse reactions.The specific criteria used to define normal in this situation must, however, be clarified: a rate less than 100 beats/min, a QRS width less than 0-I s, and a corrected QT interval less than 0-418 s.4It is also important to point out that only 10% of unconscious pauients in the study of Hojer and colleagues had taken a large amount of tricyclic antidepressants.In another study this figure was as high as 48%,' and the risk of adverse reactions may be higher in this group.We therefore suggest that readers consider the local prevalence of overdosage with tricyclic antidepressants before accepting the widespread use of flumazenil in comatose patients.
STATIC FOOT ERROR.ANALYSIS OF ONE THOUSAND CASES.
Authors: WILLIAM E. BLODGETT
Journal: JAMA (1904)

The object of this investigation was (1) to contribute to the sum of available statistics of static foot error; (2) to draw from the cases any warrantable conclusions. <h3>STATISTICAL SUMMARIES.</h3> The cases are from the Orthopedic Out-patient Department of the Carney Hospital, Boston, through the courtesy of Dr. Painter, and include only those cases of foot trouble in which the chief factor appears to be static, i. e., an error of weight bearing. Thus acute and chronic arthritis of the foot, paralytic, circulatory, and recent traumatic and inflammatory conditions are excluded; but those cases are included in which any of the preceding causes determined a faulty static condition which itself had become the chief factor in the foot trouble. The cases are the thousand next preceding Sept. 1, 1903, and cover a period of two years and four months. The data are from the hospital records and from
91 ANTIVIRAL ACTIVITY OF THE LIVER-TARGETED NUCLEOTIDE HCV POLYMERASE INHIBITOR IDX184 CORRELATES WITH TROUGH SERUM LEVELS OF THE NUCLEOSIDE METABOLITE IN HCV-INFECTED CHIMPANZEES
Authors: D.N. Standring, R. Lanford, B. Li, R.J. Panzo, M. Seifer, M. Larsson, S.S. Good, X.-J. Zhou
Journal: Journal of Hepatology (2009)