tbuckley/cabot-search huggingface dataset:
A Short Summary OF THE DEVELOPMENT OF THE TREATMENT OF UTERINE FIBROMYOMATA WITHIN THE LAST TWENTY-FIVE YEARS, With a Record of over One Hundred Consecutive Successful Cases of Supravaginal Hysterectomy
Authors: F. W. N. Haultain
Journal: BMJ (1906)

THE development of and success in the treatment uterine fibromyomata during the last twenty-five years maybe considered the greatest advance of gynaecology, and takes its place, in the very van of surgery, or any
Effectiveness of Local Endoscopic Resection of Rectal Carcinoid Tumors
Authors: S. Higaki, M. Nishiaki, N. Mitani, H. Yanai, M. Tada, K. Okita
Journal: Endoscopy (1997)

In the treatment of rectal carcinoid tumors, confusion arises in the choice between radical surgery and local endoscopic resection, since the malignancy of individual tumors differs widely. We investigated the appropriateness of using endoscopic therapy for this disease.Twenty-two patients were diagnosed with rectal carcinoid tumors at the First Department of Internal Medicine, Yamaguchi University School of Medicine and its affiliated hospitals, from 1977 to 1994. The tumors were resected and examined regarding their size, depth of invasion, and histological atypia. The post-treatment course in patients whose tumors were completely resected without atypia was observed by colonoscopy and ultrasonography at yearly intervals.In 21 patients, tumor invasion did not extend beyond the submucosal layer, and there were no signs of atypia. The size of the tumor varied from 2.2 mm to 10.0 mm in diameter, with an average of 5.4 mm. After endoscopic resection of the tumors in 18 patients and surgical local resection in three patients, no local recurrences or liver metastases were experienced. The patients survived for a minimum of 29 months and a maximum of 237 months; the mean survival period was 72.8 months. In one patient, the tumor showed cellular atypia invading into the tunica muscularis, and measured 25 mm in diameter. The patient underwent surgery, but died ten months later due to liver metastasis.Endoscopic treatment of rectal carcinoid tumors was found to be appropriate when the tumor measured 10 mm or less in diameter, did not infiltrate beyond the submucosal layer, and had no histological atypia.
Gila Monster Bite
Authors: James A. Roller
Journal: JAMA (1976)

<h3>To the Editor.—</h3> We recently encountered a 20-year-old preveterinary student who was bitten by one of his five pet Gila monsters (<i>Heloderma suspectum</i>) and was seen in the emergency room with severe pain, chills, nausea, and tense edema of the left hand and arm. Bites are not rare in Sonoran Gila handlers, however a<i>Heloderma</i>bite in the Ozarks is unusual. We found this case to be interesting and unique for several reasons: The patient was monitored in the intensive care unit, and although a left radial pulse was not palpable, results of an intermittent Doppler examination disclosed good arterial flow and venous return. Previous reports have indicated that arteriospasm is a chief cause of morbidity in Gila bites. The patient's pain subsided spontaneously soon after admission. We were thus able to avoid the use of narcotics, some of which potentiate Gila venom. Electrocardiographic findings on admission
To the point of farce: a martian view of the hardinian taboo the silence that surrounds population control
Authors: M. King, C. Elliott
Journal: BMJ (1997)

We humans have problems controlling our population. We apply the “Hardinian taboo”—a refusal to consider or discuss population control—so as to prevent ourselves having to deal with the problem adequately. Our worst problem is demographic entrapment. If the Hardinian taboo on entrapment is not removed, there will be increasing slaughter and starvation throughout much of Africa and elsewhere (malignant uproar), as recently shown in Rwanda.1 If it is removed, there will be intense discussion (benign uproar), followed—we argue—by behaviour change in the countries of the North (sustainable lifestyles) and of the South (reduced fertility). Which is it to be? Do we open the dialogue or don't we? The “foundations” of this taboo include the problems of one child families. The US State Department has, we believe, been orchestrating the global population debate to the point that it has corrupted critical aspects of academic demography, to the greatest possible disadvantage of trapped populations, presumably lest its own consumption of resources be criticised. We follow Hardin2 in thinking that, with modern communications, the solution to “the population problem” could come quite quickly. The difficulty is removing the taboo sufficiently to get enough “benign uproar.”

#### Summary points

The Hardinian taboo is a refusal to contemplate overpopulation as a problem

The choice is between the vigorous argument that will follow the lifting of the Hardinian taboo and the slaughter and starvation of letting it remain

The world wide web could be the key factor in lifting it

Lifting the taboo has important implications for the market economy

Lifting it would be a powerful agent for good

Lady M: Back home in Mars we have long been interested in you humans. We can measure Earth's rising temperature and see your disappearing ice caps and your vanishing forests. We watch your television and subscribe to the …
392 SPECIFIC HBSAG GENETIC-DETERMINANTS ARE ASSOCIATED WITH OCCULT HBV-INFECTION IN VIVO AND HBSAG-DETECTION
Authors: V. Svicher, V. Cento, M. Bernassola, M. Neumann-Fraune, R. Salpini, R. Longo, M. Visca, S. Romano, V. Micheli, A. Bertoli, G. Gubertini, N. Marino, F. Mazzotta, C. Sarrecchia, M. Andreoni, M. Angelico, A. Ursitti, A. Spanò, F. Ceccherini-Silberstein, J. Verhejen, G. Cappiello, C.F. Perno
Journal: Journal of Hepatology (2011)
KIFC2 Is a Novel Neuron-Specific C-Terminal Type Kinesin Superfamily Motor for Dendritic Transport of Multivesicular Body-Like Organelles
Authors: Nobuhito Saito, Yasushi Okada, Yasuko Noda, Yoshihiro Kinoshita, Satoru Kondo, Nobutaka Hirokawa
Journal: Neuron (1997)
Synthetic glucocorticoids potentiate IgE synthesis
Authors: H. G. Nüsslein, G. Weber, J. R. Kalden
Journal: Allergy (1994)

Recently, hydrocortisone (HC) has been shown significantly to enhance interleukin‐4 (IL‐4)‐induced in vitro IgE synthesis. For investigation of possible effects of synthetic corticosteroids but also of effects of other important human hormones, peripheral blood mononuclear cells (PBMC) were incubated with IL‐4 and various concentrations of the hormones. IgE secreted in the supernatant was determined after a 14‐d culture period. Like HC, all synthetic corticosteroids potentiated IgE secretion. A minor effect was noted for the mineralocorticoid aldosterone. No modulating effect on IL‐4‐induced IgE formation was observed for adrenocorticotropic hormone (ACTH), somatotropin (STH), thyroid‐stimulating hormone (TSH), triiodothyronine, thyroxine, epinephrine, noradrenaline, insulin, and glue agon.
Adhesion and proliferation of cultured human aortic smooth muscle cells on polystyrene implanted with N+, F+ and Ar+ ions: correlation with polymer surface polarity and carbonization
Authors: Lucie Bačáková, Václav Švorčík, Vladimír Rybka, Ivan Miček, Vladimír Hnatowicz, Věra Lisá, František Kocourek
Journal: Biomaterials (1996)
Health Care Cost Control and Views of Physicians
Authors: Jacob Korula
Journal: JAMA (2013)

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
Rethinking ward rounds
Authors: D. K Sokol
Journal: BMJ (2009)

If you were a patient, would you prefer your medical team to use an ethics checklist?

It’s the morning round in the hospital. In a dreary voice the doctor presents the patient, a 43 year old man with fever, chills, and a productive cough. He has a new diagnosis of HIV infection. He is married and has a girlfriend. The two bioethicists in the room, hitherto lulled by the long list of treatments, stir uncomfortably in their seats: there may be problems afoot. Do the wife and girlfriend know about each other? Can the team distinguish one from the other? Does the patient want to share the diagnosis with either? Should they be told of their likely exposure to HIV, even without the patient’s consent?

The purpose of oral presentations in rounds is to tell the patient’s story. It is primarily a medical story, which may start before the patient’s birth (if genetics are relevant) and extend to the future. The narrative helps the healthcare team make sense of the patient’s situation and provide safe, effective care. Although the stories should …
No Vivisection Without Anesthesia.
Authors: Joseph Kirkland.
Journal: JAMA (1894)

definitely extended."Yet Dr. J. H. Girdner, apparently speaking as a representative for the Academy of Medicine, appeared before the Congressional Committee who were con- sidering the bill, and misrepresented the position of the Chicago Society by the statement that its opposition to the bill was based on the ground that the latter was not radical enough.When asked where the Marine Hospital Service was weak, and in what particulars it did not cover the work outlined in the proposed
Evaluation of coronary artery anatomy in patients with tetralogy of Fallot by two-dimensional echocardiography.
Authors: J M Berry, S Einzig, K A Krabill, J L Bass
Journal: Circulation (1988)

A major coronary artery crossing the right ventricular outflow tract in patients with tetralogy of Fallot interferes with a transannular patch, and preoperative detection of this artery is important. We evaluated the ability of two-dimensional echocardiography to define noninvasively the coronary artery anatomy in 37 consecutive patients (age range, 1 day to 18 years; mean age, 40.9 months). The origin and distribution of the right anterior descending and circumflex coronary arteries, as well as any anteriorly coursing vessel, were examined from parasternal views. Complete studies were obtained in 29 (78%) of the 37 patients. Coronary artery anatomy was determined to be normal by echocardiography in 20 (69%) of the 29 patients. An anterior vessel across the right ventricular outflow tract was detected in the remaining nine patients. Six patients had an anterior descending artery from the left main coronary artery (paired anterior descending arteries in three patients, a right anterior descending artery from the left main coronary artery in two patients, and a right coronary-to-pulmonary artery fistula in one patient). Three patients had no anterior descending artery from the left main coronary artery (anterior descending artery from the right main coronary artery in two patients, and anterior descending and circumflex arteries from the right main coronary artery in one patient). Angiography, surgery, or autopsy confirmed the diagnoses in all but the final patient in whom the anterior descending artery arose from the right main coronary artery as observed at surgery, but the circumflex artery was not seen. Accurate evaluation of coronary artery anatomy is possible by echocardiography in the majority of patients with tetralogy of Fallot. Noninvasive identification of a major coronary artery coursing anteriorly can influence the timing of cardiac catheterization and surgery and the need for angiography.
Developmental Care for Very Low-Birth-Weight Infants-Reply
Authors: H. Als, F. H. Duffy, G. B. McAnulty, J. G. Blickman, R. Gibes-Grossman, G. Lawhon
Journal: JAMA (1995)

<h3>In Reply.</h3> —We thank those who wrote for their vigorous criticism and feedback, which has provided us with an opportunity to further explore our conclusions. Groups did not differ in severity of initial illness, as reconfirmed by analysis of variance of score for neonatal acute physiology<sup>1</sup>(<i>P</i>&lt;.42) and background variable MANOVA (<i>P</i>&lt;.59). All eligible infants meeting the initial 3-hour criteria also met the 48-hour criteria. Only two control group infants were unavailable for study; one died at 8 months, the other moved out of state. Outcome measures were predetermined and directionality was hypothesized, calling for one-tailed tests.<sup>2(p14)</sup>Only three of the 11 "significant" outcome variables narrowly miss the two-tailed.05 level. Considering that all our infants weighed 1250 g or less and were aged 29 weeks or less, control group IVH incidence of 55.56% compares favorably with other estimates of overall incidence (51.13%<sup>3(Table 5)</sup>) for infants
Predictive values of component-specific IgE for the outcome of peanut and hazelnut food challenges in children
Authors: K. Beyer, L. Grabenhenrich, M. Härtl, A. Beder, B. Kalb, M. Ziegert, A. Finger, N. Harandi, R. Schlags, M. Gappa, L. Puzzo, H. Röblitz, M. Millner-Uhlemann, S. Büsing, H. Ott, L. Lange, B. Niggemann
Journal: Allergy (2014)

Oral challenges are the gold standard in food allergy diagnostic, but time-consuming. Aim of the study was to investigate the role of peanut- and hazelnut-component-specific IgE in the diagnostics of peanut and hazelnut allergy and to identify cutoff levels to make some challenges superfluous.In a prospective and multicenter study, children with suspected peanut or hazelnut allergy underwent oral challenges. Specific IgE to peanut, hazelnut, and their components (Ara h 1, Ara h 2, Ara h 3, and Ara h 8, Cor a 1, Cor a 8, Cor a 9, and Cor a 14) were determined by ImmunoCAP-FEIA.A total of 210 children were challenged orally with peanut and 143 with hazelnut. 43% of the patients had a positive peanut and 31% a positive hazelnut challenge. With an area under the curve of 0.92 and 0.89, respectively, Ara h 2 and Cor a 14-specific IgE discriminated between allergic and tolerant children better than peanut- or hazelnut-specific IgE. For the first time, probability curves for peanut and hazelnut components have been calculated. A 90% probability for a positive peanut or hazelnut challenge was estimated for Ara h 2-specific IgE at 14.4 kU/l and for Cor a 14-specific IgE at 47.8 kU/l. A 95% probability could only be estimated for Ara h 2 at 42.2 kU/l.Ara h 2- and Cor a 14-specific IgE are useful to estimate the probability for a positive challenge outcome in the diagnostic work-up of peanut or hazelnut allergy making some food challenges superfluous.
Structural and functional alterations of the intramyocardial coronary arterioles in patients with arterial hypertension.
Authors: B Schwartzkopff, W Motz, H Frenzel, M Vogt, S Knauer, B E Strauer
Journal: Circulation (1993)

BACKGROUND In hypertensive patients with angina pectoris, the coronary vasodilator reserve is frequently impaired despite a normal coronary angiogram. Experimental data indicate that structural alterations of the intramyocardial coronary vasculature contribute to an increased minimal coronary resistance and a diminished coronary flow reserve. METHODS AND RESULTS In 14 patients (10 men and 4 women) with arterial hypertension and 8 normotensive subjects, minimal coronary resistance and vasodilator reserve (dipyridamole: 0.5 mg/kg body wt, gas chromatographic argon method) were determined after the angiographic exclusion of relevant coronary artery disease. Coronary reserve was depressed in hypertensive patients (2.7 +/- 2.3 vs 4.6 +/- 1.3, P &lt; or = .05) due to increased minimal coronary resistance (0.64 +/- 30 vs 0.24 +/- 0.055 mm Hg.min.100 g.mL-1, p &lt; or = 0.002). In right septal biopsies, mean external arteriolar diameter (21.6 +/- 2.3 vs 17.2 +/- 2.5 microns, P &lt; or = .001), mean arteriolar wall area (271 +/- 61 vs 172 +/- 62 microns 2, P &lt; or = .01), percent medial wall area (69.9 +/- 4.0 vs 66.0 +/- 3.2%W, P &lt; or = .05), mean periarteriolar fibrosis area (216 +/- 122 vs 104 +/- 68 microns 2, P &lt; or = .05), and volume density of total interstitial fibrosis (3.6 +/- 1.8 vs 1.9 +/- 0.5Vv% fibrosis, P &lt; or = .05) were increased in hypertensive patients compared with normotensive subjects. Minimal coronary resistance correlated with %W (r = .6, P &lt; or = .003) and Vv% fibrosis (r = .62, P &lt; or = .002). Left ventricular mass index (111 +/- 21 vs 97 +/- 17 g/m2, P = NS) and left ventricular end-diastolic pressure (12 +/- 6 vs 8 +/- 3 mm Hg, P = NS) did not correlate significantly with minimal coronary resistance. In multivariate analysis, both %W and Vv% fibrosis explained half of the variability of minimal coronary resistance (r2 = .5, P &lt; or = .002). CONCLUSIONS Structural remodeling of the intramyocardial coronary arterioles and the accumulation of fibrillar collagen are decisive factors for a reduced coronary dilatory capacity in patients with arterial hypertension and angina pectoris in the absence of relevant coronary artery stenoses.
P1306 COMPARISON OF IFNL4- ΔG AND IFNL3 3′UTR rs4803217 GENOTYPES FOR ASSOCIATION WITH HCV TREATMENT RESPONSE
Authors: T. O'Brien, R. Pfeiffer, W. Tang, K. Kuhs, S. Chen, C. Howell, L. Prokunina-Olsson
Journal: Journal of Hepatology (2014)
A NEW NASAL DRESSING.
Authors: JAY G. ROBERTS
Journal: JAMA (1907)

I think it will be generally admitted that the ordinary methods of packing the nasal cavities after operation are unsatisfactory. Packing with gauze is particularly so. It is difficult by this method to secure sufficient pressure in the proper place to control hemorrhage efficiently. By its capillarity the gauze acts as a drain, keeping up a continual oozing, which may even reach alarming proportions. It is continually getting down into the pharynx, causing retching and tempting the patient to remove it. Its removal is painful, interferes with healing and always occasions more or less secondary hemorrhage. The open method, with or without the application of collodion to the surfaces operated on, is dangerous and not to be considered as a routine measure. The Simpson tampon of compressed absorbent cotton in various sizes is a fairly satisfactory dressing but for the difficulty attendant on its introduction or removal. It bends, swells
Quality of plasma cholesterol measurements in primary care.
Authors: P. M. Broughton, D. G. Bullock, R. Cramb
Journal: BMJ (1989)

Three surveys were made of the quality of plasma cholesterol measurements performed with a commercial desktop analyser (BCL Reflotron) in primary care. Each survey included three specimens, and results were received from 37, 61, and 69 participants. Although many participants obtained satisfactory results, 8.6% of the results differed by 1.0 mmol/l or more from the target values, and the overall between instrument dispersion of results was 1.3 times that between hospital laboratories. It was found that common sources of error were poor technique and the use of outdated reagent strips. Users of such instruments outside the laboratory need help and advice with training, and guidelines for this are provided. The main recommendations are that users should establish contact with a local clinical chemistry laboratory for training and support and should participate in external quality assessment schemes.
Ethics group rules on treating premature babies
Authors: Lynn Eaton
Journal: BMJ (2006)

Doctors should not normally give intensive care to premature babies born between 22 and 23 weeks' gestation, says a working party set up by the Nuffield Council on Bioethics. 

The chances that these babies survive once they leave hospital are so low that such treatment is not appropriate, it argues. 

“Natural instincts are to try to save all babies, even if the baby's chances of survival are low,” said Margaret Brazier, the chairwoman of the working party and professor of law at Manchester University. 

“However, we don't think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable.” 

The new guidelines follow an increase in the number of extremely premature babies being born since the 1980s. Although the age at which such babies can survive has been falling, most will still die, says the report. 

The council's consultation exercise has …
Temperature-dependent modulation of lipopolysaccharide-induced interleukin-1 beta and tumor necrosis factor alpha expression in cultured human astroglial cells by dexamethasone and indomethacin.
Authors: S Velasco, M Tarlow, K Olsen, J W Shay, G H McCracken, P D Nisen
Journal: Journal of Clinical Investigation (1991)

In bacterial meningitis, LPS induces production in cerebrospinal fluid of the cytokines IL-1 beta and tumor necrosis factor alpha (TNF alpha), which are the principle mediators of meningeal inflammation. IL-1 beta and TNF alpha induce fever, and elevated temperature may affect cytokine expression. Dexamethasone treatment improves outcome in bacterial meningitis possibly by inhibiting IL-1 beta and TNF alpha. In this report, the effects of elevated temperature and dexamethasone on LPS-stimulated IL-1 beta and TNF alpha mRNA gene expression and protein synthesis were studied in human astrocytoma cell lines and primary cultures of human fetal astrocytes. Cells cultured at 40 degrees C exhibited smaller peaks of IL-1 beta and TNF alpha transcription and protein synthesis compared with cells cultured at 37 degrees C. The addition of dexamethasone before, during, or after exposure of the cells to LPS resulted in temperature-dependent inhibition of IL-1 beta transcription and protein synthesis. The most extensive inhibition occurred in pretreated cells cultured at 37 degrees C. Cotreatment with LPS and dexamethasone also inhibited TNF alpha mRNA transcription at both temperatures. The effects of another antiinflammatory agent, indomethacin, on LPS induction of IL-1 beta and TNF alpha mRNA were temperature and cell line dependent. These findings provide a possible explanation for the efficacy of dexamethasone treatment of bacterial meningitis and support the proposal that fever may be beneficial to the host in this disease.
THE DIFFERENTIAL DIAGNOSIS OF ACUTE POLIOMYELITIS
Authors: M. BERNARD BRAHDY
Journal: JAMA (1934)

There are few infectious diseases so frequently incorrectly diagnosed as acute poliomyelitis. In a survey of this disease over a period of four years at the Herman Kiefer Hospital in Detroit, Gordon 1 found that in only half of the 446 patients admitted with a diagnosis of poliomyelitis was the diagnosis confirmed by clinical study and laboratory investigation. Such a finding means that there is need for improvement in diagnostic technic. By studying the mistakes and suggesting, when possible, how these mistakes can be avoided, the profession should be able to increase its diagnostic accuracy. With this purpose we record our observations during the epidemic of poliomyelitis in New York in 1931. There were 1,123 patients admitted to the Willard Parker Hospital with a diagnosis of poliomyelitis. After careful examination and observation, poliomyelitis was excluded in 113. These 113 patients form the material for our presentation. This of necessity limits