tbuckley/cabot-search huggingface dataset:
A NEW COMBINED STETHOSCOPE CHEST PIECE
Authors: Howard B. Sprague
Journal: JAMA (1926)

Because of the variable qualities of different cardiac murmurs, it has been evident for a considerable time that no single stethoscope chest piece is satisfactory in transmitting all the sounds produced in the heart. Ideally, a stethoscope that could be made to vary its optimal resonating qualities between wide limits in order to respond correctly to both high and low pitched sounds would be the most sensitive instrument to use. Practically, such instruments are cumbersome and complicated. For clinical uses two forms of stethoscope chest piece have been found adequate in transmitting heart sounds and murmurs, except in the rare instances in which the naked ear is more satisfactory in responding to high pitched, blowing murmurs, such as those of aortic regurgitation. These two chest pieces are the bell type, which is most useful for low pitched murmurs, and the Bowles type, which registers high pitched murmurs more accurately. The
Ponatinib efficiently kills imatinib-resistant chronic eosinophilic leukemia cells harboring gatekeeper mutant T674I FIP1L1-PDGFRα: roles of Mcl-1 and β-catenin
Authors: Yanli Jin, Ke Ding, Honglin Li, Mengzhu Xue, Xiaoke Shi, Chengyan Wang, Jingxuan Pan
Journal: Molecular Cancer (2014)

Abstract Background T674I FIP1L1-PDGFRα in a subset of chronic eosinophilic leukemia (CEL) is a gatekeeper mutation that is resistant to many tyrosine kinase inhibitors (TKIs) (e.g., imatinib, nilotinib and dasatinib), similar to T315I Bcr-Abl. Therefore, novel TKIs effective against T674I FIP1L1-PDGFRα are needed. Ponatinib (AP24534) is a novel orally bioavailable TKI against T315I Bcr-Abl, but it is not clear whether ponatinib is effective against T674I FIP1L1-PDGFRα. The purpose of this study was to examine the effect of ponatinib on T674I FIP1L1-PDGFRα. Methods Molecular docking analysis in silico was performed. The effects of ponatinib on PDGFRα signaling pathways, apoptosis and cell cycling were examined in EOL-1, BaF3 cells expressing either wild type (WT) or T674I FIP1L1-PDGFRα. The in vivo antitumor activity of ponatinib was evaluated with xenografted BaF3-T674I FIP1L1-PDGFRα cells in nude mice models. Results Molecular docking analysis revealed that ponatinib could bind to the DFG (Asp-Phe-Gly)-out state of T674I PDGFRα. Ponatinib potently inhibited the phosphorylation of WT and T674I FIP1L1-PDGFRα and their downstream signaling molecules (e.g., Stat3, Stat5). Ponatinib strikingly inhibited the growth of both WT and T674I FIP1L1-PDGFRα-carrying CEL cells (IC 50 : 0.004–2.5 nM). It induced apoptosis in CEL cells with caspase-3-dependent cleavage of Mcl-1, and inhibited tyrosine phosphorylation of β-catenin to decrease its stability and pro-survival functions. In vivo, ponatinib abrogated the growth of xenografted BaF3-T674I FIP1L1-PDGFRα cells in nude mice. Conclusions Ponatinib is a pan-FIP1L1-PDGFRα inhibitor, and clinical trials are warranted to investigate its efficacy in imatinib-resistant CEL.
Medical manpower mismanagement: mirage or miracle?
Authors: W J Appleyard
Journal: BMJ (1982)

If the controversy over the Department of Health and Social Security's current  on hospital medical staffing structure erupts into open opposition against consultants there will be no winners. Our patients will be the losers. Despite active dis? cussions on medical manpower with the profession at the time, the DHSS independently launched its initiative in June 1980 before the Social Services Committee started work in November of that year. A letter implementing its policy was sent to chair? men of regional health authorities in September 1981,1 well before the report on medical education from the Social Services Committee (Short Report)2 was published and without any consultation or agreement with the profession. A further letter to regional medical officers in January 1982a provided a model by which some of the effects of moving towards a consultant provided rather than a consultant-led service could be quantified and evaluated. In February the Government's response to the Short Report crystallised the DHSS's thinking.4 In essence this : (1) Doubles the number of consultants over the next 15 years. (2) Changes fundamentally the pattern of consultant work. (3) Reverses the present ratio of one consultant to 1-8 juniors, to 1-8 consultants to one junior doctor. (4) Introduces an immediate standstill in the number of senior house officer posts, leading to a 50% reduction over 15 years. The profession has been seeking an expansion of the consultant  for many years. The last manpower agreement with the DHSS, made 10 years ago, for a 4% expansion in consultants and a 2J% expansion in registrars was never realised and finally the agreement was broken by the Department in the late 'seventies. During those years some growth money to fund such an expansion was available. With the Government now stating that the proposed expansion of the consultant  would not take up extra resources at a time when the growth expenditure on hospitals and community health services is bound to be restricted, it is difficult to envisage the new target of 5% a year being reached. The DHSS is, however, committed to a sub? stantial endeavour to try and meet this by changing the grade mix?to use the DHSS's own jargon. Its proposals need to be examined in detail as the changes envisaged and their implications will profoundly alter the nature and provision of consultant services in this country. If the number of consultants is to be doubled in the next 15 years and the new 1-8 to one consultant to junior ratio applied an extra 13 000 extra consultants would be required in England and Wales, with the number of junior doctors reduced from 21 700 to 14 000 (table I). The net increase in total numbers of doctors over the period would be approximately 6000.
Interleukin 1 promotes tumor cell adhesion to cultured human endothelial cells.
Authors: E Dejana, F Bertocchi, M C Bortolami, A Regonesi, A Tonta, F Breviario, R Giavazzi
Journal: Journal of Clinical Investigation (1988)

We report that IL 1 acts on the endothelium, inducing a long-lasting increase in its adhesivity to tumor cells. Selective pretreatment of cultured human umbilical vein endothelial cells (EC) with IL 1 caused a significant increase in adhesion of three human colorectal carcinoma (HT-29, HCC-P2988, and HCC-M1410) cell lines and one human melanoma (A-375) cell line. Tumor necrosis factor (TNF) was as effective as IL 1 in promoting tumor cell adhesion to EC, whereas IFN gamma and IL 2 were inactive. The IL 1 and TNF induction of EC adhesivity was both concentration (threshold concentration 1 U/ml) and time dependent (peak 4-6 h), reversible within 24 h, and blocked by a protein synthesis inhibitor. The IL 1 and TNF action on EC may play a role in tumor cell lodgement.
How to assess the impact of arthritis on the individual patient: the WHO ICF
Authors: G Stucki
Journal: Annals of the Rheumatic Diseases (2005)

The ICF is not only a comprehensive and adequate framework for assessing the impact of arthritis on individual patients but also its impact on populations. The ICF framework and applications such as the ICF Core Sets for rheumatoid arthritis, osteoarthritis, osteoporosis, and low back pain are therefore likely to be used extensively not only in clinical practice but also in outcomes and rehabilitation research, education, health statistics, and regulation.
Association of Elevated Serum Ferritin Levels and the Risk of Gestational Diabetes Mellitus in Pregnant Women: The Camden Study 
Authors: X. Chen
Journal: Diabetes Care (2006)

OBJECTIVE- We examined the influence of a moderately elevated serum ferritin level at entry to care on the risk of gestational diabetes mellitus (GDM) and a possible mechanism (increased iron stores versus inflammation). RESEARCH DESIGN AND METHODS- In a prospective observational study with 1,456 healthy pregnant women in Camden, New Jersey, serum ferritin and anthropometric measurements were determined. Serum C-reactive protein (CRP) concentration was measured in a nested case-control study of 172 subjects. RESULTS- Women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM (P < 0.001). Elevated serum ferritin level (highest quintile) was significantly and positively correlated with prepregnant BMI and skinfold measurements. Women in the highest quintile of serum ferritin had a twofold increased risk of developing GDM adjusted for several known risk factors (adjusted odds ratio, 2.02 [95% CI 1.04-3.92], P < 0.05). Similar results were obtained with a nested case-control study, in which women in the highest tertile of serum ferritin (2.35 [1.06-5.22], P < 0.05) or CRP (2.67 [1.16-6.17], P < 0.001) had a greater than twofold increased risk of GDM. However, these effects were modified and became nonstatistically significant after additional adjustment for prepregnant BMI. CONCLUSIONS- Elevated serum ferritin concentrations early in gestation are associated with an increased risk of GDM. The association, at least in part, is mediated by the maternal fat mass and obesity. These data suggest a possible link between elevated serum ferritin and low-grade inflammation.
New system for detecting drug side effects can beat regulatory agency
Authors: Bob Roehr
Journal: BMJ (2007)

Officials in Nigeria have filed criminal and civil charges against Pfizer for its role in the deaths and disabilities of children who were treated with an experimental drug during a meningitis outbreak in Kano in 1996.The charges, filed by government prosecutors in Nigeria, follow three attempts by families of the children to sue in US courts.All three attempts were denied after Pfizer successfully argued that the US courts were not an appropriate forum.Four separate legal actions have been filed in Nigeria, including 31 criminal counts against 10 people, according to the Washington Post (www.washingtonpost.com, 2 Jun, "Pfizer faces new charges over Nigerian drug test").The plaintiffs also seek a total of $9bn (£4.5bn; €7bn) in civil suits.The charges stem from Pfizer's test of its unlicensed drug, trovafloxacin (Trovan) to treat 100 children with meningitis.A comparator group of 100 children were treated with a low dose of ceftriaxone.Suits on appeal in US courts charge Pfizer with causing harm to the children in both arms of the trial, alleging that a number of the children either died or were left deaf, mute, or brain damaged.The families allege that the company failed to tell them that their children were being enrolled in an experimental drug trial and that free, effective treatment was available from Médecins Sans Frontières at the same hospital.Five children in the trovafloxacin arm and six in the ceftriaxone arm died, according to Pfizer.Pfizer issued a statement in response to the charges, saying "Pfizer continues to emphasise-in the strongest terms-that the 1996 Trovan clinical study was conducted with the full knowledge of the Nigerian government and in a responsible and ethical way consistent with the company's abiding commitment to patient safety."Any allegations in these lawsuits to the contrary are simply untrue." Niger�ia files cr�iminal char�ges against Pfizer�
Calcinosis cutis following liver transplantation: a complication of intravenous calcium administration
Authors: A. JUCGLÀ, G. SAIS, N. CURCO, J. MARCOVAL, A. MORENO, J. PEYRI
Journal: British Journal of Dermatology (2006)

Calcinosis cutis may be a complication of administration of intravenous calcium solutions. We report four patients who developed calcinosis cutis following orthotopic liver transplantation, all of whom had received calcium chloride solutions intravenously during surgery. There was no evidence of extravasation of the solutions. A gradual improvement of the lesions was seen in the subsequent months. This complication of intravenous calcium infusions is probably related to the large amounts of blood‐derived products and of calcium salts administered during surgery.
Abdominal Distention and Aortic Obstruction Associated With Phenothiazines
Authors: M. Margaret Kemeny
Journal: JAMA (1980)

SPORADIC reports of prolonged paralytic ileus due to the use of phenothiazines in treating psychiatric disorders have appeared in the literature. In some cases, this has progressed to intestinal pseudoobstruction with bowel perforation. If the patient's psychiatric disorder is such that he delays seeking medical attention for this complication, the results can be disastrous. <h3>Report of a Case</h3> A 37-year-old male schizophrenic who had been receiving thioridazine (Mellaril), 50 mg four times a day for many years, was admitted to Kings County Hospital with abdominal pain and distention. Medical history included antrectomy and truncal vagotomy with Billroth II reconstruction for bleeding duodenal ulcer one month previously. His postoperative course at that time was uneventful, and he had been eating and moving his bowels normally until one week prior to admission. At this time, physical examination disclosed a grossly distended, tympanitic abdomen with generalized guarding and rigidity. A roentgenogram of the
Surveillance of Drug Therapy
Authors: Jean K. Weston
Journal: JAMA (1969)

Early last year the state of the art of adverse drug reaction reporting was assessed inThe Journal,<sup>1</sup>found severely wanting, and suggestions voiced for its improvement. In this issue, the two communications by Jick, Slone, and associates from the Lemuel Shattuck Hospital, Boston, report two of the early fruits of a carefully conceived in-hospital drug surveillance program. This is a study of considerable depth and sophistication. It employs full-time paramedical personnel and insists on putting into the computer complete data on all drugs received by patients, as well as much potentially meaningful clinical data, all of which seems adequately and carefully monitored and validated under close nursing and medical supervision. The profile data covers many significant features in each patient, including genetic markers, such as the ABO, MNSs, and other blood groups, when available. By this means, a data bank has resulted which is continually expanding and which
The War Against Hepatitis B
Authors: S. Iwarson
Journal: BMJ (1996)

William Muraskin University of Pennsylvania Press, $29.95, pp 248 ISBN 0 8122 3267 4

I was surprised that someone had taken the time to write a volume of 240 pages about the achievements of the International Task Force on Hepatitis B Immunisation. William Muraskin explains: “I kept wishing that someone would take an aggressive approach to the epidemic, in opposition to the cautious, self-protective way that seemed to dominate American policies. Much of my enthusiasm for the Task Force derives from the contrast I found between the halting effort in the United States and the dynamic activity …
SOME SUGGESTIONS IN THE PROPHYLAXIS AND MANAGEMENT OF PUERPERAL ECLAMPSIA.
Authors: H. D. THOMASON
Journal: JAMA (1896)

manifests itself in the two conditions of sarcoma and carcinoma.When a fibroid tumor at the menopause is quiescent for a few months, then within a period of three or four months shows a disposition to increase, we may reasonably conclude that it is a malignant tumor, and the probability is that there is grafted upon it an irritation in the uterus, a condition of sarcoma.These tumors, under the peculiar malignancy which occurs, take upon themselves the condition of sarcoma, and in six months they increase more than they have in sixteen years.When you have a supposed fibroid tumor of the uterus which has shown little growth under your observation for a period of three or four years, and then begins to increase in size, you can not too soon remove it.It is an important consideration in relation to these changes that they occur in fibroid tumors.Dr. Charles P. Noble, Philadelphia-It has been my expe- rience to have operated on a large number of cases of fibroid tumors, and many of the women did not know they had them until after the menopause.They probably existed, but were small and gave rise to no symptoms until after the menopause, so that my own experience amply supports one point in Dr. Clarke's paper, that fibroid tumors which have given no symp- toms before the menopause very frequently take on rapid growth after it, give pressure symptoms or cause hemorrhage after the menopause.I distinctly recall three cases of tumors which became sarco- matous after having been operated on.Two of the patients died from recurrence.Another case has a recurrence at this time, so that of the three cases of sarcoma two are dead, and in the
Heterogeneity in Meta-analysis of FDG-PET Studies to Diagnose Lung Cancer
Authors: Edward J. Mills, Jeroen P. Jansen, Steve Kanters
Journal: JAMA (2015)

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
Fyn and Cdk5 Mediate Semaphorin-3A Signaling, Which Is Involved in Regulation of Dendrite Orientation in Cerebral Cortex
Authors: Yukio Sasaki, Chi Cheng, Yutaka Uchida, Oumi Nakajima, Toshio Ohshima, Takeshi Yagi, Masahiko Taniguchi, Takashi Nakayama, Reiji Kishida, Yoshihisa Kudo, Shigeaki Ohno, Fumio Nakamura, Yoshio Goshima
Journal: Neuron (2002)
G20 pathologist is struck off
Authors: M. Limb
Journal: BMJ (2012)

Pathologist Freddy Patel has been struck off the medical register after a medical tribunal condemned his handling of postmortem tests on a man who died during the G20 protests in London in 2009.

The Medical Practitioners Tribunal Service said Patel, who carried out the first postmortem tests on Ian Tomlinson and wrongly maintained he died from a heart attack, should no longer be able to practise as a doctor in the UK.

Patel, who has been suspended twice previously for failings in relation to postmortem examinations, was found guilty of misconduct, deficient professional performance, and dishonesty.1

Niall Dickson, chief executive of the General Medical Council, welcomed the decision.

He …
Leading health maintenance organisation near bankruptcy
Authors: F. Charatan
Journal: BMJ (2000)

Harvard Pilgrim Health Care (HPHC), the largest and fastest growing health maintenance organisation in New England, has been placed by court order into temporary receivership. Linda Ruthardt, insurance commissioner for Massachusetts, last week assumed management of the $2.8bn (£1.75bn) a year health plan.

The action, one step away from bankruptcy, is for the purpose of conservation and rehabilitation of HPHC, which is ranked one of the top 10 health maintenance organisations …
Beyond plasma bilirubin: The effects of phototherapy and albumin on brain bilirubin levels in Gunn rats
Authors: Frans J.C. Cuperus, Andrea B. Schreuder, Deirdre E. van Imhoff, Libor Vitek, Jana Vanikova, Renata Konickova, Charles E. Ahlfors, Christian V. Hulzebos, Henkjan J. Verkade
Journal: Journal of Hepatology (2012)
Response to Letter Regarding Article, “Aerobic Interval Training Versus Continuous Moderate Exercise as a Treatment for the Metabolic Syndrome: A Pilot Study”
Authors: Arnt Erik Tjønna, Øivind Rognmo, Tomas Stølen, Anja Bye, Per Magnus Haram, Jan Pål Loennechen, Stig A. Slørdahl, Ulrik Wisløff, Sang Jun Lee, Qusay Y. Al-Share, Sonia M. Najjar, Eirik Skogvoll, Ole J. Kemi
Journal: Circulation (2009)
The Sustenance of Teaching
Authors: John Chamberlain
Journal: Annals of Internal Medicine (2003)

On Being a Doctor17 June 2003The Sustenance of TeachingJohn Chamberlain, MDJohn Chamberlain, MDFrom University of Rochester; Rochester, NY 14626.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-12-200306170-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail It was one of those rare lulls practitioners savor. Brief but refreshing. The piles could wait. The mood invited reflection. The door granted solitude with a gentle nudge.The allure of medicine had been powerful. How were my classmates? Their stories had been similar. Nurtured by a kindly role model with a healing touch and compassionate smile. Driven by idealism. Awed by the science. Stimulated by the intellectual challenges. Charged by the character and power of its practitioners. Determined to make a difference.I followed. If they could do it, so could I. Noble aspiration came later.Dr. C., they ... Author, Article, and Disclosure InformationAuthors: John Chamberlain, MDAffiliations: From University of Rochester; Rochester, NY 14626.Corresponding Author: John Chamberlain, MD, 328 Boca Avenue, Rochester, NY 14626; e-mail, Jkenneth@rochester.rr.com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 June 2003Volume 138, Issue 12Page: 1003KeywordsAscitesHand strengthInflammationOvariesPainPelvisPregnancyTouchUrineVital signs ePublished: 17 June 2003 Issue Published: 17 June 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Ensuring medical students are “fit for purpose”
Authors: Val Wass
Journal: BMJ (2005)

It is time for the UK to consider a national licensing process 

“T he intent to develop liberally educated graduates, rather than competent technicians, is what makes a university a university.”1

This statement stands to be challenged. Postgraduate medical training in the United Kingdom is undergoing profound change as the Modernising Medical Careers project introduces a generic competency based curriculum for all newly graduated (foundation) doctors. A new culture of assessment is developing which increasingly focuses on testing clinical skills in the workplace.2 Licensing processes will be quality assured by the Postgraduate Medical Education Training Board (PMETB). The principles formulated for this encourage reliable, well designed assessments mapped against the requirements of the General Medical Council's (GMC) Good Medical Practice guidance (www.gmc-uk.org/med_ed/default.htm), appropriate standard setting, lay involvement, and transparency of process for candidates (http://www.pmetb.org.uk/). Royal colleges are reviewing their accreditation processes to meet these requirements.

Against this background it is time to reconsider undergraduate examinations for UK medical students. In contrast to the United States and Canada, where national licensing examinations are held, the …