tbuckley/cabot-search huggingface dataset:
Paracentesis by Moonlight
Authors: Eliezer M Van Allen
Journal: JAMA (2011)

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
Validity of spirometry performed online
Authors: J.F. Masa, M.T. González, R. Pereira, M. Mota, J.A. Riesco, J. Corral, J. Zamorano, M. Rubio, J. Teran, R. Farré
Journal: European Respiratory Journal (2010)

Spirometry is essential for the diagnosis and management of common respiratory diseases. However, its use and quality are low in primary care. An important reason for this is the technical difficulty in performing conventional spirometry. If high-quality spirometry could be performed online, from the pulmonary function laboratory in hospitals, most of the technical problems could be solved. The aim of the present study was to compare spirometries performed online by remote technicians with conventional spirometry. This was a controlled, randomised crossover study of 261 patients referred from primary care centres for pulmonary consultation. They were randomised to undergo either conventional or online spirometry. The technician, located remotely, controlled the spirometer computer. Using a teleconference link, the technician guided the patient through the spirometry. The comparison between conventional and online spirometries was performed on intention to treat and per protocol bases for spirometric values and quality criteria. Agreement between the two spirometric methods was assessed with a Bland–Altman plot. A subpopulation of off-range patients was also characterised. Finally, intra- and interobserver agreement was evaluated using the intraclass correlation coefficient. No clinically significant differences were seen between the online and conventional spirometric values in both the intention to treat and per protocol analyses. The agreement in Bland–Altman analysis was poorer for intention to treat than for the per protocol analysis. The latter had a lower percentage of off-range patients and high agreement to determine abnormal spirometry in the off-range group. Conventional spirometry had a higher percentage of patients with spirometric quality criteria although the quality criteria difference was only 5.9%, when both procedures were the first to start. Very good agreement was found between intra- and interobserver reliability. Spirometry performed online from a hospital can be an adequate alternative to conventional spirometry for primary care centres.
Points from Letters: Disposable Syringes
Authors: C. V. Bullen
Journal: BMJ (1966)

that thoughtless minority who are out to claim all they can without concern for their doctor's discomfiture.Rather than embark on propaganda designed to prevent abuse of a tottering ser- vice I look forward to the day when a more positive approach becomes evident-namely, providing the general practitioner with the proper premises and facilities so badly needed to cope adequately with the sort of medicine required of him in this modern age.If distributing leaflets is the best that can be done I hope the planners find other means of so doing rather than through us.-Iam, etc., Resolven, Glam.
Pathological Considerations on Surgical Interference for Perforative Ulcer of the Stomach and Duodenum
Authors: T. N. Kelynack
Journal: BMJ (1894)

ALMOST the sole hope in cases of intraperitoneal perforation of gastric and duodenal ulcers lies in prompt surgical interference.Impending death can only be avoided by early diagnosis and immediate operation.If we act up to our recognition of pathological facts, free and speedy co-operation of physician and surgeon is essential.But successful surgical treatment must be based on an accurate knowledge of the lesion.The actual pathology, it is true, is still shrouded in considerable mystery, but much valuable information is forthcoming as to the general character of these ulcers.Having recently had exceptional opportunities for the pathological examination of a number of these cases, I pro- pose very briefly to record a few impressions, limiting myself, however, to a consideration of those points which may prove helpful in indicating the extent and possibilities of surgical interference.I shall restrict myself almost entirely to cases in which actual perforation occurred. FREQUENCY OF PERFORATION.In order to obtain some idea of the frequency of acute peritonitis consequent on perforation of gastric and duodenal ulcers, as compared with that due to perforation of other parts of the gastro-intestinal tract, and arising in the course of other diseases, I have examined the records of 3,471 post- mortem examitions made in the Manchester Royal Infirmary.The result of the analysis may be briefly tabulated thus: Class of Cases.No. of General Cases.
REPORT OF A CASE OF ECHINOCOCCUS CYST OF THE NOSE.
Authors: W. K. ROGERS
Journal: JAMA (1900)

The subject of this report, Mrs. W. M. S., was referred to the writer by Dr. Hatch, of Newark, Ohio, April 29, 1895, for the removal of what seemed to be a rather large fibroid polypus nearly filling the vault of the pharynx. It was attached to the septum, on the left side, near its posterior extremity, and nasal breathing could not be accomplished. Growing from a point near the posterior extremity of the left middle turbinated body was another tumor about one-half an inch long and one-quarter of an inch thick, much softer, and differing in no way from an ordinary mucoid polypus in appearance. Both were removed; the former by means of forceps, through the mouth, and the latter with a cold wire snare through the nose. The stump of each was touched with a galvanocautery point, and under Dr. Hatch's care the surfaces healed satisfactorily. On account
Twin methodology is not always easily understood
Authors: K. O. Kyvik
Journal: BMJ (1996)

R P D Cooke and colleagues offer further sup- portive evidence for the adequacy of single doses of gentamicin in febrile neutropenic patients.Their approach of halving the dose if the trough concentration of gentamicin is 1-2 mg/l may be overcautious, since serum concentrations of aminoglycosides have not been shown to have much predictive value for efficacy or toxicity.5
Two-Year Follow-Up of Angina Pectoris: Medical or Surgical Therapy
Authors: WlLBERT S. ARONOW
Journal: Annals of Internal Medicine (1975)

The effects of bypass graft surgery versus continued medical management in 40 patients with stable angina were evaluated at 2 years: 17 of 20 surgical patients (85%) and 18 of 20 medical patients (90%) were alive, and 5 of 20 surgical patients (25%) and 2 of 20 medical patients (10%) had developed myocardial infarction; 8 of 17 surgical patients (47%) and 4 of 18 medical patients (22%) had no angina, and 13 of 17 surgical patients (76%) and 9 of 18 medical patients (50%) had no angina or greater than a 25% increase in exercise time until angina. No statistically significant differences were demonstrated between the medical and surgical groups for all variables submitted to statistical analysis.
Hepatitis C virus replicates in peripheral blood mononuclear cells of patients with occult hepatitis C virus infection
Authors: I Castillo
Journal: Gut (2005)

<b>Background:</b> Occult hepatitis C virus (HCV) infection is characterised by the presence of HCV-RNA in the liver in the absence of anti-HCV, and serum viral RNA. Up to 70% of these patients also have HCV-RNA in peripheral blood mononuclear cells (PBMC) but it is not known if HCV is replicating in these cells. <b>Aim:</b> We studied possible HCV replication in PBMC of 18 patients with an occult HCV infection who were selected on the basis of HCV-RNA positivity in PBMC. <b>Methods:</b> Detection of HCV-RNA positive and negative strands in PBMC was done by strand specific reverse transcriptase-polymerase chain reaction (RT-PCR) and by in situ hybridisation. <b>Results:</b> The presence of HCV-RNA positive strand in PBMC was confirmed in all patients by strand specific RT-PCR and by in situ hybridisation. Mean percentage of PBMC which had the HCV-RNA positive strand was 3.3% (95% confidence interval (CI) 2.1–4.4) The HCV-RNA negative strand was found in the PBMC of 11/18 (61%) patients by strand specific RT-PCR and confirmed by in situ hybridisation, and the percentage of PBMC harbouring the HCV-RNA negative strand was 3.1% (95% CI 0.8–5.5). There was a significant correlation (p = 0.001, <i>r</i> = 0.84) between the percentage of PBMC with the HCV-RNA positive strand and that of PBMC with the HCV-RNA negative strand. <b>Conclusion:</b> HCV replicates in the PBMC of patients with occult HCV infection and thus, although these patients do not have serum HCV-RNA, they could be potentially infectious.
P511Immunomagnetic purification of cardiomyocytes, cardiac fibroblasts and endothelial cells from neonatal mouse and rat hearts
Authors: P Christalla, M Kernbach, J Riesen, A-M Wiencierz, A Bosio, D Eckardt
Journal: Cardiovascular Research (2014)

Pure cardiovascular cell lineages are a requisite for an unbiased and cell type specific investigation of (patho-) physiological mechanisms involved in heart failure. Moreover pure heart cells are needed as building blocks for engineered heart mimetics. The latter offers the possibility to replace infarcted myocardium and to investigate heart development and cardiomyogenesis in a simplified in vitro model. However, it has to be acknowledged that strategies capable to specifically purify heart cells are not well established. To overcome these experimental limitations we developed a rapid and automated neonatal heart dissociation protocol enabling an immunomagnetic enrichment of the three major heart cell types, namely cardiomyocytes (CMs), cardiac fibroblasts (Fibs) and endothelial cells (Endos) from both, mouse and rat neonatal hearts.
Points from Letters: T.A.B. Reactions
Authors: L. R. S. MacFarlane
Journal: BMJ (1964)

BDffMponsibilities and carry their burdens without themselves breaking under the strain.Social workers everywhere are trained to respect their clients' integrity and to en- courage them to make their own decisions with a view to helping them retain or recover their self-respect and independence as far as may be possible.Only as a last resort will a social worker seek to solve the problem by removing it-for example, by arranging insti- tutional care.Moreover, the importance they attach to the uniqueness of the individual, whoever he may be and whatever his circumstances, which is a basic principle of social casework, helps to counteract the tendency to standardization which is a recognized risk arising from the size and complexity of the social services.Admittedly, the developments just described do not and cannot go all the way to overcoming the tendency, to which all of us are liable in greater or lesser degree, to accept what is given and rely on others to see us through our difficulties, and any attempt to alleviate distress by collective provisions involves the risk of encouraging this, but I think it right, especially in view of the quota- tions cited by Pertinax, to draw attention to the fact that the most recent developments in the social services are directed towards giving individuals and families (to quote the Child- ren and Young Persons Act, 1963) "professional advice, guidance and assistance," which, it is hoped, will encourage and enable them to cope with their difficulties without forfeiting their independence and self-respect.
The relationship between object manipulation and language development in Broca's area: A connectionist simulation of Greenfield's hypothesis
Authors: Ronan G. Reilly
Journal: Behavioral and Brain Sciences (2002)

In her Behavioral and Brain Sciences target article, Greenfield (1991) proposed that early in a child's development Broca's area may serve the dual function of coordinating object assembly and organizing the production of structured utterances. As development progresses, the upper and lower regions of Broca's area become increasingly specialized for motor coordination and speech, respectively. This commentary presents a connectionist simulation of aspects of this proposal. The results of the simulation confirm the main thrust of Greenfield's argument and suggest that an important impetus for the developmental differentiation in Broca's area may be the increasing complexity of the computational demands made upon it.
Norfloxacin: A New Targeted Fluoroquinolone Antimicrobial Agent
Authors: JOHN S. WOLFSON
Journal: Annals of Internal Medicine (1988)

Norfloxacin is an oral fluoroquinolone antimicrobial agent recently released for the treatment of uncomplicated and complicated urinary tract infections. The drug antagonizes DNA gyrase, an enzyme essential for bacterial DNA replication. Norfloxacin is more potent and broader in spectrum than the earlier developed analogue, nalidixic acid, and is active in vitro against virtually all bacterial pathogens causing urinary tract and gastrointestinal infections, aerobic gram-negative bacilli causing sepsis in neutropenic patients, and Neisseria gonorrhoeae. The drug is administered orally twice daily and achieves high concentrations in urine, stool, renal tissue, and bile. Norfloxacin was at least as effective as currently used agents in treating urinary tract infections, and, in limited studies, bacterial gastroenteritis, gonorrhea, bacterial prostatitis, and prevention of gram-negative bacillary infection in neutropenic patients. Adverse drug effects were mild and included disturbances of the gastrointestinal tract and the central nervous system. Norfloxacin shows promise as an antibacterial agent for genitourinary and gastrointestinal infections.
African-American leaders call for concerted action on AIDS in US
Authors: Bob Roehr
Journal: BMJ (2007)

African-American leaders launched a call to action to address HIV/AIDS in the black community at a Capitol Hill news conference last month. The aim is to halve the rates of new infections, reduce the stigma of AIDS, increase by a half both the number of people who know their HIV status, and who are receiving care for HIV infection. 

“AIDS is a black disease no matter how you look at it—through the lens of gender, or sexual orientation, or age, socioeconomic class, education, or region of the country—black people bear the brunt of the epidemic,” said Phill Wilson, executive director of the Los Angeles …
Potential Complications of High-Dose Epinephrine
Authors: Steven B. Karch
Journal: JAMA (1991)

To the Editor.  —The article by Callaham et al 1 did not address the cause of cardiac arrest. It might have been secondary to ischemia, asphyxia, or even poisoning (eg, cocaine). Patients with cardiomyopathy will have different β-receptor profiles than will patients with human immunodeficiency virus-positive myocarditis or other patients with stroke or pneumonia. The authors appear to be assuming that high-dose epinephrine therapy is safe and equally effective no matter what the underlying disease. Basic considerations of receptor physiology and pathological anatomy argue otherwise.  Similar considerations apply to patient medications, which were also not recorded. How many of these patients were taking β-blockers? The outcome of high-dose catecholamine therapy must have something to do with the number of receptors present. If large numbers of patients were receiving β-blockers, then the unrecognized presence of these drugs could confound subsequent statistical analysis.  In their discussion, the authors failed to mention that
NHS England's five year plan
Authors: G. Iacobucci
Journal: BMJ (2014)

Full realisation of the vision will cost an extra £8bn

The NHS is on a financial precipice, with healthcare leaders forecasting that current funding shortages, combined with the needs of an ageing population, will lead to a deficit of £30bn (€38bn; $48bn) by 2020-21. Faced with this stark reality, the leaders of the NHS in England have launched an ambitious five year plan to tackle this looming shortfall by radically altering how care is delivered.

The Five Year Forward View ,1 produced by NHS England in partnership with five other national bodies, sets out a vision for creating a more sustainable and integrated service. The proposals are wide ranging, but the broad focus is on three areas: managing demand, improving efficiency, and additional funding. Recommendations include a substantial expansion in prevention and public health, alongside patients being given more control of their own care.

It also calls for the removal of traditional boundaries between primary and secondary care and sets out a range of new models of care that local areas could adopt.2 The plan is not overly prescriptive as to what these new models should be, saying that neither a “one size fits all” approach nor “a thousand flowers bloom” scenario would be suitable. …
De novo synthesis of purine nucleotides in human peripheral blood leukocytes. Excessive activity of the pathway in hypoxanthine-guanine phosphoribosyltransferase deficiency.
Authors: S Brosh, P Boer, B Kupfer, A de Vries, O Sperling
Journal: Journal of Clinical Investigation (1976)

Human peripheral blood leukocytes were studied for the presence and the regulatory properties of the pathway of de novo synthesis of purine nucleotides. The cells were found to incorporate the labeled precursors formate and glycine into purines. The rate of [14C]-formate incorporation was decreased by several compounds known to inhibit purine synthesis by affecting the activity by glutamine phosphoribosylpyrophosphate (PRPP) amidotransferase, the first committed enzyme in the pathway, either through decreasing the availability of PRPP, a substrate for this enzyme, or through exerting inhibition on this enzyme. PRPP availability in the leukocyte was found to be limiting for purine synthesis. Increased PRPP availability resulting from activation of PRPP synthetase by increasing inorganic phosphate (Pi) concentration caused acceleration of purine synthesis. On the other hand, no clear-cut evidence was obtained for the availability of ribose-5-phosphate in the leukocyte being rate limiting at physiological extracellular Pi concentration for PRPP generation, and thus for purine synthesis. However, the addition of methylene blue, which accelerates the oxidative pentose shunt that produces ribose-5-phosphate, resulted in acceleration of PRPP generation and of purine synthesis only when PRPP synthetase was largely activated at high Pi concentration. These results may be taken to suggest that ribose-5-phosphate availability is indeed not limiting for PRPP generation under physiological conditions. Purine synthesis de novo was accelerated more than 13-fold in the leukocytes of two gouty patients affected with partial deficiency of hypoxanthine-guanine phosphoribosyltransferase, but was normal in the leukocytes of an obligate heterozygote for this enzyme abnormality. The results domonstrate in peripheral human leukocytes the presence of the complete pathway of de novo synthesis of purine nucleotides and the manifestation in these cells of the biochemical consequences of hypoxanthine-guanine phosphoribosyltransferase deficiency, i.e., increased availability of PRPP and acceleration of purine synthesis de novo. The results indicate the usefulness of leukocytes as a model tissue for the study of purine metabolism in man.
Funding in Africa is concentrating too heavily on the “big three”
Authors: Klaus Morales
Journal: BMJ (2005)

Certain tropical diseases are being unjustly ignored in Africa because funding is so heavily concentrated on the “big three” diseases—HIV/AIDS, tuberculosis, and malaria—says a new study by David Molyneux and colleagues ( PLoS Medicine , doi: 10.1371/journal.pmed.0020336).

The neglected tropical diseases, including schistosomiasis, onchocerciasis, trachoma, lymphatic filariasis, and the soil-transmitted helminth infections, are responsible for as many as 500 000 deaths a year. But the international health community gives priority to the big three.

“Instead of 95% of funding being addressed to the big three, give them 90% and we will be able to do a …
Tuberculous Pseudotumor of the Liver
Authors: RAMESH D. DHEKNE, WARREN H. MOORE, STEPHEN E. LONG, BRUCE J. BARRON
Journal: Clinical Nuclear Medicine (1987)

Tuberculosis of the liver in association with generalized miliary tuberculosis is not an uncommon clinical entity. A solitary tuberculous liver abscess, however, is rare. Two such cases, in which there was no clinical evidence of extrahepatic tuberculosis, are reported. The similarities between this condition and other causes of hepatic lesions are discussed, with particular emphasis placed on the imaging patterns of various diagnostic imaging procedures.
The gratuitous relationship between Broca's aphasia and Broca's area
Authors: Nina F. Dronkers
Journal: Behavioral and Brain Sciences (2000)

Many authors assume that Broca's area subserves the functions that are lost in patients with Broca's aphasia. This commentary attempts to clarify the relationship between Broca's area and Broca's aphasia and suggests that statements about the neurology of patients' specific language functions might be better supported by their individual structural neuroimaging data.