tbuckley/cabot-search huggingface dataset:
Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children
Authors: A Appelboam, A D Reuben, J R Benger, F Beech, J Dutson, S Haig, I Higginson, J A Klein, S L. Roux, S S M Saranga, R Taylor, J Vickery, R J Powell, G Lloyd
Journal: BMJ (2008)

<b>Objective</b> To determine whether full elbow extension as assessed by the elbow extension test can be used in routine clinical practice to rule out bony injury in patients presenting with elbow injury. <b>Design</b> Adults: multicentre prospective interventional validation study in secondary care. Children: multicentre prospective observational study in secondary care. <b>Setting</b> Five emergency departments in southwest England. <b>Participants</b> 2127 adults and children presenting to the emergency department with acute elbow injury. <b>Intervention</b> Elbow extension test during routine care by clinical staff to determine the need for radiography in adults and to guide follow-up in children. <b>Main outcome measures</b> Presence of elbow fracture on radiograph, or recovery with no indication for further review at 7-10 days. <b>Results</b> Of 1740 eligible participants, 602 patients were able to fully extend their elbow; 17 of these patients had a fracture. Two adult patients with olecranon fractures needed a change in treatment. In the 1138 patients without full elbow extension, 521 fractures were identified. Overall, the test had sensitivity and specificity (95% confidence interval) for detecting elbow fracture of 96.8% (95.0 to 98.2) and 48.5% (45.6 to 51.4). Full elbow extension had a negative predictive value for fracture of 98.4% (96.3 to 99.5) in adults and 95.8% (92.6 to 97.8) in children. Negative likelihood ratios were 0.03 (0.01 to 0.08) in adults and 0.11 (0.06 to 0.19) in children. <b>Conclusion</b> The elbow extension test can be used in routine practice to inform clinical decision making. Patients who cannot fully extend their elbow after injury should be referred for radiography, as they have a nearly 50% chance of fracture. For those able to fully extend their elbow, radiography can be deferred if the practitioner is confident that an olecranon fracture is not present. Patients who do not undergo radiography should return if symptoms have not resolved within 7-10 days.
Survey of health visiting in antenatal care.
Authors: F McCabe, Y Rocheron
Journal: BMJ (1985)

The range of the health visitor9s work is expanding. To find out what antenatal work health visitors actually carry out and what their attitudes towards such work are we surveyed general practitioners, midwives, and health visitors in three district health authorities. The results indicate that health visitors are qualified and willing to work with women in the antenatal period.
VASCULAR RESPONSES TO DRUG-ELUTING STENTS WITH BIODEGRADABLE POLYMER VERSUS DURABLE POLYMER: AN OPTICAL COHERENCE TOMOGRAPHY SUBSTUDY OF THE NEXT
Authors: Takashi Kubo, Takashi Akasaka, Yasushi Ino, Keiichi Igarashi, Kazushige Kadota, Ken Kozuma, Kengo Tanabe, Yoshihisa Nakagawa, Toshiya Muramatsu, Yoshihiro Morino, Takeshi Kimura
Journal: Journal of the American College of Cardiology (2014)
GMC accuses cardiologist of submitting trial data to a congress knowing they were wrong
Authors: C. Dyer
Journal: BMJ (2012)

A consultant cardiologist who took part in a clinical trial of a US made heart device is facing accusations by the UK medical regulator that he submitted an abstract to an international congress knowing that the data in it were wrong.

Michael Mullen, of the Heart Hospital in London, faces a two week hearing next month at the Medical Practitioners Tribunal Service in Manchester.

Mullen, formerly of London’s Royal Brompton …
Verrucous Carcinoma of the Esophagus
Authors: H. P. Koerfgen, B. Husemann, J. Giedl, W. Hohenberger
Journal: Endoscopy (1988)

The special problems involving the histopathology of verrucous carcinoma of the esophagus are presented on the basis of two patients with this tumor seen at our department. The discussion centers on the question whether a verrucous carcinoma of the esophagus can infiltrate the basal membrane and give rise to metastases.
Heart Disease in Women
Authors: Elsa-Grace V. Giardina
Journal: Annals of Internal Medicine (2003)

Medical Writings: Book Notes4 February 2003Heart Disease in WomenElsa-Grace V. Giardina, MDElsa-Grace V. Giardina, MDCenter for Women's Health Division of Cardiology, Columbia University, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-3-200302040-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Wilansky S, Willerson JT, eds. 670 pages. London: Churchill Livingstone; 2002. $129.00. ISBN 0443079005. Order at www.us.elsevierhealth.com.Field of medicine: Cardiovascular disease and women's health.Format: Hardcover book.Audience: Primary care physicians (internists, obstetriciansgynecologists, and primary cardiologists), as well as house officers and fellows who want a reference textbook.Purpose: To discuss issues related to women and heart disease.Content: The text is divided into 12 sections and includes topics for a general cardiology text, such as coronary and valvular heart disease, hypertension, cardiomyopathies, arrhythmias, and arterial disease, with particular attention to women. It also includes subject matter critical and ... Author, Article, and Disclosure InformationAffiliations: Center for Women's Health Division of Cardiology, Columbia University, New York, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 February 2003Volume 138, Issue 3Page: 240KeywordsArrhythmiaAtherosclerosisCardiovascular diseasesCardiovascular therapyCoronary heart diseaseHormone replacement therapyLipidsObstetrics and gynecologyPregnancyStable coronary artery disease ePublished: 4 February 2003 Issue Published: 4 February 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Clinical presentation and natural history of mild discrete subaortic stenosis. Follow-up of 1--17 years.
Authors: A Shem-Tov, A Schneeweiss, M Motro, H N Neufeld
Journal: Circulation (1982)

We report 21 patients with discrete subaortic stenosis (DSS) causing mild obstruction with a peak systolic left ventricular outflow pressure gradients less than 50 mm Hg. They were followed 1--17 years (mean 6.5 years), and eight were recatheterized before surgery, 2--17 years after the first cardiac catheterization. Three patients (14%) had subacute bacterial endocarditis. Ten (48%) had aortic insufficiency, one of whom had no pressure gradient across the left ventricular outflow tract. In three of the 10 patients, aortic insufficiency was found only at the second catheterization. Nine patients (43%) had hyperactive, asymmetric left ventricular contraction; in three, this finding was present only at the second catheterization. Seven of the eight patients who were recatheterized (33% of the entire group) showed an increase in gradient. The increase was from a mean gradient of 35.2 mm Hg to 76.7 mm Hg. Seventeen patients (81%) had at least one of these four features. In view of these data, we suggest that surgical indications for DSS might be expanded, although definitive recommendations are not possible. All cases of DSS should be carefully followed. Surgery should be performed if signs of progressive complications develop.
Physician Service Opportunities Abroad
Authors: Marsha F. Goldsmith
Journal: JAMA (1993)

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
Scott's parabola and the rise and fall of metal-on-metal hip replacements
Authors: D. Hamilton, C. Howie, P. Gaston, H. Simpson
Journal: BMJ (2012)

I only realised how much my osteoarthritic hip had altered my life after the operation enabled me to return to activities I did not know I had stopped. Identifying need for and benefit from treatments should focus on relative changes in experience and function, not on a person’s absolute state at a particular time.
STEMI AND OUT OF HOSPITAL CARDIAC ARREST (START) REGISTRY: ANGIOGRAPHIC FINDINGS IN PATIENTS WITH AND WITHOUT SHOCKABLE INITIAL ARREST RHYTHMS
Authors: Joseph Thomas, Meena Zareh, Jeffrey Rade, Jordan Prutkin, Atman Shah, Zachary Shinar, Nathan Deal, Jaekyoung Hong, Shoma Desai, Henry Kim, David Pearson, Stuart Swadron, David Shavelle
Journal: Journal of the American College of Cardiology (2015)
Skipping toward Personalized Molecular Medicine
Authors: Eric P. Hoffman
Journal: New England Journal of Medicine (2007)

“Personalized molecular medicine.” As with other catchy terms for big ideas, such as “reversing global warming” and “renewable energy,” the concept of personalized molecular medicine is certainly important, but the path to achieving it is far from clear. When such phrases are considered, definitions are important. Does personalized molecular medicine mean the tailoring of drugs for the individual patient, an approach that evokes images of Bones on Star Trek making instantaneous diagnoses with his Tricorder followed by loud pneumatic injections of customized drugs? Such a concept would place the realization of this technology in the same time frame as the . . .
Effects of postmenopausal hormone replacement therapy on central abdominal fat, glycemic control, lipid metabolism, and vascular factors in type 2 diabetes: a prospective study.
Authors: K Samaras, C S Hayward, D Sullivan, R P Kelly, L V Campbell
Journal: Diabetes Care (1999)

OBJECTIVE: To examine the effects of hormone replacement therapy (HRT) on lipid metabolism, glycemic control, total body and central abdominal fat, blood pressure (BP), and arterial pulse wave velocity (APWV) in overweight postmenopausal females with type 2 diabetes. RESEARCH DESIGN AND METHODS: This was a 12-month prospective study of 14 subjects (mean +/- SD age 57.5+/-5.6 years, BMI 29.5+/-4.8 kg/m2) randomized to 6 months of observation or HRT before crossover. HRT consisted of 2 months of conjugated equine estrogen (CEE) 0.625 mg daily, followed by 4 months CEE and medroxyprogesterone 5 mg daily. Measures included anthropometry, fasting glucose, insulin, HbA1c, total and HDL cholesterol, triglycerides, apolipoprotein B, LDL particle size, nonesterified fatty acids (NEFA), sex hormone-binding globulin, resting energy expenditure (REE), total and central abdominal fat (by dual-energy X-ray absorptiometry), resting BP, APWV (by applanation tonometry), physical activity, well-being, and sexual function. RESULTS: Six months of HRT resulted in significant reductions in waist-to-hip ratio (-0.03+/-0.01 vs. 0.01+/-0.009, P = 0.007), HbA1c (-0.34+/-0.24 vs. 0.6+/-0.4%, P = 0.04), total cholesterol (-0.6+/-0.1 vs. 0.2+/-0.2 mmol/l, P = 0.001), central abdominal fat (-175+/-51 vs. -24+/-56 g, P = 0.05), and improved physical functioning (P = 0.05), compared with observation. There was a minor increase in REE with HRT (33+/-23 vs. -38+/-23 kJ/day, P = 0.04). Total fat mass, fasting glucose, insulin, triglyceride, apolipoprotein B, NEFA, resting BP, APWV, and physical activity were unchanged. CONCLUSIONS: Postmenopausal HRT in these overweight women with type 2 diabetes was associated with a reduction in central adiposity and improvement in lipid metabolism and glycemic control without deterioration in weight status or cardiovascular parameters measured. Whether HRT-induced improvements in these cardiovascular risk factors result in lower long-term cardiovascular morbidity and mortality, as observed in nondiabetic women, awaits further study.
1281 URSODEOXYCHOLYL LYSOPHOSPHATIDYLETHANOLAMIDE (UDCA-LPE) EVOKES HEPATOPROTECTION VIA G-PROTEIN COUPLED RECEPTORS AND BY MODULATING DESATURASE GENE EXPRESSION
Authors: W. Chamulitrat, W. Xu, N. Katava, A. Pathil, W. Stremmel
Journal: Journal of Hepatology (2011)
Purification of antigenic peptide from murine hepatoma cells recognized by Class-I major histocompatibility complex molecule-restricted cytotoxic T-lymphocytes induced with B7-1-gene-transfected hepatoma cells
Authors: Katsuhisa Nakatsuka, Hirotaka Sugiyama, Yohko Nakagawa, Hidemi Takahashi
Journal: Journal of Hepatology (1999)
Assessment of hypoproteinaemic oedema: a simple physical sign.
Authors: J A Henry, P Altmann
Journal: BMJ (1978)

Assessment of hypoproteinaemic oedema: a simple physical sign It is well known that hypoproteinaemia can cause pitting oedema.We have found that hypoproteinaemic oedema pits and recovers dif- ferently from other types of oedema but can find no reference to this in reports or texts on physical signs.We therefore investigated the relation between the rate of recovery of pitting and the serum albumin concentration in a group of oedematous patients. Patients, methods, and resultsOver four months all patients coming to our notice who had had pitting leg oedema for less than three months were studied.Their oedema was on 20 July
Liver histopathology in chronic common bile duct stenosis due to chronic alcoholic pancreatitis
Authors: Angelos Afroudakis, Neil Kaplowitz
Journal: Hepatology (1981)

The liver histopathology in 40 liver biopsies from 24 patients with verified chronic common bile duct stenosis due to chronic alcoholic pancreatitis has been reviewed code-blinded. This represents an 8% prevalence of this complication in approximately 300 patients with alcoholic pancreatitis screened biochemically for alkaline phosphatase &gt;two-fold for &gt;1 month. The majority were anicteric with no symptoms other than from acute exacerbations of chronic pancreatitis. Biliary obstructive liver histopathology of varying severity was diagnosed in 19 patients (79%), seven of whom (29%) had secondary biliary cirrhosis. In 3 of these 7 cases, progression to biliary cirrhosis was documented with sequential biopsies. The remainder demonstrated this histologic picture when first diagnosed, supporting the insidious nature of this process. Stromal edema of the portal tracts, increased portal connective tissue, and marked proliferation of interlobular bile ducts and ductules were the most striking histologic features. Histologic cholangitis, although frequent, was generally mild or absent, reflecting the incomplete nature of the duct obstruction. Features of alcoholic liver disease were observed in only two cases. The results indicate that (1) chronic alcoholic pancreatitis with incomplete duct obstruction frequently causes secondary biliary cirrhosis, (2) significant alcoholic liver disease very infrequently coexists with persistent common bile duct stricture from alcoholic pancreatitis, and (3) surgical biliary decompression should be considered in any patient with documented persistent common bile duct stenosis from alcoholic pancreatitis.
Patient survival rates for individual surgeons will be published from 2013
Authors: G. Iacobucci
Journal: BMJ (2012)

Surgeons in 10 specialties in the NHS in England will be ranked in new league tables covering survival rates of patients and quality of care from next year, the NHS Commissioning Board has announced.

In its planning guidance for 2013-14, published this week, the board set out plans for healthcare providers to publish consultant level data for specialties including adult cardiac, vascular, and orthopaedic surgery by summer 2013.1 

Results for individual cardiothoracic surgeons have been published since 2005, because the specialty was prompted to collect the data by the publication of the Kennedy report into children’s heart surgery at Bristol Royal Infirmary.

Publication of data from surgeons in a wider group of specialties will become a contractual obligation from 2014-15 to allow comparison across hospitals. Information on interventional cardiology, upper gastrointestinal, colorectal, bariatric, urological, head and …
Neuro-ophthalmology Update
Authors: Thomas R. Hedges
Journal: JAMA (1978)

The editor of this volume has contributed three articles of his own and is coauthor of three more of the 40 chapters in this latest volume on neuro-ophthalmology. He has solicited 34 other papers with the intent to "update neuro-ophthalmology," admittedly a rapidly changing field. The highlights in this volume were contributed by neurosurgeons and neuroradiologists as well as neuroophthalmologists. Especially good were the reviews of the computerized tomography scan in ophthalmology by Post and Quencer, in neurosurgery by Fleischer et al, and in sella-suprasellar lesions by Richens. The neurosurgical aspect of the chiasma syndrome by Udverhelyi was especially well done. A chapter by Wilden and Dempsey on transsphenoidal removal of pituitary tumors (250 operations) was excellent, pointing out the importance of evaluating secretory activity, the visual symptoms (24%), and the surgical results (0.4% mortality). The most important complication occurred in seven patients who had persistent extraocular motor paresis. The
Psychological Distress and Quality of Life in Endocrine Disease
Authors: Nicoletta Sonino, Giovanni A. Fava, Franco Fallo, Marco Boscaro
Journal: Psychotherapy and Psychosomatics (1990)

Despite an upsurge of research in psychoneuroendocrinology, there has been very little interest in the psychological aspects of clinical care in endocrine disease. The clinical and research implications of quality of life in endocrinology (life events preceding disease onset, psychological distress associated with acute illness and convalescence, abnormal illness behavior) are discussed.
Metabolic Effects of Continuous Ambulatory Peritoneal Dialysis
Authors: G Morrison
Journal: Annual Review of Medicine (1989)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China in December 2019 and quickly spread around the globe, killing more than 4 million people and causing a severe economic crisis. ...Read More
The Sick Building Syndrome in Office Buildings -- A Breath of Fresh Air
Authors: Kathleen Kreiss
Journal: New England Journal of Medicine (1993)

Complaints from office workers about building-related symptoms began to flood public health agencies during the late 1970s, in the wake of the energy crisis. The eye, nose, and throat irritation, headache, and difficulty concentrating that occurred in persons working in office buildings came to be called the sick building syndrome. Ventilation standards had been lowered to 5 ft3 (0.14 m3) of outdoor air per minute per person in 1975, and the new building-related symptoms were assumed to be attributable to lower rates of ventilation. In buildings with a high prevalence of sick building syndrome, the most common recommendation of . . .
Student Loan Deferment-Reply
Authors: Laura Kroll
Journal: JAMA (1993)

<h3>In Reply.</h3> —I agree with and share Dr Amann's concerns over the massive debt burden of resident physicians. However, I disagree with his premise that the results of the grass roots campaign only pacify current residents and medical students, while neglecting those who will follow. Early versions of the reauthorization of the HEA eliminated deferment and limited forbearance to 3 years. Lobbying by the AMA and other groups, coupled with a major grass roots campaign by residents, medical students, senior physicians, and the AMA Auxiliary, led to the reinstitution of forbearance for the duration of residency and deferment for those residents who can prove need. The people who contacted their congressional representatives were working to retain the best possible outcome for all residents, current and future. Through their hard work and dedication to the profession, they influenced a government that wanted to severely limit repayment options for medical residents. The
Exo-erythrocytic Forms of Malaria Parasite
Authors: G. Bastianelli
Journal: BMJ (1948)

MDICAL JOURNALvisit (day, night, Sundays), and minor operations.The patient pays his doctor, who initials a receipt provided by the social security organization.The fee is later refunded minus 20%.The advantages of this system are many and amply compensate the slightly more complicated administrative machine which is needed. (a) The patient has complete freedom to choose or change his doctor. (b) The doctor-patient relationship is preserved, as the State enters into a contract with the patient and not with the doctor.(c) The doctor is not called out for trivial complaints, as the patient must pay out of his own pocket one-fifth of the fee.(d) The more experienced doctor or the older physician may raise his fees (within accepted limits) to lessen the burden of his practice.This system works well, and I have no doubt a similar system could be devised to meet our needs.-Iam, etc.,
Anatomical configuration of the His bundle and bundle branches in the human heart.
Authors: G K Massing, T N James
Journal: Circulation (1976)

The relationships among the His bundle, the origin of both bundle branches, and the interventricular (IV) septum were examined histologically in 32 human hearts, and the entire bundle branch systems were delineated in 13 of these. The His bundle in five hearts traversed the right IV septal crest, and the LBB origin was a very narrow stem (maximum 1.5 mm in cross-section) crossing from right to left through the inferior margin of the membranous septum. Proximal LBB anatomy was extremely variable, demonstrating multiple fiber groups which fanned out over the entire left septal surface. The LBB did not divide into two discrete divisions without multiple interconnections. The RBB formed an obtuse angle with the His bundle in 27 of 32 hearts. In those five hearts with "right-sided His bundles," the right bundle branch was a direct continuation. The clinical, electrophysiologic, and electrocardiographic implications of these anatomical observations are discussed.
Initial ventricular activation in left-sided intraventricular conduction defects.
Authors: D S Cannom, M G Wyman, B N Goldreyer
Journal: Circulation (1980)

Nine patients with ECG evidence of rate-related left bundle branch block (LBBB) were studied using His bundle electrograms, electrograms from the right ventricular (RV) apex and vectorcardiograms recorded as heart rate was increased to produce LBBB. In five patients, when LBBB occurred, initially normal septal activation reversed and the HV intervals increased 10-30 msec, while the H-RVA interval did not change (group 1). Four patients had initially normal QRS duration (90-100 msec) but reversed septal activation (group 2). When LBBB developed there was no shift in either the HV interval or H-RVA interval. Only the QRS complex itself widened to distinguish these patients from group 1. These studies defined ventricular septal activation in normal conduction and in complete LBBB (group 1) and incomplete LBBB (group 2). The conduction patterns of group 1 and 2 patients are similar but are both markedly different from normal.