tbuckley/cabot-search huggingface dataset:
Prognosis in Civilian Head Injuries
Authors: E. Guttmann
Journal: BMJ (1943)

ordinarily go beyond one crop, but new crops may appear up to five or six weeks, though this is unusual.By Cory's law the time taken in the maturation of pocks should be inversely proportional to the degree of immunity, and rapid maturation of new pocks will indicate that immunity is being developed.In diagnosis the following considerations will be helpful:1. Auto-inoculation should be excluded.2. The eruption does not appear earlier than the fourth, and seldom earlier than the ninth, day after vaccination.3. The eruption must be elsewhere-'than in the neighbourhood of the vaccination site.4. There must be a vesicular stage.The eruption may arise on any part of the skin-limitation to one sole has been reported-and within the mouth.The distribution is not specific, and any resemblance to that of small-pox is accidental.When profuse the elements may show much diversity in size, up to that of a sixpence or even larger, as contrasted with the almost uniform size seen in discrete small-pox. TreatmentIn some quarters it is the practice to seek to prevent severe reactions in adult primary vaccinations by puncturing and evacuating the vesicle on the seventh or eighth day after vaccination and applying a dressing of permanganate of potash.This is not free from the risk of impairment of protection, as immunity against small-pox is not satisfactorily established before the ninth day and it would not be justifiable as an attempt to prevent the unusual complication of generalized vaccinia.Mervyn Gordon (1941) has suggested, however, that permanganate of potash, to which the viruses of both vaccinia and small-pox are extremely susceptible, might be effectively used in treatment by the application of a wet compress of the permanganate solution to the vesicles of the eruption.Even in a dilution of 1 in 100,000, he states, permanganate can inactivate the vaccinia virus, but glycerin should not be added, for it inhibits the virucidal action.He advises also that in a severe case trial should be made of serum from a recently vaccinated person-a treatment which, in fact, he was the first to suggest in post-vaccinial encephalitis.The most potent serum, in his opinion, would be that taken from young healthy adults 14 days after vaccination.
Contractual problems in Oxford
Authors: J. Doctor
Journal: BMJ (1982)

<b>Objectives</b> To examine the risk of relapse and time to relapse after discontinuation of antidepressants in patients with anxiety disorder who responded to antidepressants, and to explore whether relapse risk is related to type of anxiety disorder, type of antidepressant, mode of discontinuation, duration of treatment and follow-up, comorbidity, and allowance of psychotherapy. <b>Design</b> Systematic review and meta-analyses of relapse prevention trials. <b>Data sources</b> PubMed, Cochrane, Embase, and clinical trial registers (from inception to July 2016). <b>Study selection</b> Eligible studies included patients with anxiety disorder who responded to antidepressants, randomised patients double blind to either continuing antidepressants or switching to placebo, and compared relapse rates or time to relapse. <b>Data extraction</b> Two independent raters selected studies and extracted data. Random effect models were used to estimate odds ratios for relapse, hazard ratios for time to relapse, and relapse prevalence per group. The effect of various categorical and continuous variables was explored with subgroup analyses and meta-regression analyses respectively. Bias was assessed using the Cochrane tool. <b>Results</b> The meta-analysis included 28 studies (n=5233) examining relapse with a maximum follow-up of one year. Across studies, risk of bias was considered low. Discontinuation increased the odds of relapse compared with continuing antidepressants (summary odds ratio 3.11, 95% confidence interval 2.48 to 3.89). Subgroup analyses and meta-regression analyses showed no statistical significance. Time to relapse (n=3002) was shorter when antidepressants were discontinued (summary hazard ratio 3.63, 2.58 to 5.10; n=11 studies). Summary relapse prevalences were 36.4% (30.8% to 42.1%; n=28 studies) for the placebo group and 16.4% (12.6% to 20.1%; n=28 studies) for the antidepressant group, but prevalence varied considerably across studies, most likely owing to differences in the length of follow-up. Dropout was higher in the placebo group (summary odds ratio 1.31, 1.06 to 1.63; n=27 studies). <b>Conclusions</b> Up to one year of follow-up, discontinuation of antidepressant treatment results in higher relapse rates among responders compared with treatment continuation. The lack of evidence after a one year period should not be interpreted as explicit advice to discontinue antidepressants after one year. Given the chronicity of anxiety disorders, treatment should be directed by long term considerations, including relapse prevalence, side effects, and patients’ preferences.
The effects of intravenous pamidronate on the bone tissue of children and adolescents with osteogenesis imperfecta
Authors: Frank Rauch, Rose Travers, Horacio Plotkin, Francis H. Glorieux
Journal: Journal of Clinical Investigation (2002)

Cyclical pamidronate infusions increase bone mass in children suffering from osteogenesis imperfecta. The histological basis for these effects remains unknown. Therefore, we compared parameters of iliac bone histomorphometry from 45 patients before and after 2.4 ± 0.6 years of pamidronate treatment (age at the time of the first biopsy, 1.4–17.5 years; 23 girls). Although biopsy size did not change significantly (P = 0.30), cortical width increased by 88%. Cancellous bone volume increased by 46%. This was due to a higher trabecular number, whereas trabecular thickness remained stable. Bone surface–based indicators of cancellous bone remodeling decreased by 26–75%. There was no evidence for a mineralization defect in any of the patients. These results suggest that, in the growing skeleton, pamidronate has a twofold effect. In remodeling, bone resorption and formation are coupled and consequently both processes are inhibited. However, osteoclasts and osteoblasts are active on different surfaces (and are thus uncoupled) during modeling of cortical bone. Therefore resorption is selectively targeted, and continuing bone formation can increase cortical width.
Eradication of Leukemia Stem Cells as a New Goal of Therapy in Leukemia
Authors: Farhad Ravandi, Zeev Estrov
Journal: Clinical Cancer Research (2006)

Abstract Leukemias have traditionally been classified and treated on the basis of phenotypic characteristics, such as morphology and cell-surface markers, and, more recently, cytogenetic aberrations. These classification systems are flawed because they do not take into account cellular function. The leukemia cell population is functionally heterogeneous: it consists of leukemia stem cells (LSC) and mature leukemia cells that differentiate abnormally to varying extents. Like normal hematopoietic stem cells, LSCs are quiescent and have self-renewal and clonogenic capacity. Because they are quiescent, LSCs do not respond to cell cycle–specific cytotoxic agents used to treat leukemia and so contribute to treatment failure. These cells may undergo mutations and epigenetic changes, further leading to drug resistance and relapse. Recent data suggest that mature leukemia cells may acquire LSC characteristics, thereby evading chemotherapeutic treatment and sustaining the disease. Ongoing research is likely to reveal the molecular mechanisms responsible for LSC characteristics and lead to novel strategies for eradicating leukemia.
Emmprin Promotes Anchorage-Independent Growth in Human Mammary Carcinoma Cells by Stimulating Hyaluronan Production
Authors: Erica A. Marieb, Alexandra Zoltan-Jones, Rongsong Li, Suniti Misra, Shibnath Ghatak, Jian Cao, Stanley Zucker, Bryan P. Toole
Journal: Cancer Research (2004)

Emmprin (CD147; basigin) is a plasma membrane glycoprotein, enriched on the surface of many cancer cells, which induces matrix metalloproteinase synthesis via cell-cell interactions. Elevated emmprin production causes increased growth in vivo of human mammary carcinoma cells. In this study, we show that elevation of emmprin expression in less aggressive human carcinoma cells, which normally express low emmprin levels, induces the ability to grow under anchorage-independent conditions. We also found that elevated emmprin expression stimulates hyaluronan production and that the effect of emmprin on anchorage-independent growth is dependent on hyaluronan. Furthermore, emmprin stimulates cell survival pathway signaling in a hyaluronan-dependent manner. From these and other studies we conclude that emmprin enhances several malignant properties of cancer cells, including anchorage-independent growth, invasiveness, and chemoresistance.
FDG PET/CT in Malignant Eccrine Porocarcinoma Arising in a Pre-existing Poroma
Authors: Arber Golemi, Esther Hanspeter, Eva Brugger, Antonio Ruiu, Mohsen Farsad
Journal: Clinical Nuclear Medicine (2013)

In a 61-year-old man with known poroma of right lower abdomen, malignant transformation to porocarcinoma was suspected and confirmed by biopsy. PET/CT was requested for tumor staging, which revealed high FDG uptake in the known skin nodules located in the right side of abdominal and chest wall and identified further some adenopathy in the right axillary. All nodules and axillary lymph nodes were removed, and diagnosis of eccrine porocarcinoma was confirmed. The primary tumor and secondary lesions of porocarcinoma show a high glucose metabolism; thus, PET/CT could be useful for staging, follow-up, and detection of recurrence of patients with eccrine porocarcinoma.
Coronary Angiography and Acute Renal Failure in Diabetic Azotemic Nephropathy
Authors: L. A. WEINRAUCH
Journal: Annals of Internal Medicine (1977)

Thirteen juvenile-onset diabetics with azotemic diabetic nephropathy (mean serum creatinine level, 6.8 mg/dl) being evaluated fro renal transplantation underwent cardiac catheterization with angiography. All were followed for development of acute renal failure. Twelve (92%) developed some evidence of acute renal failure. Two required potassium exchange resin therapy. Six required dialysis acutely. There were no deaths. All patients who received greater than 65 ml/m2 of iodinated contrast developed acute renal failure. No patient with a hemoglobin value greater than 9.9 g/dl required dialysis or potassium exchange resin. The single patients without acute renal failure received less than 50 ml/m2 of iodinated contrast and had the highest hemoglobin value (12.0 g/dl). No cardiac or angiographic variables were predictive of acute renal failure. In this group at high risk for acute renal failure, radiographic contrast procedures should only be done if the information to be obtained is weighed against the potential for injury.
Test of intelligence
Authors: Fred Charatan
Journal: BMJ (2005)

obvious information that you have the wrong drug-for example, a label marked ephedrine instead of the expected epinephrine-may be ignored or misinterpreted to confirm your expectation that the drug is correct. 20 Although the danger of confirmatory bias is greatest when making decisions about diagnosis, ongoing treatment decisions are also affected.It is thus critical to remain constantly vigilant for any information that may contradict your existing diagnosis, and to give any such information careful consideration, rather than dismissing it as irrelevant.It is also a good idea to try to think of specific reasons why your current theory might be wrong and to ask questions that could potentially disprove your hypothesis.Always be aware of alternative hypotheses and ask yourself whether they may be better than your current ideas.
Book: Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine
Authors: J. Eberhart-Phillips
Journal: BMJ (2002)

Patricia Thomas Public Affairs, £19.99, pp 515 ISBN 1 891620 88 6 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> Every day more than 10 000 people around the globe become infected with HIV—two to three times the number who perished in the terrorist attacks of September 11. Day in and day out, the widening circle of AIDS quietly expands. In the 20 years since AIDS was first recognised, more than 25 million people have died from complications of HIV infection. Another 40 million are today living with HIV, most with no hope of accessing costly new antiretroviral drugs. The staggering human toll of the AIDS pandemic has no historical precedent. Ambitious preventive programmes based on public education, testing and counselling, and the distribution of condoms … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
1000 Genomes Project
Authors: Joan Stephenson
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
Multiple hepatic abscesses complicating continuous ambulatory peritoneal dialysis.
Authors: L Luciani, M G Gentile, B Scarduelli, R A Sinico, G D'Amico, G Samori
Journal: BMJ (1982)

are similar regulations in many parts of the USA, Canada, and South Africa.No such legislation exists in this country; it has been stated that the number of deaths is comparatively small and that it is difficult to justify safety regulations that affect private property.Accidents that leave a child dead or severely handicapped, however, are a tragedy, particularly when they most probably could have been prevented by simple safety measures.Although these deaths are a relatively small proportion of the 50 or so children aged under 5 who are drowned each year,5 they are preventable; it is surely not unreasonable, therefore, to require the owners of swimming pools, who are usually relatively wealthy, to ensure that they are safely enclosed.We thank Mr R Ferguson of the Home Office and Mrs J Burton of the medical statistics unit, Office of Population Censuses and Surveys, for their help.The analysis and conclusions described in this article, however, are ours alone.
THE GROWTH OF COMMERCIALISM IN MEDICINE.
Authors: JOHN SHRADY
Journal: JAMA (1898)

In approaching this complex theme there are many besetments which involve more or less controversy. Indeed, there may be suspicions of ulterior motives for, mayhap, an untried form of ambuscade, since it is widely conceded that statecraft may even masquerade as diplomacy. At the outset, however, there need be a disclaimer to the effect that there is to be any eulogy of honesty in any form, lest it be set down as cant in favor of the code. The purpose, then, to be announced is that of self-examination as to whether or not there may not be some sins of our own which require the penitential tear. We have heard not a little of the outrages that have been perpetrated against us in the way of non-recognition, or what hurts our pride not a little, of that indefinite something which we consent to call ingratitude. It is not to be
PWE-008 Placide: Probiotics in the Prevention of Antibiotic Associated Diarrhoea (AAD) and Clostridium Difficile Associated Diarrhoea (CDD) in Elderly Patients Admitted to Hospital – Results of a Large Multi-Centre RCT in the UK
Authors: S Allen, K Wareham, D Wang, C Bradley, B Sewell, H Hutchings, W Harris, A Dhar, H Brown, A Foden, M Gravenor, S Plummer, D Mack, C J Phillips
Journal: Gut (2013)

<h3>Introduction</h3> Antibiotic associated diarrhoea (AAD) and <i>Clostridium difficile</i> associated diarrhoea (CDD) occur in 5–39% of pts exposed to antibiotics. Despite previous papers proposing a beneficial role of probiotics, there has been no large randomised controlled trial evaluating their preventative effect. <h3>Methods</h3> This large RCT funded by the HTA was aimed at finding the efficacy and cost-effectiveness of a high dose, multi-strain probiotic for prevention of AAD and CDD in older people admitted to hospital. Pts aged &gt; 65yrs, exposed to one or more oral/parenteral antibiotics without pre-existing diarrhoea, recent CDD or risk of probiotic adverse effects were eligible. Of 17,420 patients screened, 2,981(17.1%)were recruited and allocated sequentially by a computer-generated random allocation sequence stratified by centre. 1,493(50.1%)were allocated to probiotic and 1,488(49.9%)to placebo arm. Two strains of lactobacilli and two strains of bifidobacteria with a total of 6x1010 organisms/day were taken as a daily single capsule for 21 days. The placebo was inert maltodextrin powder. Occurrence of AAD or CDD within 12 weeks of recruitment was assessed by research nurses, blinded to arm allocation. <h3>Results</h3> ITT analysis included 2,941(98.7%)participants. Potential risk factors for antibiotic-associated diarrhoea at baseline were similar in both arms. The frequency of AAD was similar in the probiotic (159/1470, 10.8%)and placebo arms (153/1471, 10.4%), RR: 1.04; 95%CI0.84–1.28; P = 0.72.CDD was an uncommon cause of AAD and occurred in 12/1470(0.8%)participants in the probiotic and 17/1471(1.2%)in the placebo arm (RR 0.71; 95%CI0.34–1.47; P = 0.35).Adverse events and other outcomes were similar in both arms. Total health care costs per patient did not differ significantly between probiotics (£8020.11; 95%CI£7622.31-£8417.90) and placebo (£8011.37; 95%CI£7600.53-£8422.22).The incremental cost-effectiveness ratio of £45,636/QALY was robust to changes in key parameters. <h3>Conclusion</h3> This study found no evidence that probiotic administration was effective in the elderly in preventing AAD, although there was a trend towards reduced CDD in the probiotic arm. <h3>Disclosure of Interest</h3> S. Allen: None Declared, K. Wareham: None Declared, D. Wang: None Declared, C. Bradley: None Declared, B. Sewell: None Declared, H. Hutchings: None Declared, W. Harris: None Declared, A. Dhar Grant/Research Support from: NIHR Grant Holder, Speaker bureau with: Shire Pharmaceuticals, Warner Chilcott UK, H. Brown: None Declared, A. Foden: None Declared, M. Gravenor: None Declared, S. Plummer Employee of: Research Director of Obsidian Research Limited and Director of Cultech Limited, D. Mack: None Declared, C. Phillips: None Declared
Memo to JAMA
Authors: Catherine Anne Collins
Journal: JAMA (1984)

I have often noted a peculiar trait in physicians. It seems that many of them greatly underestimate the capacity of their patients to understand their physical problems. Most persons seeking medical assistance are filled with questions and concerns, although, granted, some are able to articulate them better than others. Is it the physician's duty merely to treat? Or does he have an extended obligation to offer, whenever possible, information that might cultivate the patient's understanding of his condition, so that he might participate in treatment, or at least have a greater awareness of the disorder? (After all, the patient is the one who goes home with it.) Many doctors seem impatient and reluctant to answer questions, when explanations, somewhat simplified and tailored to the person, would be so helpful and welcome. The implication of this reserved attitude seems to be that they possess knowledge that patients are incapable of comprehending.
Adhesion of rheumatoid peripheral blood and synovial fluid mononuclear cells to high endothelial venules of gut mucosa.
Authors: A Kadioglu, P Sheldon
Journal: Annals of the Rheumatic Diseases (1992)

Mononuclear cells isolated from paired blood and synovial fluid of seven patients with rheumatoid arthritis showed cytoadherence to porcine Peyer's patch high endothelial venules using the Stamper-Woodruff method. A significantly greater proportion of binding was found among the synovial fluid lymphocytes. These would appear to be a population of cells that share adherence characteristics with cells known to be of gut mucosal origin, suggesting that in rheumatoid arthritis some lymphocytes derived from mucosa migrate to joints.
Corticosteroids reduce regenerative repair of epithelium in experimental gastric ulcers.
Authors: M Carpani de Kaski, R Rentsch, S Levi, H J Hodgson
Journal: Gut (1995)

The association between corticosteroid treatment and gastric ulcer healing is controversial. The effects of corticosteroids on experimental ulcer healing in the rat were studied and the effect of coadministration of a prostaglandin E1 analogue was determined. Forty male adult rats were divided into five groups and pretreated for 10 days as follows: (a) control, (b) prednisolone (10 mg/kg), (c) prednisolone and misoprostol (300 micrograms/kg), (d) misoprostol, and (e) indomethacin (2 mg/kg) Gastric ulcer was induced by applying a cryoprobe to the serosal surface of the stomach. Healing was assessed by determining the ulcer size at three and six days. Mucosal regenerative activity at the ulcer edge was assessed by quantitating DNA synthesis in cells by immunohistochemical techniques using monoclonal antibodies to detect expression of proliferating cell nuclear antigen (PCNA) and incorporated 5-bromo-5-iododeoxyuridine (BrdU). Compared with control rats, the rate of healing and the mucosal regenerative activity were significantly reduced in rats treated with prednisolone and indomethacin (p < 0.05). Coadministration of misoprostol and corticosteroids reversed the delay in healing and the reduction in mucosal regeneration induced by corticosteroids alone. With misoprostol alone, the ulcer size and the number of epithelial cells that actively synthesised DNA did not differ from control animals. A comparison between the two immunohistochemical markers of cell proliferation showed a highly significant correlation between the two techniques (r = 0.64, p < 0.005), indicating that the simpler PCNA technique should prove valuable in assessing regeneration in experimental ulcer disease.
Radiograph of the ossification centres of a child's wrist
Authors: R. Mitchell-Hay, B. Hedayati
Journal: BMJ (2012)

We report the potentials elicited by posterior tibial nerve stimulation and recorded simultaneously from the scalp and from electrodes within the interhemispheric fissure. The primary cortical potential was recorded from cortex contralateral but from scalp ipsilateral to the stimulated nerve. The scalp recordings thus demonstrated “paradoxical lateralization” as reported previously, and the similar morphology of the scalp and contralateral cortical recordings confirm that this “paradoxical lateralization” is most likely the result of a horizontal dipole located within the interhemispheric fissure.