tbuckley/cabot-search huggingface dataset:
Teaching Family Medicine in Rural Clinical Clerkships
Authors: Theodore J. Phillips
Journal: JAMA (1974)

Clinical clerkships that lasted for a term of six weeks in rural areas were used for instruction of undergraduate students in family medicine at the University of Washington School of Medicine. Once the objectives for such clerkships had been determined, teaching contracts between the University and rural practitioners were made whereby these practitioners assumed full responsibility for teaching the clerks. Although some problems, such as how to avoid "overstudy" of clerkship participants while documenting results, remain unsolved, it was found that the practitioner, in his realistic clinical setting, can make unique contributions to the education of both medical students and residents. (<i>JAMA</i>228:1408-1410, 1974)
Quality of Care—How Good Is Good Enough?
Authors: Harold C. Sox
Journal: JAMA (2010)

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
Combination Chemotherapy for Patients With Malignant Lymphoma
Authors: Paul P. Carbone
Journal: JAMA (1972)

The development of effective combination chemotherapy for patients with malignant lymphoma was based on clinical experience in patients with acute leukemia developed at the National Cancer Institute, and specific baseline knowledge of the effects of single agents in patients with malignant lymphoma. In 1965 we reported the results of a controlled clinical trial in a large number of patients, observing the effects of a vinca alkaloid or cyclophosphamide on induction of response, complete response rate, cross resistance, and the effect of maintenance on remission duration. We also reported the usefulness of a new agent, procarbazine hydrochloride, that appeared to be effective in alkylating agent-resistant patients. These results indicated that a combination treatment program in stage III or IV cases with mechlorethamine hydrochloride (nitrogen mustard), vincristine, procarbazine, and prednisone (MOPP) would be ideal, since these drugs were individually effective and had different major clinical toxicities. Besides the concept of combining these
Hypertonic Saline Induction of Abortion
Authors: Robert C. Goodlin
Journal: JAMA (1970)

<h3>To the Editor.—</h3> I must disagree with Manabe's condemnation of hypertonic saline for the induction of abortion (<b>210:</b>2091, 1969). As he states, there were reports of deaths occurring in Japan after World War II following the intra-amniotic administration of saline, but because of the lack of specific details in the reports, the English-reading physician can only conclude that the technique was dangerous in Japan in the early 1950's. We have done approximately 900 therapeutic abortions with hypertonic saline in the Stanford University Hospital, and, though the risks associated with this technique are certainly well recognized, we believe it is a useful and relatively safe method of terminating pregnancies in the second trimester.<sup>1</sup> Dr. Manabe refers to an absence of even one maternal death in Japan resulting from the use of other techniques for midterm abortions in apparently hundreds of thousands of interrupted pregnancies.<sup>2</sup>It is of interest
Tobias Smollett
Authors: George S. Rousseau
Journal: JAMA (1971)

Physicians, in addition to their medical skill, often possess talents in music and literature. Few doctors do not either play musical instruments competently or at least enjoy classical music; and the last three centuries attest to the extraordinary literary gifts of men of medicine: Boyle, Smollett, Goldsmith, Keats, our own William Carlos Williams, to mention a few. As early as the 17th century, Bartholinus compiled a list of medieval and Renaissance physicians who had been poets, and Pierre Bayle was so deeply impressed with his findings that he reprinted the list in hisDictionary. The reasons for these particular leanings, rather than, say, painting, sculpture, or the dance, are not perfectly clear, but a number of theories exists, ranging from broad social factors to individual psychological ones. And yet the matter remains something of a mystery.  Tobias Smollett (1721-1771), a contemporary of Fielding, Richardson, Sterne, Goldsmith, and Dr. Johnson, is
Patterns of drinking and liver cirrhosis – What do we know and where do we go?
Authors: Jürgen Rehm, Michael Roerecke
Journal: Journal of Hepatology (2015)

Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada; Addiction Policy, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 3M7, Canada; Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada; Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
ET-21 * COMBINATION OF INTRAVENOUS AND INTRACEREBRAL INJECTION OF ONCOLYTIC PARVOVIRUS H-1 IN A PHASE I/IIA CLINICAL TRIAL OF PATIENTS WITH RECURRENT GLIOBLASTOMA MULTIFORME: PENETRATION OF H-1 VIRUS ACROSS THE BLOOD-BRAIN BARRIER
Authors: K. Geletneky, A. Angelova, B. Leuchs, R. Bhat, A. Just, D. Capper, O. Krebs, M. Dahm, B. Huber, A. Unterberg, J. Hajda, J. Rommelaere
Journal: Neuro-Oncology (2014)

A promising alternative strategy for the treatment of glioblastoma multiforme (GBM) is the use of oncolytic viruses (OVs) that specifically replicate in and destroy tumor cells. In addition to direct oncolysis, OVs offer the chance for the induction of anti-tumor immune effects and OVs can be combined with standard therapies. Parvovirus H-1 (H-1PV) is a small single-stranded DNA virus of rodent origin with oncolytic anti-glioma properties in rat models. Intratumoral and intravenous infection led to the cure of orthotopic gliomas while at the same time raising an antitumor memory immune response. These results led to the launch of a phase I/IIa clinical trial (ParvOryx01) in patients with recurrent malignant GBM. Different from other OV studies in GBM patients, this trial not only uses rather traditional local treatment by intratumoral injection, but also intravenous infusions of H-1PV. By protocol, tumors have to be resected 10 days after the initial virus treatment, thereby offering the opportunity to analyze virus distribution and whether also in humans virus particles can cross the blood-brain/tumor barrier. As the trial is currently ongoing no clinical conclusions can be drawn. However, intriguing laboratory investigations in resected tumors and blood samples support the dual approach of local and systemic treatment. Immunohistochemistry and FISH analyses provided evidence for H-1PV crossing of the blood-brain barrier, intratumoral virus spreading and virus replication in tumor tissue. First evidence points to the the potential for induction of anti-tumor and anti-virus immunostimulation. Intratumoral effects and virus blood levels appear to be dose dependent and at present the highest administered cumulative dose was 5E9 pfu. The confirmation of H-1PV penetration into brain tumors after systemic therapy opens new opportunities to overcome the possible shortcomings of only local virus therapiy of GBM by providing the chance to access multiple tumor sites or remote tumor cells.
Both Immediate and Delayed Intracavernous Injection of Autologous Adipose-derived Stromal Vascular Fraction Enhances Recovery of Erectile Function in a Rat Model of Cavernous Nerve Injury
Authors: Xuefeng Qiu, Thomas M. Fandel, Ludovic Ferretti, Maarten Albersen, Haiyang Zhang, Guiting Lin, Ching-Shwun Lin, Tania Schroeder, Tom F. Lue
Journal: European Urology (2012)
Effect of venesection on calf blood flow in polycythaemia.
Authors: D W Milligan, J E Tooke, J A Davies
Journal: BMJ (1982)

Calf blood flow at rest and during postocclusive reactive hyperaemia was measured using an electrocardiogram-triggered plethysmograph in 14 patients with polycythaemia (nine with primary disease and five with polycythaemia secondary to cyanotic heart disease) before and after a course of venesection. The mean packed cell volume was reduced from 0.57 to 0.47, and whole-blood viscosity fell by 50% at low shear rates. Venesection did not affect rest flow, but peak flow was increased by 18%. The increase in peak flow failed to compensate for the reduced haemoglobin content of the blood, calculated haemoglobin delivery being reduced by 23% at rest and 10% during reactive hyperaemia. These results indicate that while venesection improves blood viscosity, this does not necessarily lead to improved delivery of oxygen to the tissues.
Identification of Adropin as a Secreted Factor Linking Dietary Macronutrient Intake with Energy Homeostasis and Lipid Metabolism
Authors: K. Ganesh Kumar, James L. Trevaskis, Daniel D. Lam, Gregory M. Sutton, Robert A. Koza, Vladimir N. Chouljenko, Konstantin G. Kousoulas, Pamela M. Rogers, Robert A. Kesterson, Marie Thearle, Anthony W. Ferrante, Randall L. Mynatt, Thomas P. Burris, Jesse Z. Dong, Heather A. Halem, Michael D. Culler, Lora K. Heisler, Jacqueline M. Stephens, Andrew A. Butler
Journal: Cell Metabolism (2008)
Commons votes for human embryo stem cell research
Authors: S. Mayor
Journal: BMJ (2001)

British MPs have backed proposals to permit research with human embryonic stem cells. Under current regulations, embryos up to 14 days old can be used for some specific research purposes, to treat infertility, and in the diagnosis of genetic and chromosomal disorders.

Under the new draft regulation, the Human Fertilisation and Embryology Authority, which regulates this area, would be able to license a wider range of research to explore the therapeutic potential of stem cells in the treatment of several disorders, such …
Pretreatment with FK506 up-regulates insulin receptors in regenerating rat liver
Authors: Oscar Escribano, María Dolores Fernández-Moreno, María Jesús Piña, Jesús Fueyo, César Menor, Irene Dolores Román, Luis G. Guijarro
Journal: Hepatology (2002)

This report examines the effect of FK506 pretreatment on liver insulin receptor expression in partially (70%) hepatectomized rats. FK506 pretreatment led to an increased insulin receptor number 24 hours after hepatectomy, detected by means of insulin binding and cross-linking procedures. This increase was related to enhanced insulin receptor expression determined by in vitro mRNA translation and Western blot techniques. We also tested the functionality of the expressed insulin receptors by [ 3 H] thymidine incorporation into DNA in insulin-stimulated hepatocytes. The results show that FK506 pretreatment elicits an increase in the amount of insulin receptor α-subunits as measured by Western blot. Maximum α-subunit expression recorded 24 hours after surgery was preceded by increased insulin receptor mRNA levels, which were detected 6 hours after hepatectomy. Moreover, in FK506-pretreated rat hepatocytes, obtained from remnant livers 24 hours after partial hepatectomy (PH), the increase in insulin receptor number was associated with improved sensitivity to the hormone. However, in both experimental groups (FK506-pretreated and nonpretreated rats), the sensitivity of hepatocytes toward epidermal growth factor (EGF) showed no significant change, which suggests a specific effect of FK506 on insulin receptor expression. In conclusion, our findings suggest that FK506 pretreatment induces insulin receptor expression in regenerating rat liver and promotes liver regeneration in hepatectomized rats.
Model for directly assessing and improving clinical competence and performance in revalidation of clinicians
Authors: R. K McKinley
Journal: BMJ (2001)

It is now clear that revalidation and clinical governance will drive continuing professional development in medicine in the United Kingdom. 1 2 Thus patients, society, and the profession are to be assured that individual doctors not only are fit to practise but are providing high quality care for patients. The focus of professional revalidation is rightly moving from the requirement that practitioners merely provide evidence of participation in continuing education towards the requirement that they provide evidence that better reflects their clinical practice. 3 4 Nevertheless, the primary screening procedures that have been proposed for revalidation are indirect (see box).4 If used at all, tests of clinical competence come much later in the process, but few tests include direct observation of practice. We present the case for the primacy of obtaining direct evidence of clinical competence of any doctor being revalidated; discuss the essential attributes of any process of obtaining such evidence; describe the ways in which such evidence can be gathered; explore the limitations of review tools currently available; and suggest an appropriate model for performance review.

#### Summary points

The measures currently proposed for assessing competence in clinician revalidation are mainly indirect or proxy

As the consultation is the single most important event in clinical practice, the central focus of revalidation should be the assessment of consultation competence

Such assessment should be by direct observation and satisfy five criteria—reliability, validity, acceptability, feasibility, and educational impact

Assessment of consultation competence would be followed by assessment of specific skills and regular performance review

Such an assessment procedure is recommended for use in the revalidation of all clinicians

#### Recent proposed components of revalidation in United Kingdom

Indirect …
Review of Francois Ansermet and Pierre Magistretti.<i>Biology of Freedom: Neural Plasticity, Experience, and the Unconscious</i>, trans. Susan Fairfield.<sup><i>1</i></sup>
Authors: Jonathan D. Moreno
Journal: The American Journal of Bioethics (2008)

No moment in the folklore of psychology has more resonance than the hand Sigmund Freud is said to have extended to William James, quite literally, as the older Harvard philosopher struggled to his ...
1188 PHASE 2 RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF NITAZOXANIDE WITH PEGINTERFERON ALFA-2A AND RIBAVIRIN IN NONRESPONDERS (NR) WITH CHRONIC HEPATITIS C GENOTYPE 1: FINAL REPORT
Authors: M.L. Shiffman, A. Ahmed, I.M. Jacobson, R.E. Pruitt, E.B. Keeffe
Journal: Journal of Hepatology (2010)
Eight Americas: A New Definition for “Americas”?
Authors: Howard Junca
Journal: PLoS Medicine (2007)

s PLoS Medicine, Daniel Reidpath and Kit Yee Chan challenge the widely cited link between HIV-related stigma and the spread of the epidemic [1].This is an important question, given the heavy emphasis on stigma in policies of the World Health Organization, the Joint United Programme on HIV/AIDS, and other public health institutions, but in making their argument Reidpath and Chan misrepresent the connections that other authors have made between stigma and viral transmission, ignore evidence that does suggest an association, and propose a model of their own for which they offer no evidence.HIV infection establishes itself fi rst in certain high-risk groups-men who have sex with men, intravenous drug users, sex workers, mobile populations-and only later moves into the general population.In the early stages of the epidemic, stigma facilitates transmission within high-risk groups, because these already marginalized groups receive little attention from policy makers and the health-care community and are further discriminated against when they are identifi ed with HIV and AIDS [2].Stigma also prevents or makes it more diffi cult for members of high-risk groups to access preventive services, including HIV antibody testing [3].Reidpath and Chan distort this dynamic by describing a model in which stigma leads to fear which leads to unsafe behavior.We know of no one who suggests that stigma causes sex between men or intravenous drug use.Instead, there is evidence that HIV-related stigma makes it diffi cult for people to take actions to reduce their risks; for example, by accessing HIV education [4], exchanging needles [5], and negotiating condom use [6].Stigma may even lead women who know they are HIV positive to breast-feed their infants rather than arouse suspicion of their serostatus through formula feeding [7].This undoubtedly increases the risk of vertical viral transmission.Reidpath and Chan go on to propose that stigma may actually "slow the spread of infection from those [highrisk] groups to the general population."Although there is a plausible logic to this suggestion, there is no evidence for it.Even if stigma does reduce the opportunities that marginalized groups have to transmit HIV to the broader population, this would have little effect on the dynamics of a generalized epidemic.While they recognize that stigma presents a barrier to the treatment and care of people living with HIV, Reidpath and Chan fail to recognize the association this may have with increased transmission.HIV-related stigma discourages people from disclosing their status, entering care, and adhering to antiretroviral regimens, all of which represent missed opportunities for prevention.Around the world HIV capitalizes on and reinforces social stigma and discrimination, especially the low status of women.Defeating the epidemic requires an honest examination of all these phenomena and interventions that target both the virus itself and its widespread social impacts.
Taxol inhibits neointimal smooth muscle cell accumulation after angioplasty in the rat.
Authors: S J Sollott, L Cheng, R R Pauly, G M Jenkins, R E Monticone, M Kuzuya, J P Froehlich, M T Crow, E G Lakatta, E K Rowinsky
Journal: Journal of Clinical Investigation (1995)

Despite significant improvements in the primary success rate of the medical and surgical treatments for atherosclerotic disease, including angioplasty, bypass grafting, and endarterectomy, secondary failure due to late restenosis continues to occur in 30-50% of individuals. Restenosis and the later stages in atherosclerotic lesions are due to a complex series of fibroproliferative responses to vascular injury involving potent growth-regulatory molecules (such as platelet-derived growth factor and basic fibroblast growth factor) and resulting in vascular smooth muscle cell (VSMC) proliferation, migration, and neointimal accumulation. We show here, based on experiments with both taxol and deuterium oxide, that microtubules are necessary for VSMCs to undergo the multiple transformations contributing to the development of the neointimal fibroproliferative lesion. Taxol was found to interfere both with platelet-derived growth factor-stimulated VSMC migration and with VSMC migration and with VSMC proliferation, at nanomolar levels in vitro. In vivo, taxol prevented medial VSMC proliferation and the neointimal VSMC accumulation in the rat carotid artery after balloon dilatation and endothelial denudation injury. This effect occurred at plasma levels approximately two orders of magnitude lower than that used clinically to treat human malignancy (peak levels achieved in this model were approximately 50-60 nM). Taxol may therefore be of therapeutic value in preventing human restenosis with minimal toxicity.
REPRODUCIBILITY OF IN-VIVO CORONARY FOURIER DOMAIN OPTICAL COHERENCE TOMOGRAPHY
Authors: Takayuki Okamura, Nieves Gonzalo, Patrick W. Serruys, Nico Bruining, Robert J. van Geuns, Jurgen M. Ligthart, Gijs van Soest, Evelyn Regar
Journal: Journal of the American College of Cardiology (2010)
Office Surgery for Family Physicians
Authors: David Breitwieser
Journal: JAMA (1986)

Cost containment, ambulatory surgery, and outpatient procedures—all have become an established part of the medical vocabulary in America today. With regard to health care expenditures, emphasis has shifted from solely quality care to quality care in a cost-effective manner. Numerous studies as well as the weight of historical experience support the increasing use of office and outpatient procedures to deliver cost-effective quality care. Drs Pories and Thomas have written this text for family physicians who perform office surgery. Although this is not explicitly stated, the book appears to be intended for the physician already in practice, but it would be valuable during training as well. <i>Office Surgery for Family Physicians</i>is well designed, with procedures described in a step-by-step fashion. One outstanding feature is the close proximity of illustrations and their related text, saving the reader the frustration of flipping pages to match them visually. The drawings show attention to
Clio and the Doctors: Psycho-History, Quanto-History, and History
Authors: Lester S. King
Journal: JAMA (1975)

Historian Barzun turns his critical artillery on "psychohistory," that attempt to use modern psychiatric insights as a major tool in historical research. I must confess my own personal delight with Professor Barzun's utterly devastating barrage, for the studies perpetrated by psychohistorians—some of them quite respectable scholars, other far-from-scholarly—I have found for the most part repulsive rather than attractive. And I am happy to find myself in such good company as Dr. Barzun. His analogous attack on "quantitative" history—the reliance on quantification as the major evidence for historical subjects—does not have quite the same devastation but serves as a potent and welcome corrective to a contemporary trend that is going to excesses. In between his strictures and his criticisms, Barzun provides many fine comments and obiter dicta on the nature of history and historical writing, its purposes, methods, and limitations. These ideas may stir considerable controversy among professional historians. The book
Incidence of Idiopathic Venous Thromboembolism in Nurses
Authors: L. E. Ramsay, M. A. MacLeod
Journal: BMJ (1973)

The incidence of idiopathic deep vein thrombosis and pulmonary embolism in a group of nurses (9.4 per 1,000 per year and 7.5 per 1,000 per year respectively) was much higher than the reported incidence in women of childbearing age in the general population (0.65 per 1,000 per year and 0.11 per 1,000 per year respectively). We suggest that these results show that nurses face an increased risk of idiopathic thromboembolism as a result of their occupation.