tbuckley/cabot-search huggingface dataset:
Parapneumonic effusions secondary to community-acquired bacterial pneumonia in human immunodeficiency virus-infected patients
Authors: V Gil Suay, PJ Cordero, E Martinez, JJ Soler, M Perpina, JV Greses, J Sanchis
Journal: European Respiratory Journal (1995)

The purpose of this study was to determine whether the clinical and microbiological characteristics of parapneumonic effusions in patients with community-acquired pneumonia (CAP) infected with the human immunodeficiency virus (HIV) were different from those observed in patients without HIV infection. One hundred and thirty seven patients with parapneumonic effusions were included and divided into two groups depending on whether they had HIV infection or not. The parapneumonic effusion rate was significantly higher in HIV-positive than in noninfected patients (21 vs 13%). Their clinical course was more severe, presenting a higher rate of bacteraemias (58 vs 18%). Pleural fluid in patients infected with HIV had significantly lower glucose levels than that of patients without HIV infection. Chest tube drainage was more frequent in parapneumonic effusions of patients infected with HIV than in those without HIV infection (71 vs 44%). Staphylococcus aureus was the most common microorganism found in the bacteriological samples of patients with CAP infected with HIV (53 vs 12%). We conclude that patients with community-acquired pneumonia and HIV infection have a higher rate of parapneumonic effusions and a more severe clinical course than non-HIV patients, and that Staphylococcus aureus predominates in their bacteriological samples.
TCT-463 Impact of Late Catch-up Phenomenon on Delayed Restenosis After Sirolimus-Eluting Stent and Bare-Metal Stent Implantation
Authors: Kenji Sakata, Yuki Horita, Naoto Tama, Toshimitsu Takagi, Isao Inoki, Hedenobu Terai, Masatoshi Ikeda, Masanobu Namura, Masakazu Yamagishi
Journal: Journal of the American College of Cardiology (2013)
U-100 Insulin
Authors: James M. Moss
Journal: JAMA (1977)

IN FEBRUARY 1973, U-100 insulin (100 units/ml) was introduced in the United States by Eli Lilly & Company and a few months later by E. R. Squibb & Sons. The marketing of this strength of insulin was the culmination of many years of concern by the American Diabetes Association (ADA), the Food and Drug Administration, and the insulin manufacturers over medication errors that resulted from confusion between U-40 and U-80 insulins. Specifically, a few patients requiring U-40 insulin were inadvertently administering U-80, and marked hypoglycemia developed, while some requiring U-80 were using U-40 insulin with subsequent loss of control of the diabetes. Another hazard was the confusion frequently caused by the glass syringe marked with scales for both U-40 and U-80 insulins.  The concentration of U-100 (100 units/ml) was agreed on by the ADA, the FDA, the Canadian regulatory agency (Health Protection Branch), and manufacturers of insulin in the United
Eating and ulcers.
Authors: K Barlow
Journal: BMJ (1980)

may be responsible for stress.Though this possibility should not be overlooked, simple observation of increased smoking during war time suggests that smoking alleviates stress or fulfils some other basic human need (for example, relieves boredom) for many people, a view consistent with the US Surgeon-General's recognition of "significant beneficial effects of smoking primarily in the area of mental health."3Dr T Khosla and Professor H Campbell (2 February, p 331) suggested that, by restricting my attentions to those under 65, I had given a
Comparison of Flecainide with Quinidine for Suppression of Chronic Stable Ventricular Ectopic Depolarizations
Authors: David M. Salerno, Morrison Hodges, Gregory Granrud, Patricia Sharkey
Journal: Annals of Internal Medicine (1983)

In a randomized placebo-controlled double-blind trial, we compared flecainide to quinidine for treatment of ventricular ectopic depolarizations in 19 patients. The mean percent suppression of total ventricular ectopic depolarizations was 95% for flecainide and 56% for quinidine (p < 0.05). A greater than 80% reduction of total ventricular ectopic depolarizations was obtained in eight of nine patients given flecainide and in five of ten patients given quinidine (p = 0.09). After the randomized protocol, the patients who had received quinidine were given flecainide; 9 of the 10 patients had greater than 80% reduction of total ventricular ectopic depolarizations. Flecainide produced 100% suppression of nonsustained ventricular tachycardia and 99.5% suppression of paired ventricular depolarizations. Flecainide prolonged the PR and QRS intervals; quinidine prolonged the PR and JTC intervals. Side effects were commoner with quinidine than flecainide (p = 0.06). Three other patients failed to complete the protocol because of serious adverse experiences.
The Professionalism Movement: Can We Pause?
Authors: Delese Wear, Mark G Kuczewski
Journal: The American Journal of Bioethics (2004)

The topic of developing professionalism dominated the content of many academic medicine publications and conference agendas during the past decade. Calls to address the development of professionalism among medical students and residents have come from professional societies, accrediting agencies, and a host of educators in the biomedical sciences. The language of the professionalism movement is now a given among those in academic medicine. We raise serious concerns about the professionalism discourse and how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label of "professionalism." In particular, we argue that the professionalism discourse needs to pay more attention to the academic environment in which students are educated, that it should articulate specific positive behaviors, that the theory of professionalism must be constructed from a dialogue with those we are educating, and that this theoretical and practical discourse must aim at a deeper understanding of social justice and the role of medicine within a just society.
Diagnostic usefulness of a nested polymerase chain reaction assay for detecting <i>Sarcoptes scabiei</i> DNA in skin scrapings from clinically suspected scabies
Authors: S. Fukuyama, T. Nishimura, H. Yotsumoto, A. Gushi, M. Tsuji, T. Kanekura, T. Matsuyama
Journal: British Journal of Dermatology (2010)
THE CONTROL OF SYPHILIS: A CRITICAL EXAMINATION OF SOME OF ITS PROBLEMS.*
Authors: JOHN H. STOKES
Journal: British Journal of Dermatology (1936)

Journal Article THE CONTROL OF SYPHILIS: A CRITICAL EXAMINATION OF SOME OF ITS PROBLEMS.* Get access JOHN H. STOKES, M.D. JOHN H. STOKES, M.D. Duhring Professor of Dermatology and Syphilology, School of Medicine, University of Pennsylvania, Philadelphia. From the Department of Dermatology and Syphilology, School of Medicine, University of Pennsylvania Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 48, Issue 11, 1 November 1936, Pages 527–563, https://doi.org/10.1111/j.1365-2133.1936.tb10295.x Published: 01 November 1936
Primary care in Bradford: from group to trust and beyond
Authors: N. Small, S. Proctor
Journal: BMJ (2001)

In April 1999, four primary care groups were set up to cover the district of Bradford in England.1 The four groups were Bradford City (population 146 600, 54.1% from ethnic minority communities; 44 practices, 28 with one partner and eight with two partners), Airedale (population 116 450; 70 general practitioners in 19 practices), Bradford South and West (population 147 100; 92 general practitioners in 23 practices) and Bradford North (population 91 850; 54 general practitioners in 13 practices). In October 2000, keeping the same geographic boundaries, all four groups achieved primary care trust status. In April 2001, Bradford City became one of the first three primary care trusts in Britain to be awarded teaching status.

Using the observations of a small group of key staff (mostly general practitioners), we describe how the four primary care groups decided to become trusts, and we examine the process that followed the decision. We look at the early experience of group members once trust status had been achieved and consider issues of continuity and change during this eventful time.

#### Summary points

Advantages can be gained by multiple primary care groups in one area applying for trust status at the same time

The biggest challenge in the transfer from group to trust is the timetable

The work needed to compile the submission document can detract from everyday duties, but it can also help to maintain the momentum

Primary care trusts need a different organisational structure to groups

General practitioners can be reassured by the trust focusing on strengthening the practice as a unit of care

We asked colleagues for comments for this article. We also analysed and interpreted quotes from discussions involving 100 professionals during Bradford University's conference “Primary care groups—one year on” (April 2000) and from questionnaires completed by 40 professionals who met to look …
Improving the Quality of Medical Care
Authors: Richard Grol
Journal: JAMA (2001)

Physicians today are confronted with increasing demand to ensure and improve care of their patients. A variety of approaches claim to provide solutions to the problems of health care delivery. These approaches represent different perspectives on optimal care and the best method for improving care. By summarizing recent reviews and debates in this field, this article critically reflects on the value of some of the approaches that have gained popularity during the last decades: evidence-based medicine and clinical practice guidelines, professional development, assessment and accountability, patient empowerment, and total quality management. Evidence regarding the impact and feasibility of the various approaches is mixed or simply lacking. In particular, the health care community lacks an understanding of which approaches are most appropriate for what types of improvement in what settings and of the determinants of successful performance change. Given the complexity of improvement and change in patient care, it is not realistic to expect that one approach can solve all the problems in health care delivery. None of the popular models for improving clinical performance appear to be superior. Therefore, bridges must be built and models must be integrated to be truly effective.
Surfactants identified in synovial fluid and their ability to act as boundary lubricants.
Authors: B A Hills, B D Butler
Journal: Annals of the Rheumatic Diseases (1984)

Thin-layer chromatography has been used to identify phospholipids extracted from canine synovial fluid, the major component (45%) being phosphatidyl choline (PC). The extracts and their components have been shown to be surface active in reducing the surface tension of water and to be readily adsorbed to hydrophilic solids, whose surfaces then become hydrophobic. These adsorbed monolayers of synovial surfactant were then found to be excellent boundary lubricants in vitro, reducing the coefficient of kinetic friction (mu) in the dry state and under physiological loading by up to 97% for extracts and 99% for PC alone, reaching mu = 0.01. Surface-active phospholipid is put forward as the possible active ingredient in joint lubrication and shown to be consistent with previous biochemical studies to elucidate its identity. The model essentially follows the classical Hardy model for boundary lubrication imparted by surfactants. It is discussed in relation to a new approach in providing artificial lubrication and facilitating tissue release in patients with arthritis.
Absence of refractoriness in asthmatic subjects after exercise with warm, humid inspirate.
Authors: A G Hahn, S G Nogrady, G R Burton, A R Morton
Journal: Thorax (1985)

Twelve asthmatic adults each completed two six minute treadmill runs separated by an interval of 20 minutes. Running speed was constant for each subject, and inspired air temperature averaged 5.5 degrees C (SD 1.5 degree) for both tests. Total minute ventilation and total respiratory heat loss showed no significant difference between the two runs. Forced expiratory volume in one second (FEV1) was measured before exercise and at five minute intervals throughout the recovery periods, during which subjects breathed room air at an average temperature of 17.8 degrees C (1.8 degree). Reduction in FEV1 from pre-exercise readings averaged 39.3% (13.3%) for the first run and 11.5% (7.3%) for the second. On another day the subjects underwent an identical procedure except that the first exercise period was performed with the saturated inspirate at 37.3 degrees C (1.7 degree). This run produced a mean FEV1 reduction of only 3.1% (7.3%). The ensuing run, during which the inspiratory temperature averaged 6.0 degrees C (2.0 degrees), led to a mean fall in FEV1 of 37.3% (17.3%). This was not significantly different from the value recorded for the first of the paired runs with cool air. We therefore have been unable to confirm that exercise with warm humid inspirate may induce refractoriness to exercise induced asthma. Our data are compatible with the theory that refractoriness may be due to depletion of mediators during an initial exercise induced asthma attack.
Orthostatic Hypotension Associated with Pernicious Anemia
Authors: John M. Kalbfleisch
Journal: JAMA (1962)

POSTURAL HYPOTENSION, first described by Bradbury and Eggleston in 1925, has been well documented in a variety of systemic diseases affecting the central nervous system such as tabes dorsalis and diabetes mellitus. The syndrome is characterized by orthostatic hypotension, a relatively fixed pulse rate (except with diabetes mellitus when it may be variable), and hypohidrosis. The following case report is of interest because it represents a well-documented case of orthostatic hypotension with pernicious anemia, and there was a complete remission following treatment with Cyanocobalamin (vitamin B<sub>12</sub>) and folic acid. Report of a Case A 66-year-old retired government employee was admitted to the Oklahoma City Veterans Administration Hospital in September, 1959, complaining of weakness and light-headed spells. His symptoms had begun 3 years previously but had subsided after several months of therapy which reputedly consisted of iron and liver. One year before admission, his symptoms had recurred, with associated anorexia, for
Hodgkin's disease: a clue or a fluke?
Authors: J Clark
Journal: BMJ (1973)

NO 5 00 I -ICE 0.4-0.8 0.8-1.6 1.6-3.1 3.1-6.26.2-12.512.5-25 25-50 50-00 >100 MI.C. methicillin (pg/ml) FIG.2-Correlation of zone size (less diameter of disc) with M.I.C. methicillin determined after 18 hours incubation at 30'C.are usually regarded as sensitive.The rapid sensitivity test reliably distinguishes between these and methicillin-resistant staphylococci.-We are, etc.,
Mistletoe as a treatment for cancer
Authors: Edzard Ernst
Journal: BMJ (2006)

Has no proved benefit, and can cause harm 

Most doctors in the United Kingdom will be surprised to learn from a case reported in this week's BMJ of a use for mistletoe ( Viscum album ) that has nothing to do with Christmas.1 Some patients with cancer inject themselves with extract of mistletoe in the hope of improving their condition. In continental Europe, at least 30 different mistletoe preparations are available. In Europe, most cancer patients use such extracts, at a total expense of about £30m (€45m; $59m) each year,2 and in Germany the insurance system pays for this treatment. 

A Google search (20 November 2006) showed that 145 000 websites promote or mention mistletoe as a treatment for cancer. This much publicity may mean that many cancer patients in the UK will try mistletoe in the future or ask their doctor about it. It is therefore timely to discuss the value …
Association of Smoking Cessation and Weight Change With Cardiovascular Disease Among Adults With and Without Diabetes
Authors: Carole Clair, Nancy A. Rigotti, Bianca Porneala, Caroline S. Fox, Ralph B. D’Agostino, Michael J. Pencina, James B. Meigs
Journal: JAMA (2013)

<h3>Importance</h3>Smoking cessation reduces the risks of cardiovascular disease (CVD), but weight gain that follows quitting smoking may weaken the CVD benefit of quitting.<h3>Objective</h3>To test the hypothesis that weight gain following smoking cessation does not attenuate the benefits of smoking cessation among adults with and without diabetes.<h3>Design, Setting, and Participants</h3>Prospective community-based cohort study using data from the Framingham Offspring Study collected from 1984 through 2011. At each 4-year examination, self-reported smoking status was assessed and categorized as smoker, recent quitter (≤4 years), long-term quitter (&gt;4 years), and nonsmoker. Pooled Cox proportional hazards models were used to estimate the association between quitting smoking and 6-year CVD events and to test whether 4-year change in weight following smoking cessation modified the association between smoking cessation and CVD events.<h3>Main Outcome Measure</h3>Incidence over 6 years of total CVD events, comprising coronary heart disease, cerebrovascular events, peripheral artery disease, and congestive heart failure.<h3>Results</h3>After a mean follow-up of 25 (SD, 9.6) years, 631 CVD events occurred among 3251 participants. Median 4-year weight gain was greater for recent quitters without diabetes (2.7 kg [interquartile range {IQR}, −0.5 to 6.4]) and with diabetes (3.6 kg [IQR, −1.4 to 8.2]) than for long-term quitters (0.9 kg [IQR, −1.4 to 3.2] and 0.0 kg [IQR, −3.2 to 3.2], respectively, P &lt; .001). Among participants without diabetes, age- and sex-adjusted incidence rate of CVD was 5.9 per 100 person-examinations (95% CI, 4.9-7.1) in smokers, 3.2 per 100 person-examinations (95% CI, 2.1-4.5) in recent quitters, 3.1 per 100 person-examinations (95% CI, 2.6-3.7) in long-term quitters, and 2.4 per 100 person-examinations (95% CI, 2.0-3.0) in nonsmokers. After adjustment for CVD risk factors, compared with smokers, recent quitters had a hazard ratio (HR) for CVD of 0.47 (95% CI, 0.23-0.94) and long-term quitters had an HR of 0.46 (95% CI, 0.34-0.63); these associations had only a minimal change after further adjustment for weight change. Among participants with diabetes, there were similar point estimates that did not reach statistical significance.<h3>Conclusions and Relevance</h3>In this community-based cohort, smoking cessation was associated with a lower risk of CVD events among participants without diabetes, and weight gain that occurred following smoking cessation did not modify this association. This supports a net cardiovascular benefit of smoking cessation, despite subsequent weight gain.
Metabolic Risk and Health Behaviors in Minority Youth at Risk for Type 2 Diabetes
Authors: Marita G. Holl, Sarah S. Jaser, Julie A. Womack, Vanessa L. Jefferson, Margaret Grey
Journal: Diabetes Care (2010)

OBJECTIVE The purpose of this study was to determine the impact of sex and race/ethnicity on metabolic risk and health behaviors in minority youth. RESEARCH DESIGN AND METHODS A total of 173 seventh graders (46% male and 54% female; 49% Hispanic and 51% African American) with BMI ≥85th percentile and a family history of diabetes were assessed with weight, height, BMI, percent body fat, and waist circumference measures. Laboratory indexes included 2-h oral glucose tolerance tests with insulin levels at 0 and 2 h, fasting A1C, and lipids. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Youth also completed questionnaires evaluating health behaviors. RESULTS Average BMI (31.6 ± 6.4 kg/m2) and percent body fat (39.5 ± 10.6%) were high. All participants demonstrated insulin resistance with elevated HOMA-IR values (8.5 ± 5.2). Compared with African American youth, Hispanic youth had higher triglycerides and lower HDL cholesterol despite similar BMI. Hispanic youth reported lower self-efficacy for diet, less physical activity, and higher total fat intake. Male youth had higher glucose (0 and 2 h) and reported more physical activity, more healthy food choices, and higher calcium intake than female youth. CONCLUSIONS Screening high-risk youth for insulin resistance and lipid abnormalities is recommended. Promoting acceptable physical activities and healthy food choices may be especially important for Hispanic and female youth.
Evaluation of Thyroid Status
Authors: Mark H. Zweig
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The recent article by Slag et al (1981;246:2702) entitled "Free Thyroxine Levels in Critically Ill Patients" attempts to address the dilemma of assessing the thyroid status of patients with nonthyroidal illness. The stated goal was "to determine the clinical usefulness of methods of free T<sub>4</sub>[thyroxine] determinations in critically ill patients." The question implicit in the goal is: Can any of these tests identify and classify persons who have abnormal thyroid function in a group of seriously ill patients? However, the study was not designed properly to answer this question or in any way determine the actual clinical value of these tests for free T<sub>4</sub> Because the authors give no indication of clear criteria for determining the "true" thyroid status (and there apparently was not a definitive assessment of actual thyroid status), we cannot tell which, if any, of the tests might have clinical relevance,
MicroRNA expression in lymphocyte development and malignancy
Authors: C H Lawrie, N J Saunders, S Soneji, S Palazzo, H M Dunlop, C D O Cooper, P J Brown, X Troussard, H Mossafa, T Enver, F Pezzella, J Boultwood, J S Wainscoat, C S R Hatton
Journal: Leukemia (2008)
Theme Issue on Health of the Nation
Authors: Phil B. Fontanarosa, Catherine D. DeAngelis, Drummond Rennie
Journal: JAMA (2008)

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
Landmarks in Cardiac Surgery
Authors: A. H. B. De Bono
Journal: BMJ (1971)

Dr. Beighton has an impressive experience of this rare abnormality of connective tissue in which the skin and the joints are so extensible that the sufferers are often able to earn a living as the "India-rubber man" of the fairground.In this preface he notes that only 300 cases are recorded in the world lit- erature, but he has personal experience of 130 patients in Great Britain and North America.His monograph of some 190 pages deals in a logical fashion with the historical aspects of the condition, the clinical manifestations, the pathology, including the disordered physical properties of the skin, and the d:fferential diagnosis.That the condition is