tbuckley/cabot-search huggingface dataset:
Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974–1998
Authors: A. Debeljak, J. S˘orli, E Mus˘ic˘, P Kecelj
Journal: European Respiratory Journal (1999)

The authors reviewed their experience with therapeutic bronchoscopy for removal of tracheobronchial foreign bodies in the adult. Bronchoscopy records and collection of foreign bodies in the endoscopic department were retrospectively examined. Among 37,466 bronchoscopies performed between 1974-1998, 62 (0.2%) were performed for the removal of tracheobronchial foreign bodies. Medical history was suggestive of foreign body aspiration in 33 patients and the chest radiograph was suggestive in 10 patients. The procedure was performed with the flexible bronchoscope in 42 patients (68%), rigid bronchoscope in 4 (6%), and with both in 16 (26%) patients. Foreign bodies were found in the right bronchial tree on 42 occasions, in the left on 20 and in the trachea once. In 39 patients, inflammatory granulations were found around the foreign body. The origins of the foreign bodies included: bone fragments (n=31), vegetable (n=10), broncholith (n=8), a part of dental prosthesis (n=7), endodontic needle (n=2), a metallic (n=2), or plastic (n=1) particle, a tracheostomy tube (n=1) and a match (n=1). In one patient, 2 foreign bodies were found. The foreign bodies were successfully removed in all but 2 patients (3%). The most useful instruments for removal were alligator forceps and the wire basket. Foreign bodies in the tracheobronchial system are rare in adults. They can be successfully removed in the majority of patients under either flexible or rigid bronchoscopy.
Dentists can help detect alcohol misuse, say surgeons
Authors: L. Ritchie
Journal: BMJ (2012)

Dental teams should be identifying alcohol misuse and educating patients on its negative health impact as part of their preventive approach that includes dental hygiene and smoking cessation, maxillofacial surgeons have suggested.

Because most people visit their dentist for routine check ups, but only attend their GP when they are ill, dentists are in a prime position to ask patients about their drinking habits and spot the early signs of excessive drinking such as dental neglect, erosions, and cancerous changes, they say in the Royal College of Surgeons’ Faculty Dental Journal (2012; 3:doi: …
Getting Maintenance of Certification to Work
Authors: David A. Cook, Eric S. Holmboe, Kristi J. Sorensen, Richard A. Berger, John M. Wilkinson
Journal: JAMA Internal Medicine (2014)

Despite general support for the goals of maintenance of certification (MOC), concerns have been raised about its effectiveness, relevance, and value.To identify barriers and enabling features associated with MOC and how MOC can be changed to better accomplish its intended purposes.Grounded theory focus group study of 50 board-certified primary care and subspecialist internal medicine and family medicine physicians in an academic medical center and outlying community sites.Eleven focus groups.Constant comparative method to analyze transcripts and identify themes related to MOC perceptions and purposes and to construct a model to guide improvement.Participants identified misalignments between the espoused purposes of MOC (eg, to promote high-quality care, commitment to the profession, lifelong learning, and the science of quality improvement) and MOC as currently implemented. At present, MOC is perceived by physicians as an inefficient and logistically difficult activity for learning or assessment, often irrelevant to practice, and of little benefit to physicians, patients, or society. To resolve these misalignments, we propose a model that invites increased support from organizations, effectiveness and relevance of learning activities, value to physicians, integration with clinical practice, and coherence across MOC tasks.Physicians view MOC as an unnecessarily complex process that is misaligned with its purposes. Acknowledging and correcting these misalignments will help MOC meet physicians' needs and improve patient care.
The effects of acne treatment with a combination of benzoyl peroxide and erythromycin on skin carriage of erythromycin resistant propionibacteria
Authors: E. A. EADY, R. A. BOJAR, C. E. JONES, J. H. COVE, K. T. HOLLAND, W. J. CUNLIFFE
Journal: British Journal of Dermatology (1996)

Concomitant application of 5% w/w benzoyl peroxide and 3% w/w erythromycin has previously been shown to prevent the overgrowth, on the skin of acne patients, of erythromycin-resistant coagulase-negative staphylococci, which occurs when the antibiotic is used alone. Two in vivo studies were carried out to assess the ability of the same therapeutic combination to inhibit the growth of pre-existing erythromycin-resistant propionibacteria and to prevent the selection of resistant strains during treatment. A double-blind clinical trial in 37 patients with mild to moderate acne vulgaris showed that the combination brought about a > 3 log10 c.f.u. reduction in total propionibacterial numbers/cm2 after 6 weeks therapy (P < 0.001, Wilcoxon's matched pairs) and also significantly reduced the number of erythromycin-resistant propionibacteria (P < 0.05). In contrast, erythromycin alone reduced the total propionibacterial count by < 1.5 log10 c.f.u./cm2 after 6 weeks (P < 0.05) and did not affect the number of erythromycin-resistant strains. The combined formulation was significantly more effective at reducing total propionibacterial numbers at 6 (P < 0.01, Mann-Whitney) and 12 weeks (P < 0.05) than erythromycin alone, although, after 12 weeks, the anti-propionibacterial efficacy of both preparations was less marked. Five patients on combination therapy, and five treated with erythromycin alone, acquired erythromycin-resistant strains de novo at week 6 or week 12. In an open study in 21 acne patients, who each carried > 10(3) c.f.u. erythromycin-resistant propionibacteria/cm2 skin pretreatment, the combination of erythromycin and benzoyl peroxide reduced the total propionibacterial count by > 2.5 log10 and the number of erythromycin-resistant strains by a similar amount (P < 0.001, Wilcoxon). This was accompanied by highly significant reductions in acne grade and lesion counts (P < 0.001). These data suggest that the combination of 5% w/w benzoyl peroxide and 3% w/w erythromycin has greater in vivo anti-propionibacterial activity than 3% w/w erythromycin alone, and brings about significant clinical improvement in acne patients with high numbers of erythromycin-resistant propionibacterial strains pretreatment.
Photodynamic therapy: a better treatment for widespread Bowen's disease
Authors: P.J. ROBINSON, J.A.S. CARRUTH, G.M. FAIRRIS
Journal: British Journal of Dermatology (1988)

We report here the use of photodynamic therapy to treat two patients with multiple lesions of Bowen's disease. A total of over 500 lesions were treated, less than 10% requiring two treatments, and at follow-up 6 months later no lesions remained in either patient. The only important side-effect of treatment was a marked photosensitivity reaction. We consider photodynamic therapy an efficient treatment for Bowen's disease; multiple lesions can be treated in a short treatment session, without local anaesthesia, and healing occurs within 2 weeks.
Fortnightly Review: Managing lower urinary tract symptoms in older men
Authors: P Abrams
Journal: BMJ (1995)

<h3>Summary points</h3> The presence of lower urinary tract symptoms does not indicate bladder outlet obstruction Size of the prostate does not correlate with bladder outlet obstruction: small prostates may cause severe obstruction Bothersomeness and effect on quality of life are the preferred indicators for treatment Conservative treatment is justified by the long clinical course of the conditions Drugs are of some help and are becoming safer Transurethral resection of the prostate is the only procedure known to give good long term results New alternatives to transurethral resection of the prostate should only be used within the context of randomised controlled trials at present
P128 Smoking cessation educational poster campaign
Authors: J. Ryder, L. Davies, J. Bibby
Journal: Thorax (2011)

<h3>Introduction</h3> The health benefits of stopping smoking are well established and hospitals have a unique opportunity to contribute to protecting and promoting health through smoking cessation interventions. NICE published recommendations in 2006 stating that all health professionals should offer brief advice of the benefits to stopping smoking to their patients and a referral to a specialist service. However, despite this, smoking cessation interventions are not generally part of routine care in a hospital setting. <h3>Method</h3> A partnership with Aintree NHS Trust, Pfizer and a design agency was established to develop a creative campaign to promote the stop smoking service to hospital based health professionals who are influential messengers available to give expert advice to patients. Furthermore, we wanted to engage with the patients, friends and family directly to endorse the message. We trained staff on a number of wards to be champions for the campaign that was launched on No Smoking Day 2010. We agreed on the theme “Time to Quit” consisting of posters; leaflets; prompts in patient notes; and information folders for all wards and clinical areas. <h3>Results</h3> The campaign met its objectives to increase the number of patients referred to the hospital stop smoking service. There was a 60% increase in the referrals at Aintree over the first 8 months compared to the previous year. We particularly noticed an increase on the wards with a Champion trained in delivering a brief intervention. <h3>Conclusion</h3> A comprehensive educational campaign proved to be effective in raising awareness of the Hospital Stop Smoking Service and increasing referrals within the Trust. A similar campaign could contribute to an increase in referrals and support to patients in other secondary care settings, resulting in smoking cessation interventions becoming part of routine care in hospital settings. Moreover, the campaign contributes to supporting healthcare providers in their role in prevention and health education.
Exercise thallium-201 scintigraphy in dogs: effects of long-term coronary occlusion and collateral development on early and late scintigraphic images.
Authors: M V Cohen, R M Steingart
Journal: Circulation (1985)

To examine the effects of coronary collateral development on thallium-201 (201Tl) distribution the left circumflex coronary artery was ligated in eight dogs. Three days later these animals ran on a treadmill, and 201-thallous chloride was injected into the right atrium at peak exercise. Scintigraphic scanning was begun within 10 min and continued for 3 hr. Scanning was repeated weekly for 6 weeks. In the last week radioactive microspheres were injected into the left atrium at peak exercise to measure regional myocardial blood flow. The scintigraphically determined disparity between perfusion of the ischemic and normal myocardium was most marked at 3 days after ligation. This difference gradually lessened over the first 4 weeks until there was no difference in 201Tl distribution to normally perfused myocardium and tissue distal to the ligation. Concomitant with the improvement in the scintigrams, exercise hemodynamics also improved over this 4 week period with significant increases in cardiac output and decreases in left atrial pressure. Serial coronary angiographic studies in two animals demonstrated the appearance of collaterals in the initial weeks after coronary occlusion, and by 4 weeks the left circumflex artery distal to the obstruction was completely opacified by collateral flow. The ratio of directly measured exercise blood flow to the left circumflex and normally perfused tissues was 0.89 +/- 0.08 at 6 weeks after ligation. Scintigraphic 201Tl redistribution after 3 hr also changed over the weeks after ligation. Three days after ligation washout from the ischemic area was significantly slower than that from the normal myocardium. By 6 weeks loss of 201Tl from the two regions occurred at nearly equal rates. Thus myocardial perfusion and function during exercise after coronary occlusion are dynamic events that change with time. It is likely that coronary collateral development is responsible for these phenomena. Therefore coronary collaterals do have salutary effects in the dog.
ErbB-2 signals through Plexin-B1 to promote breast cancer metastasis
Authors: Thomas Worzfeld, Jakub M. Swiercz, Mario Looso, Beate K. Straub, Kishor K. Sivaraj, Stefan Offermanns
Journal: Journal of Clinical Investigation (2012)

Diagnosis of metastatic breast cancer is associated with a very poor prognosis. New therapeutic targets are urgently needed, but their development is hampered by a lack of understanding of the mechanisms leading to tumor metastasis. Exemplifying this is the fact that the approximately 30% of all breast cancers overexpressing the receptor tyrosine kinase ErbB-2 are characterized by high metastatic potential and poor prognosis, but the signaling events downstream of ErbB-2 that drive cancer cell invasion and metastasis remain incompletely understood. Here we show that overexpression of ErbB-2 in human breast cancer cell lines leads to phosphorylation and activation of the semaphorin receptor Plexin-B1. This was required for ErbB-2-dependent activation of the pro-metastatic small GTPases RhoA and RhoC and promoted invasive behavior of human breast cancer cells. In a mouse model of ErbB-2-overexpressing breast cancer, ablation of the gene encoding Plexin-B1 strongly reduced the occurrence of metastases. Moreover, in human patients with ErbB-2-overexpressing breast cancer, low levels of Plexin-B1 expression correlated with good prognosis. Our data suggest that Plexin-B1 represents a new candidate therapeutic target for treating patients with ErbB-2-positive breast cancer.
The Coexistence of Thyroid Malignancy with Autonomous Hot Nodules of the Thyroid
Authors: D P LIVADAS, O B KOTO??LAS, V BOUROPOULOU, J SFONTOURIS, A PSARRAS, D A KOUTRAS
Journal: Clinical Nuclear Medicine (1977)

Three cases of autonomous hot nodules of the thyroid (toxic adenomas) coexisting with thyroid cancer are reported, and the scintigraphic findings presented. In the first case the carcinoma appeared as a cold area within the hot nodule: in the second the hot nodule was on the right lobe, whereas the carcinoma involved the left lobe and the isthmus; and in the third case there were two benign autonomous hot nodules together with a malignant cold nodule.
Efficacy vs Effectiveness—Reply
Authors: Jun Ma, M. Kaye Kramer, Paul Ciechanowski
Journal: JAMA Internal Medicine (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Internal Medicine journal
Endovascular Repair of Abdominal Aortic Aneurysm — Round Two
Authors: Frank A. Lederle
Journal: New England Journal of Medicine (2005)

Last year saw the publication of the first randomized comparisons of the endovascular and open techniques for elective repair of abdominal aortic aneurysms. The Dutch Randomized Endovascular Aneurysm Management (DREAM) trial1 and the British Endovascular Aneurysm Repair Trial 1 (EVAR-1)2 each showed substantial reductions in 30-day postoperative mortality with endovascular repair, in agreement with the results of large observational studies published before3,4 and since5 then. These findings showed that endovascular repair was off to a good start, but there remained an obvious need for data on long-term outcomes.6 That need has increased in the interim, since the release of . . .
Expression of complex symbols.
Authors: D N Baron
Journal: BMJ (1978)

to belittle Harvey's great contributions to the discovery of the circulation of the blood, but is it not time that we in Britain stopped perpetuating what at least is an oversimplified claim, that it was Harvey and Harvey alone who made this great discovery?It would be most interesting, especially to me, to learn the views of professional medical historians-British, Italian, and Dutch.
The George E. Brown Memorial Lecture
Authors: DONALD E. GREGG
Journal: Circulation (1963)

The results presented are just the beginning of an attempt to study the reactions of the left coronary circulation in the unanesthetized dog to natural stresses of everyday life. They indicate in mild to moderate treadmill exercise, with little change in stroke cardiac output, that the flow and oxygen usage per heart beat does not greatly increase, so that the coronary circulation appears to be largely limited or monitored by the heart rate. During excitement and cardiac sympathetic nerve stimulation, the left coronary vascular bed undergoes massive dilatation, so that the left ventricle is able to increase its coronary circulation as the result of the combined effect of an increased number of heart beats and a greatly increased flow and oxygen usage per heart beat, the latter occurring despite a marked reduction in the duration of systole and of the cardiac cycle, and very little change in the pressure developed by the left ventricle. Although the left ventricular contraction imposes a large myocardial impediment to coronary flow, it permits a very sizable and variable contribution to systolic flow and to left coronary flow. In the resting dog, the left coronary inflow in systole generally approximates 15 to 60 per cent of that during diastole, and under different stress conditions, such as exercise, excitement, drug injections and irreversible hemorrhagic shock, both the systolic and diastolic flow per heart beat can increase by 300 to 400 per cent, the ratio between them remaining the same, or, at times, the volume of systolic flow can equal or exceed the diastolic flow. Evidence has been presented to show that much of this systolic flow represents intramural flow. These findings will, I believe, cause some recasting of our present views concerning the regulation of the coronary circulation.
No consumption of IgE antibody in serum during allergic drug anaphylaxis
Authors: A. B. Guttormsen, S. G. O. Johansson, H. Öman, V. Wilhelmsen, A. Nopp
Journal: Allergy (2007)

Background: The general understanding is that a blood sample for analysis of immunoglobulin (Ig) E antibodies to an allergen suspected to cause an anaphylaxis cannot be drawn until several weeks after the reaction. As this is most unpractical, the changes in IgE antibody levels during anaphylaxis were studied to evaluate the possibility of using samples drawn at the time of the reaction. Methods: Immunoglobulin E antibodies to suxamethonium were quantitated with ImmunoCAP before, during and after an anaphylactic reaction occurring during anaesthesia using neuromuscular blocking agents. Results: Serum IgE antibody concentrations against suxamethonium in blood samples collected up to 6 h after the reaction were not different from those in samples drawn before or days and weeks after the anaphylaxis. Conclusions: A serum sample intended to trace the drug involved in an IgE‐mediated anaphylactic reaction can be drawn in direct relation to the reaction.
A SIMPLE, PAINLESS AND PERHAPS NEW METHOD OF VACCINATION; DENUDATION VERSUS SCARIFICATION.
Authors: M. B. HUTCHINS
Journal: JAMA (1898)

This method may fall under the category of "nothing new under the sun," but I have not been able to find that the simple principles followed have ever been put into practice before. The idea of perfecting a new method of preparing the skin for inoculation was brought to my mind because of my sympathy for little children who are frightened and even given pain by the old, scarification plan. The protection from absorption possessed by the skin is due to the epidermis and chiefly to the horny layer. This being removed, or even scarified, permits absorption. An excoriation or denudation is necessary to local infection in most cases, though follicular inoculation has been credited. Given, then, an impermeable covering, it was but necessary to find an agent which would dissolve or disintegrate the upper layers of the epidermis without pain or fright to the patient. Salicylic acid in glycerin
Aggregation of γG3 proteins: relevance to the hyperviscosity syndrome
Authors: J. D. Capra, H. G. Kunkel
Journal: Journal of Clinical Investigation (1970)

Studies on the sera and isolated proteins from 14 patients with gammaG3 multiple myeloma revealed a concentration- and temperature-dependent aggregation which was not encountered in 26 sera from patients with multiple myeloma involving other gammaG subgroups. When the gammaG3 myeloma sera were diluted and characterized by analytical ultracentrifugation, complex formation was minimal. However, when these sera were examined undiluted, marked complex formation was observed. Studies on the isolated proteins, their enzymatic fragments, as well as their heavy and light polypeptide chains localized the aggregating sites to the Fd fragment of the heavy chains. The findings were also documented by acrylamide-gel electrophoresis and capillary tube viscometry.THE HYPERVISCOSITY SYNDROME WAS OBSERVED IN SIX PATIENTS: three with gammaG3 myeloma and three with gammaG1 myeloma. In the latter group extreme protein concentrations appeared essential for the development of the clinical symptoms. The gammaG3 cases, however, because of the aggregation phenomenon, showed the syndrome at relatively low protein concentrations.
I131 Levels in Milk
Authors: Eric Reiss, Malcolm L. Peterson
Journal: JAMA (1963)

<h3>To the Editor:</h3> —In the Aug 17, 1963, issue ofThe Journal(<b>185</b>:615), a physician from Delaware inquires about the significance of I<sup>131</sup>levels in milk. Your expert's answer contains errors and misleading statements. These require correction because the problem of fallout is becoming more widely discussed by laymen. Reference to "maximum permissible concentration" (MPC) is out of date in connection with radiation protection standards. The permissible concentration concept was based on the assumption that below certain radiation exposures no biological damage occurs. This is almost certainly not true for genetic effects of radiation. Whether a threshold exists for somatic effects has not been proved or disproved, but most authorities now agree that the threshold assumption cannot be safely used in the development of radiation standards. Hence, the Federal Radiation Council (FRC) in its first report of May, 1960, clearly stated the need for balancing risks and benefits