tbuckley/cabot-search huggingface dataset:
NHS 111 pilot schemes must be independently evaluated, emergency doctors say
Authors: G. Iacobucci
Journal: BMJ (2014)

The College of Emergency Medicine has urged NHS England to ensure that “widespread changes” to the NHS 111 urgent care telephone service are made only after a thorough and independent evaluation of their effectiveness.

NHS England is currently piloting changes to the non-emergency 111 telephone triage line as part of a major review of urgent and emergency care services led by its medical director, Bruce Keogh.1 The revisions include increasing the level of …
CDC recommends new tuberculosis blood test
Authors: Fred Charatan
Journal: BMJ (2006)

The US Centers for Disease Control and Prevention (CDC) is recommending a new blood test for tuberculosis that it believes is more accurate than the existing test. The QuantiFERON-TB Gold test, made by the Australian company Cellestis, has been used by the San Francisco Department of Public Health since February 2005. Officials there said that it was “one of the first [tuberculosis] advancements made since the discovery of antibiotics” and that …
The National Blood Transfusion Service today
Authors: N K Shinton
Journal: BMJ (1980)

conceded, a multifactorial disease then -high salt intake may play a significant permissive role without necessarily requiring that hypertensives consume more than normotensives.This high salt intake may allow the clinical expression of a number of other genetic and environmental factors.A parallel situation is seen in the epidemio- logy of diabetes.Australian Aborigines have a high prevalence of diabetes yet there is no difference in the calorie intake between diabetics (1500 of the population) and non- diabetics'.Similar findings have been derived from various other ethnic groups.Yet no one would deny that calorie intake is the single most important environmental factor involved in the expression of insulin-dependent diabetes: increasing calorie intake results in the emergence of diabetes in populations, while a reduced calorie intake represents the single best treatment modality for established diabetes.Parenthetically, hypertension is also seen in more rather than less urbanised Aboriginals with a greater age-related incre- ment in the former.2Aboriginals are known to use large amounts of salt but regrettably no sodium consumption or excretion data was obtained during our studies.For the present, and particularly in the light of other studies, the data of Beevers and colleagues do not exclude salt as being a significant (even major) cause of hypertension in the community.
Diffuse FDG Uptake Due to Fat Necrosis Following Transverse Rectus Abdominus Myocutaneous (TRAM) Flap Reconstruction
Authors: Nathan B. Dobbs, Hamid R. Latifi
Journal: Clinical Nuclear Medicine (2013)

We report a case of a 57-year-old female patient with right breast invasive ductal carcinoma. Bilateral mastectomy and TRAM flap reconstructions were performed. Postoperatively, a palpable focus was identified within the left breast. PET/CT showed hypermetabolism throughout the reconstructed left breast, correlating with mixed fat attenuation and inflammatory soft tissue. MRI showed extensive fat necrosis/oil cyst formation in the left breast. As a TRAM flap reconstruction with fat-rich tissue can be damaged intraoperatively due to surgical manipulation, abnormal FDG uptake in this setting is more likely related to fat necrosis than recurrent tumor.
Clinical Outcome of Chemoradiation Therapy in Patients with Limited-Disease Small Cell Lung Cancer with Ipsilateral Pleural Effusion
Authors: Seiji Niho, Kaoru Kubota, Kiyotaka Yoh, Koichi Goto, Hironobu Ohmatsu, Keiji Nihei, Nagahiro Saijo, Yutaka Nishiwaki
Journal: Journal of Thoracic Oncology (2008)
Severe Pulmonary Toxicity in Patients With Advanced-Stage Hodgkin's Disease Treated With a Modified Bleomycin, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, Prednisone, and Gemcitabine (BEACOPP) Regimen Is Probably Related to the Combination of Gemcitabine and Bleomycin: A Report of the German Hodgkin's Lymphoma Study Group
Authors: Henning Bredenfeld, Jeremy Franklin, Lucia Nogova, Andreas Josting, S. Fries, Volker Mailänder, Joachim Oertel, Volker Diehl, Andreas Engert
Journal: Journal of Clinical Oncology (2004)

Purpose To investigate a new effective, nonleukemogenic polychemotherapy regimen, BAGCOPP (bleomycin, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone, gemcitabine) in a phase I/II dose-escalation study in patients with advanced-stage Hodgkin's disease (HD). Patients and Methods Patients in clinical stages IIB with risk factors III and IV were enrolled in this nonrandomized, multicenter trial aimed at defining the maximum-tolerated dose of gemcitabine within a modified escalated BEACOPP regimen. Gemcitabine was given at a starting dose of 800 mg/m 2 on days 1 and 4 of each cycle. Results Twenty-seven patients (eight female, 19 male) were enrolled with a median age of 33 years (range, 19 to 65 years). Due to a higher than expected hematotoxicity, the day-4 application of gemcitabine was omitted after 14 patients were included and 59 cycles were given. A total of eight patients developed lung toxicity, mainly pneumonitis (six of eight), which led to the termination of the study. With a median follow-up of 27 months, 25 patients are in continuing complete remission. Conclusion The substitution of etoposide by gemcitabine in the escalated BEACOPP schema is not feasible and leads to severe pulmonary toxicity. This toxicity is probably related to the concomittant application of gemcitabine and bleomycin.
ACUTE POISONING FROM USE OF ISOPROPYL ALCOHOL IN TEPID SPONGING
Authors: Roy F. Garrison
Journal: JAMA (1953)

It has long been recognized that methyl and isopropyl alcohol can be toxic if taken internally in small amounts. Aikman<sup>1</sup>states that individual susceptibility is marked, and serious symptoms, such as coma and blindness, may occur after the ingestion of 10 cc. of methyl alcohol. The danger in inhalation or absorption of toxic amounts through the skin, however, has not been emphasized. Rubbing alcohol is commonly used in hospitals for tepid sponging of febrile children, but little note has been made of the possible dangers inherent in the practice. This report illustrates the very real danger of such procedures. <h3>REPORT OF A CASE</h3> A 22-month-old white boy was admitted to the pediatric ward of St. Joseph Hospital, Kansas City, Mo., at 3:00 p. m. on Nov. 15, 1952. He had a rectal temperature of 104.6 F, but the only other unusual physical symptom was an inflamed pharynx. The diagnosis
Increased Bioavailability of Nitric Oxide After Lipid-Lowering Therapy in Hypercholesterolemic Patients
Authors: Stefan John, Markus Schlaich, Matthias Langenfeld, Horst Weihprecht, Gerd Schmitz, Gottfried Weidinger, Roland E. Schmieder
Journal: Circulation (1998)

Background —Impaired endothelium-dependent vasodilation is an early sign of atherosclerosis in hypercholesterolemic patients. We hypothesized that lipid-lowering therapy can improve endothelial function and that this effect is mainly mediated by increased bioavailability of nitric oxide (NO). Methods and Results —In a randomized, double-blind, placebo-controlled trial, we studied 29 patients (age, 50±12 years) with hypercholesterolemia (LDL cholesterol ≥160 mg/dL) randomly assigned to receive either fluvastatin (40 mg twice daily; 17 patients) or placebo (12 patients). Forearm blood flow was measured by plethysmography before and after 24 weeks of treatment. Endothelium-dependent vasodilation was assessed by intra-arterial infusion of acetylcholine (ACh; 3, 12, 24, and 48 μg/min) and basal NO synthesis rate by intra-arterial infusion of N G -monomethyl- l -arginine (L-NMMA; 1, 2, and 4 μmol/min). Simultaneous intra-arterial infusion of L-NMMA (4 μmol/min) and ACh (12, 24, and 48 μg/min) was used to test whether any increase in endothelium-dependent vasodilation after lipid-lowering therapy could be blocked by this NO synthase inhibitor. Endothelium-dependent vasodilation improved significantly after 24 weeks of lipid-lowering therapy compared with before therapy (ACh 24 μg/min: 240±34% before versus 347±50% after therapy; P ≤0.01) and placebo (changes between after and before therapy with ACh 24 μg/min: 108±39% for fluvastatin versus −26±32% for placebo; P ≤0.05). This improvement in endothelium-dependent vasodilation could be blocked by simultaneous administration of L-NMMA (ACh 24 μg/min plus L-NMMA 4 μmol/min: 170±69% before versus 219±47% after treatment; P =NS). Conclusions —Lipid-lowering therapy with fluvastatin can improve disturbed endothelial function in hypercholesterolemic patients compared with placebo. This improvement is mediated by increased bioavailability of NO.
Nkx2-5+Islet1+ Mesenchymal Precursors Generate Distinct Spleen Stromal Cell Subsets and Participate in Restoring Stromal Network Integrity
Authors: Laura Castagnaro, Elisa Lenti, Sara Maruzzelli, Laura Spinardi, Edoardo Migliori, Diego Farinello, Giovanni Sitia, Zachary Harrelson, Sylvia M. Evans, Luca G. Guidotti, Richard P. Harvey, Andrea Brendolan
Journal: Immunity (2013)
US health reform debate is reaching critical phase, says expert
Authors: C. White
Journal: BMJ (2009)

The battle over healthcare reform in the United States has reached a critical phase, says Simon Stevens, previously health adviser to the former British prime minister Tony Blair and now president of global health at UnitedHealth Group.

Mr Stevens, who also chairs the United Centre for Health Reform, was speaking in Liverpool last week at the annual conference of the NHS Confederation, ahead of a key meeting between the US president and the American Medical Association on 15 June.

The complexities of the current systems in the US, together with the need to convince a wide array of congressional committees, meant that “widespread system change will take a lot more …
Fluvastatin and low-density lipoprotein oxidation in hypercholesterolemic renal transplant patients
Authors: Alberto Martínez-Castelao, Josep M. Grinyó, Concepció Fiol, María J. Castiñeiras, Isabel Hurtado, Salvador Gil-Vernet, Daniel Serón, Isidre Porta, Antonio Miñarro, Angel Villarroya, Jeroni Alsina
Journal: Kidney International (1999)
patients may be less risk averse than committees
Authors: Shirley Nurock
Journal: BMJ (2005)

other problems faced in all services-namely, the lack of trust and the futile and wasteful attempt to monitor every practice. 20The solution is to return to the better aspects of professional practice.Professional lead investigators could take responsibility for research and audit. 21Their professional responsibilities would include upholding good ethical practice (already integral to professional standards for many professional groups).Ethics committees could then exist to answer specific ethical concerns.They would not need to distinguish between audit and research, or indeed other areas of clinical practice.They would consider the ethical aspects of any study or situation needing it and help the investigator or clinician reach a reasonable decision.They would be expected to explain and justify their reasoning and decision, but this would be tailored to the question concerned.Responsibility for the more bureaucratic aspects of current work of ethics committees, such as ensuring clear communication with patients and documenting participant agreement, would remain with the principal investigator (with appropriate guidance and standards).This approach should reduce the burden on ethics committees by removing the bulk of minor research projects with little ethical challenge and leaving more time to review more challenging proposals, both research and audit.Contributors: DTW is a member of the BMJ ethics committee and edits a clinical journal (which does not have an ethics committee).He is involved in many research projects and advises other researchers.Information was sought from searching Medline and EMBASE using words such as audit, research, and ethics but it was not a systematic search.The ideas came from discussions held with many people, including the BMJ ethics committee.Liz Wager gave some specific advice and Peter Halligan stimulated some changes.
Should Patients with Alzheimer's Disease Be Told Their Diagnosis?
Authors: M A Drickamer, M S Lachs
Journal: New England Journal of Medicine (1992)

SHOULD patients in the early stages of Alzheimer's disease be told their diagnosis? We became interested in this subject in the course of evaluating and caring for patients with Alzheimer's disease and dealing with their care givers and families. Unlike patients with other chronic illnesses in which signs and symptoms prompt the patients to seek consultation on their own, our patients are often brought by family members who suspect the diagnosis of Alzheimer's disease. Often our evaluation is preceded by impassioned pleas from the family not to disclose our findings to the patient should this diagnosis be confirmed. Intent on . . .
Tc-99m Labeled Leukocytes in Imaging of Patients with Suspected Acute Abdominal Inflammation
Authors: R LAITINEN, J T??HTINEN, T LANTTO, M VORNE
Journal: Clinical Nuclear Medicine (1990)

One hundred patients with suspected acute abdominal inflammation were imaged at 0.5, 2-3, 4-6, and 24 hours after the administration of Tc-99m HMPAO labeled autologous leukocytes. Scan findings were retrospectively compared with final diagnosis, serum C-reactive protein (CRP), and antibiotic treatment. Clinical findings were confirmed with surgery, barium enema, or sigmoidoscopy in 61 patients, and diagnosis was based only on clinical findings in 13 patients. In 26 patients, symptoms subsided before a final diagnosis was made. Tc-99m leukocyte images were positive in 45 of the 61 patients with a confirmed diagnosis, including all patients with acute cholecystitis (N = 4) and inflammatory bowel disease (N = 8). They were also positive in nineteen out of 25 patients who had acute colonic diverticulitis and in 6 out of 7 who had intra-abdominal abscesses. Abnormal activity was found in patients with colonic carcinoma, small bowel infarction, and acute appendicitis. Abnormal activity was visualized in 0.5-hour images in all but one of the positive cases. With the exception of two postoperative cases, malignant lymphoma, and a liver abscess, a CRP level of greater than 75 mg/L was associated with positive image findings. Antibiotic treatment did not affect imaging findings. Imaging with Tc-99m labeled leukocytes appears to be valuable for detecting and localizing abdominal inflammation, and three-phase imaging during the first 4-6 hours is recommended. In some cases, 24-hour images may be useful for distinguishing small bowel from large bowel inflammation.
Agism and provision of thrombolysis
Authors: D. Ketley, K. L Woods
Journal: BMJ (1995)

strategies but have little or no leverage with general practice fundholders to implement them.The emphasis on general practice fundholders as purchasers is a move away from population based purchasing, which took into account the major influences on health.'It is not clear how a local population perspective of health and health care needs developed by health authorities will be able to influence general practice fimdholders.Furthermore, if health authorities are to become the new "regulators" of general practice fundholders4 all their resources will be taken up with this time consuming task, which will increase the transaction costs inherent in the internal market.
Tamsulosin and Ophthalmic Adverse Events After Cataract Surgery
Authors: Sergio Ponce-de-Leon
Journal: JAMA (2009)

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
Viral IL-10 Gene Transfer Inhibits DTH Responses to Soluble Antigens: Evidence for Involvement of Genetically Modified Dendritic Cells and Macrophages
Authors: Janey D. Whalen, Angus W. Thomson, Lina Lu, Paul D. Robbins, Christopher H. Evans
Journal: Molecular Therapy (2001)

Expression of the viral interleukin-10 (vIL-10) gene within one joint of an animal with polyarticular, inflammatory arthritis suppresses disease in both treated and untreated joints (the “contralateral effect”). We used a mouse delayed-type hypersensitivity (DTH) model to investigate this phenomenon. Adenoviral delivery of the vIL-10 gene suppressed DTH reactions in injected and contralateral paws. T lymphocytes recovered from immunized mice injected with the adenoviral vector (ad-vIL-10) were unable to transfer the DTH response, but were not inhibitory. Peritoneal exudate cells recovered from mice injected intraperitoneally with ad-vIL-10 inhibited DTH reactions in recipient mice, but only when the donor mice had been sensitized to the antigen used to incite the DTH response. Dendritic cells (DCs) recovered from the draining lymph nodes of mice injected with ad-vIL-10 behaved similarly. Bone-marrow-derived DCs cultured ex vivo with ad-vIL-10 or recombinant mouse IL-10 also suppressed DTH reactions by adoptive transfer when pulsed with the inciting antigen. Collectively, these data suggest a mechanism for the contralateral effect in which genetically modified macrophages and DCs present antigen in the context of high, local concentrations of vIL-10, thereby generating unresponsive T lymphocytes. These findings suggest new ways in which to treat immune-driven diseases by gene and cell therapy.
Social affordances in context: What is it that we are bodily responsive to?
Authors: Erik Rietveld, Sanneke de Haan, Damiaan Denys
Journal: Behavioral and Brain Sciences (2013)

Abstract We propose to understand social affordances in the broader context of responsiveness to a field of relevant affordances in general. This perspective clarifies our everyday ability to unreflectively switch between social and other affordances. Moreover, based on our experience with Deep Brain Stimulation for treating obsessive-compulsive disorder (OCD) patients, we suggest that psychiatric disorders may affect skilled intentionality, including responsiveness to social affordances.
Proposed Revision of the Code of Ethics of the American Medical Association—Report of the Committee on Revision.
Authors: N. S. Davis
Journal: JAMA (1894)

<h3>To the Editor:</h3> —After more than ten months of the year have passed since the last annual meeting of theAmerican Medical Association, the majority of the Committee appointed nearly two years since to inquire whether any revision of the Code of Medical Ethics was desirable, have made their report in theJournal of the Associationof the 7th inst. As less than half of the State and Territorial medical societies will have regular meetings between this time and the meeting of theAssociationin San Francisco, it is apparent that no proper consideration can be given to this report by the several State medical societies for the purpose of instructing their delegates regarding it, as was contemplated by action taken at the annual meeting in Milwaukee. And but few readers of theJournalwill fully comprehend the changes contained in the revised Code and their real import, unless they
THE DESTRUCTION OF ALKALOIDS BY EMULSIONS OF THE BODY TISSUES
Authors: A. J. Clark
Journal: BMJ (1912)

DESTRUCTION OF ALKALOIDS BY TISSUE EMULSIONS.'[j AsTlikMaxL IO99 _ZIA five normal persons (P.II.)The followinig Table shows the highest serum dilutions wlhich gave an index higher than normal saline.Hlighest dilution of Serumn whiclh shows a greater psagocyt c index than norumatl saline.BeforeII Ilnoct-3 days.4 da3 s. a days.6 days.7 day.. 8 days.9 days.10 days.
Symptoms of Carbolic Acid Poisoning by Absorption: Discharge of Pigments in the Urine
Authors: J. Wallace
Journal: BMJ (1870)

out without removing the globe; but I postponed this in order to de- termine, if possible, the nature of the disease.In the portion removed, the normal stroma of the gland could be seen, having imbedded in it innumerable small round cells and free nuclei.I obtained several normal lacrymal glands from dead bodies, and compared the microscopic appearances of these with the diseased
Effect of Race on Access to Recombinant Human Erythropoietin in Long-term Hemodialysis Patients
Authors: Kenneth R. Petronis
Journal: JAMA (1994)

To quantify access to recombinant human erythropoietin (EPO) among patients with dialysis-dependent end-stage renal disease (ESRD).National random sample of hemodialysis patients from a random sample of dialysis units, using data abstracted from patients' medical records.All US hemodialysis units.A total of 4024 Medicare-entitled in-center hemodialysis patients.The relative odds that black patients received EPO (compared with white patients).There was no evidence in this national study that black hemodialysis patients were more or less likely to receive EPO than white patients (P = .74).Three years after Food and Drug Administration approval and Medicare coverage of EPO, there was no evidence of racial disparity in access to EPO among Medicare patients with ESRD who were receiving long-term hemodialysis. However, there was evidence of greater need for EPO among black patients.
An ethical code for everybody in health care
Authors: D. Berwick, H. Hiatt, P. Janeway, R. Smith
Journal: BMJ (1997)

Perhaps there was a time when professional ethics alone gave health care a sufficient moral compass. If so, that time has passed. The fate of patients and the public's health depends now on interactions so complex that no single profession can credibly declare that its own code of ethics is enough. We think that we need an ethical code to cover everybody involved in health care, and we have embarked on the search for such a code.

Consider the following cases.

A doctor working in an NHS trust thinks it wrong that his patients will be denied a new treatment for cancer—despite the hospital formulary committee deciding that it should not be prescribed. Should he contact the local media? Should the trust punish him if he does?

A staff surgeon employed full time by a not for profit health maintenance organisation develops an approach to postoperative pain control for a surgical procedure that shortens average length of stay by 1.5 days. Is she ethically obliged to share information of her discovery with the world?

A British general practice that plans to become a fundholding practice deliberately keeps its prescribing costs high for a year so that it will receive a bigger budget in its first year as a fundholder (the budget is based on the previous year's activity). Is this defrauding other practices and health organisations or doing the best by the patients in the practice?

A health maintenance organisation considers investing in improvements in its system for caring for AIDS patients. The vice president for marketing warns that such improvements may lead to selective enrolment of unprofitable HIV positive members. Is the organisation ethically bound to improve its HIV care, even if that …