tbuckley/cabot-search huggingface dataset:
THE HOSPITAL OF THE FUTURE
Authors: D. C. L. Fitzwilliams
Journal: BMJ (1934)

There is a saying that the old order changeth, giving place to new; but change is not always manifest, and in some departments of our civilization it seems, for time, imperceptible, and then characterized by a period of great activity.One sees this in the building of hospitals.I am not here referring to the style of archi- tecture, though that has changed quite suddenly, but to the internal arrangements and the ideas which pervade them.Originally, hospitals were charitable institutions founded, for the most part, by religious orders out of pity for the.r fellow men, for the relief of suffering humanity- for those who rotted in the streets, beggars who could no longer beg, men broken in the wars, those in the last stages of disease, and for few else.Shelter and sustenance were of primary importance, and the medical side took second place.Once admitted to the institution the Anmates could remain there indefinitely.Gradually through.the ages the almshouse features were lost and the medical side grew until it became the all-important.feature of the institution as we see it to-day.-Lister's discoveries revolutionized hospital organIzation, and his influence spread far beyond surg cal confines.It introduced cleanliness everywhere, and banIshed the " smell of new-mown hay " which pervaded the institu- tions owing to the number of pyaemic cases in the wards.The tiled or terazzo floors, the rounded corners, the-new paint, and the general air of freshness associated with these institutions to-day are all due to Lister's genius.Since those great changes consequent upon his discoveries, we have been experiencing one of those pauses already hinted at.Public health authorities have influenced the water supply, sanitary arrangements, lighting, and other
Expansion of donor-derived hematopoietic stem cells with PIGA mutation associated with late graft failure after allogeneic stem cell transplantation
Authors: Kanako Mochizuki, Chiharu Sugimori, Zhirong Qi, Xuzhang Lu, Akiyoshi Takami, Ken Ishiyama, Yukio Kondo, Hirohito Yamazaki, Hirokazu Okumura, Shinji Nakao
Journal: Blood (2008)
Sight drug deal ends High Court challenge
Authors: C. Dyer
Journal: BMJ (2008)

More than 120 patients of Warwickshire Primary Care Trust with wet age related macular degeneration are to receive treatment with a new drug on the NHS pending approval by the National Institute for Health and Clinical Excellence (NICE).

The settlement, under which Novartis, the manufacturer of ranibizumab (Lucentis), has agreed to provide the drug free after 14 treatment cycles on the NHS, was brokered by High Court judge Mr Justice Forbes after three patients challenged the trust’s refusal to fund treatment …
Tamoxifen and Hypercalcemia
Authors: J. D. VELDHUIS
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 April 1978Tamoxifen and HypercalcemiaJ. D. VELDHUIS, M.D.J. D. VELDHUIS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-4-574_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The report of tamoxifen therapy in advanced breast cancer by Kiang and Kennedy (1) provides important data on hormonal therapy. The early appearance of hypercalcemia in two of their patients, however, may not have been sufficiently emphasized.In our prospective use of this agent, three of the first five patients with extensive osteolytic metastases developed hypercalcemia within 2 weeks of initiating therapy. Reports in the European literature reveal that hypercalcemia appears in as many as 20% of patients, frequently at the onset of therapy, and sometimes reverses despite continuation of treatment (2). The time-course of appearance of...References1. KIANGKENNEDY DB: Tamoxifen (antiestrogen) therapy in advanced breast cancer. Ann Intern Med 87:687-690, 1977 LinkGoogle Scholar2. HENNINGSENAMBERGER BH: Anti-estrogene Therapie des metastierenden Mammakarzinoms. Dtsch Med Wochenschr 102:713-716, 1977 CrossrefMedlineGoogle Scholar3. CZYGANSCHULZ PK: Studies of the anti-oestrogenic and oestrogen-like action of clomiphene citrate in women. Gynecol Invest 3:126-134, 1972 CrossrefMedlineGoogle Scholar4. PRASADSARKARAN MM: Mode of action of nonsteroidal antioestrogens. Acta Endocrinol [Suppl] (Kbh) 166:448-456, 1972 CrossrefMedlineGoogle Scholar5. TERENIUSLJUNGKVIST LI: Aspects of the mode of action of antiestrogens and antiprogestogens. Gynecol Invest 3:96-107, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. D. VELDHUIS, M.D.Affiliations: Milton S. Hershey Medical Center Hershey, PA 17033 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLife-Threatening Tamoxifen-Induced HypercalcaemiaFluid and Electrolyte DisordersThe pharmacology and clinical uses of tamoxifenDisorders of Mineral MetabolismDrug-Induced Electrolyte DisordersA study of prostaglandin E2, parathormone, and response to indomethacin in patients with hypercalcemia of malignancyHypercalcaemia and Endocrine Syndromes in CancerTamoxifen-induced hypercalcemia in breast cancerThe Significance of Tumour “Stimulation” by TamoxifenTamoxifen and HypercalcemiaKATHLEEN I. PRITCHARD, M.D., ROY M. CLARK, M.B., SHELDON FINE, M.D., J. WILLIAM MEAKIN, M.D., DANIELE J. PERRAULT, M.D., DONALD J. A. SUTHERLAND, M.D.Hypercalcemia and Tamoxifen ReadministeredRAYMOND TAETLE, M.D., JOHN MENDELSOHN, M.D., MARK R. GREEN, M.D. 1 April 1978Volume 88, Issue 4Page: 574-575KeywordsBreast cancerHormonal therapyHypercalcemia ePublished: 1 December 2008 Issue Published: 1 April 1978 PDF downloadLoading ...
Palliative care in chronic obstructive pulmonary disease: a review for clinicians
Authors: D. A Seamark, C. J Seamark, D. M G Halpin
Journal: Journal of the Royal Society of Medicine (2007)

Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by airflow obstruction which ultimately kills many patients. It is common in both men and women and there is a 24—30% 5-year survival rate in the UK for those with severe disease. The annual death rate in the UK from COPD approaches that from lung cancer. Patients’ symptoms can be improved by drug therapy, but stopping smoking is also an effective way of improving the outcome in patients at all stages of COPD. Predicting prognosis has been difficult in COPD due to the variable illness trajectory. However, assessment of severity of lung function impairment, frequency of exacerbations and requirement for long term oxygen therapy can help identify patients entering the final 12 months of life. Symptom burden and impact on activities of daily living for patients with COPD are comparable with that of cancer patients, and palliative care approaches are equally necessary, yet few publications exist to guide clinicians in this area. An evidence base exists for the management of dyspnoea with oxygen therapy and opioid drugs. There is less evidence for the effective treatment of depression and anxiety, fatigue and pain, and treatment is based on experience and considered best practice. This review discusses the problems that patients experience and offers practical guidance. The management of patients should be shared between primary and secondary care, with multidisciplinary teams being involved at an early stage. Patients and their families require honest and clear communication about the condition and what to expect in the future. The strict application of advance care planning and directives may not be feasible or appropriate, but there is evidence that attitudes towards resuscitation and artificial ventilation can be explored without distress. The requirement by patients and carers for surveillance and timely support is acknowledged, but how to provide such input is as yet unclear, with little evidence to support the widespread implementation of nurse-led management interventions. The hospice movement has become increasingly involved in the management of life-threatening, non-malignant disease and should be involved in the multidisciplinary care of patients dying from COPD.
Iron and coronary heart disease. Iron makes myocardium vulnerable to ischemia.
Authors: J L Sullivan
Journal: BMJ (1993)

among outpatients was not associated with any measurable benefits to patients, but 43% of doctors used information on functional status to change treatment.5It is not appropriate to generalise from American experience to British hospitals, where geriatric services are more multidisciplinary and training is longer.Similar trials are urgently needed.It would be useful to know more detail of the patterns of compliance with both measures at both times in Wessex as this may indicate where resistance lies and where research may be most usefully targeted.Interviews with the 40 consult- ants in Wessex would also be useful to explore their views on the reasons for poor compliance and to define research needs.The main weakness of the consensus approach adopted by the Royal College of Physicians and the British Geriatrics Society (and other prestigious groups in other aspects of medicine) is that acts of faith are required to bridge gaps in scientific evidence.Spending resources in applying new technologies of unknown efficacy cannot be defended unless there is a planned evaluation of the technologies' value.The NHS Research and Development division's newly constituted health technology assessment boards should provide a useful source of new funding for this purpose.
Incidental Focal Uptake in Oropharynx Due to Lingual Thyroid on Diagnostic 131I Whole-Body Scan After Total Thyroidectomy
Authors: Hee-Sung Song, Seok-Ho Yoon, Kyung Sook Jo, Dong Hyun Lee, Young-Sil An, Joon-Kee Yoon, Su Jin Lee
Journal: Clinical Nuclear Medicine (2013)

After total thyroidectomy for papillary thyroid carcinoma, a 37-year-old woman underwent a 2-mCi 131I whole-body scan which demonstrated focal uptake in the anterior neck and in the oropharynx. Preoperative contrast-enhanced neck computed tomography demonstrated a small enhancing nodule typical for ectopic thyroid at the tongue base. She was then treated with 150 mCi 131I. Small asymptomatic lingual thyroid remnants typically do not affect high-dose 131I therapy.
Pustulosis acuta generalisata is a post-streptococcal disease and is distinct from acute generalized exanthematous pustulosis
Authors: P. AUER-GRUMBACH, E. PFAFFENTHALER, H. P. SOYKR
Journal: British Journal of Dermatology (2006)

Generalized pustular eruptions with fever present a diagnostic and therapeutic problem. Based on a case of pustulosis acuta generalisata and a review of the literature, this entity can be regarded as an exclusively post-streptococcal disorder with an elevated antistreptolysin litre. It has a distinct clinical presentation of isolated pustules on normal skin, predominantly in an acral location. We propose criteria for the clear separation of this disease from acute generalized exanthematous pustulosis and from pustular psoriasis.
US Longevity Falls Short vs That of Peer Countries
Authors: Bridget M. Kuehn
Journal: JAMA (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 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
Analysis of risk factors influencing outcome in children with myelodysplastic syndrome after unrelated cord blood transplantation
Authors: A B M Madureira, M Eapen, F Locatelli, P Teira, M-J Zhang, S M Davies, A Picardi, A Woolfrey, K-W Chan, G Socié, A Vora, Y Bertrand, C M Sales-Bonfim, E Gluckman, C Niemeyer, V Rocha
Journal: Leukemia (2010)
Hospitals should offer bingo and art sessions, says BMA
Authors: J. Wise
Journal: BMJ (2011)

Hospital patients should have the opportunity to play bingo and card games and to take part in creative activities to overcome boredom and improve clinical outcomes, says a new report from the BMA’s board of science.

The report says that a patient’s physical environment is also important: sunnier rooms, views of green spaces, and quieter wards can make patients happier and speed up their recovery. While many current buildings may not allow them, consideration of such changes should be paramount in new buildings …
Variation in natural killer activity in peripheral blood during the menstrual cycle.
Authors: A N Sulke, D B Jones, P J Wood
Journal: BMJ (1985)

Natural killer activity was measured sequentially in normal female volunteers through their menstrual cycle. During the periovulatory period there was a significant fall in natural killer activity compared with in normal male volunteers. This variation was not apparent in women taking oral contraception. Cytotoxic activity was not related to oestradiol concentrations in individual women. The data support an interaction between immunological activity and sex hormones over the normal physiological range and would account for the described reduction in natural killer activity in pooled blood from female blood donors.
Castration-Resistant Prostate Cancer—Hormone Therapy Redux
Authors: Anthony W. Tolcher, Josh Cooper
Journal: Journal of Clinical Oncology (2010)

Although all authors completed the disclosure declaration, the followingauthor(s) indicated a ﬁnancial or other interest that is relevant to the subjectmatter under consideration in this article. Certain relationships markedwith a “U” are those for which no compensation was received; thoserelationships marked with a “C” were compensated. For a detaileddescription of the disclosure categories, or for more information aboutASCO’s conﬂict of interest policy, please refer to the Author DisclosureDeclaration and the Disclosures of Potential Conﬂicts of Interest section inInformation for Contributors.
THE DOCTOR-PATIENT RELATIONSHIP AND ITS HISTORICAL CONTEXT
Authors: THOMAS S. SZASZ, WILLIAM F. KNOFF, MARC H. HOLLENDER
Journal: American Journal of Psychiatry (1958)

The doctor-patient relationship which characterizes a given situation depends on two principal categories of variables: the medical situation and the social scene. The cultural matrix impinges on the individual characteristics of both physician and patient in the form of learned orientations to disease, treatment, cure and to the doctor-patient relationship itself. We have briefly reviewed and commented on the probable connections between the socio-historical and intellectual-scientific circumstances of 6 historical epochs and the prevalent type (s) of doctor-patient relationship. It is our thesis that the value of a specific pattern of the doctor-patient relationship can be established only by evaluating all the relevant and pertinent variables. We would suggest, however, that awareness of the cultural relativity of the doctor-patient relationship should make us skeptical of the assumption that our current practices are "good" or the "best possible." Probably more often than not, they are neither, but simply reflect the congruence of social expectations and socially shared ethical orientations of physicians. In this connection, physicians, and perhaps psychiatrists particularly, explicitly may consider which of the following 3 alternatives they favor: 1. That they reflect the prevalent social values and expectations of their culture; 2. That they lag behind the social changes of the time and represent the values of the immediate past; or 3. That they join with those forces in society which lead to its modification (whether to "progress" or "regress"). Critical examination of the doctor-patient relationship usually predisposes to change, while non-scrutiny of human social relations favors the status quo.
Research, Rehabilitation, Education, and Welfare
Authors: G. G. Liddle
Journal: JAMA (1971)

To the Editor.—  Last week a little old lady, whose pestering symptoms had bugbit me (the bugs pestered me, not her), declared she wanted to become a drug addict.   Liddle .—Really, Mrs. Smith, I must expostulate...   Mrs. Smith .—Never mind the expostulation. Just teach me how to become an addict. And none of this pot, I want hard stuff.   Liddle .—Sorry, granma, but...   Mrs. Smith .—Skip the gamma delta, epsilon hypocrisy and uncork 50 or 60 bags. Mainline me in, and omit the skinpopping. Let's get on the fast track. I sacked the hypos and needles on my last visit, but could use a little diagram of finger-veins for when my antecubitals give out.   Liddle .—You've been reading...   Mrs. Smith .—Yes, I've been reading the New York Times , which promises aid for heroin addicts, which tells about that $105 million Mr. Nixon wants, which would benefit perhaps one third of
1022 CLINICAL COURSE OF SUB-CENTIMETER-SIZED NODULES DETECTED DURING SURVEILLANCE FOR HEPATOCELLULAR CARCINOMA IN PATIENTS AT RISK
Authors: Y.W. Min, G.-Y. Gwak, M.W. Lee, Y.H. Paik, M.S. Choi, J.H. Lee, K.C. Koh, S.W. Paik, B.C. Yoo
Journal: Journal of Hepatology (2012)
Predictive value of early virological reduction (EVR) in the response at 24 weeks (W) of HCV treatment with Peg-interferon (Peg-IFN) &amp; ribavirine (RBV) in HIV-infected patients (P)
Authors: A.L. Ballesteros, S. Franco, D. Fuster, M.A. Martinez, L. Acosta, A. Salas, C. Rey-Joly, J. Tor, R. Planas, B. Clotet, C. Tural
Journal: Journal of Hepatology (2003)
Hereditary Spherocytosis and Glucose-6-Phosphate Dehydrogenase Deficiency
Authors: Jonathan Rubins
Journal: JAMA (1977)

The first reported case of hereditary spherocytosis (HS) and glucose-6-phosphate dehydrogenase deficiency in a black is presented. The recent literature is reviewed, with emphasis on the frequency of multiple inherited RBC defects in this ethnic group. Despite a coexisting hemoglobinopathy or enzyme deficiency, HS can be diagnosed in most cases by the peripheral blood smear, osmotic fragility curve, and family history. The implications of the double RBC abnormality are discussed, stressing the importance of splenectomy in relieving the hemolytic component due to spherocytosis. (<i>JAMA</i>237:797-798, 1977)
P221 Distal airway bacterial colonisation in patients with lung cancer
Authors: P. Agarwal, D. J. Newberry, J. Waller, J. Mullings, S. Sundaram, P. C. Russell
Journal: Thorax (2010)

<h3>Introduction</h3> Patients with lung cancer are at higher risk of pulmonary infection due to immunosuppression and impaired function of the natural protective mechanisms which can have an impact on oncological treatment and survival. Aims: To assess the proportion of potentially pathogenic microorganisms (PPM) that colonise the bronchial tree in patients with primary lung cancer. <h3>Methods</h3> A bronchoscopic study of 165 patients (101 M and 64 F) aged from 31 to 96 (mean 69 years) with confirmed malignancy on bronchial sampling was conducted from January 2005 to July 2010. In all patients, bronchial washings (BW) were performed during bronchoscopy. Obtained BW fluid was subjected to microbiological examination and culture by the semi-quantitative method. A diagnostic level of &gt;100 colony forming units (CFU) was set. Computed tomography thorax scans were also assessed for radiological signs of pneumonia. <h3>Results</h3> In 27 (16.4%) of 165 patients, bronchial colonisation of PPM was &gt;100 CFU. In 28 patients (17.0%), the culture of PPM was &lt;100 CFU. The presence of fungi and upper respiratory tract flora was confirmed in 24 (14.5%) and 35 (21.2%) patients, respectively. Mycobacterium Tuberculosis was negative in the 159 patients that had been tested and Mycobacterium Fortuitum was isolated in one patient. Sixteen (9.7%) patients were colonised with Gram positive PPM. The most frequently isolated PPM was Coliform (n=9, 5.5%) followed by <i>Staphylococcus aureus</i> (n=8, 5%) and <i>Streptococcus pneumoniae</i> (n=5, 3.0%). Bronchial colonisation of PPM was highest in patients with small cell lung carcinoma (5/26, 19.2%) and similar between primary adenocarcinoma (4/30, 13.3%) and squamous cell carcinoma (12/82, 14.6%). Four multi-drug resistant strains of bacteria (2.4%) including MRSA (n=2) were isolated. In five patients (3.0%), the bronchial tree was colonised simultaneously by two or more types of PPM. A third (9/27) of patients with PPM also had radiological evidence of pneumonia. <h3>Conclusions</h3> Less than 20% of patients with lung cancer had bronchial colonisation of microorganisms above the assumed diagnostic level. Approximately two-thirds had colonisation with Gram-positive bacteria in their distal airways. Bronchial bacterial colonisation appears to be slightly higher in patients with small cell lung cancer. The identification of potentially pathogenic microorganisms in the distal airways of lung cancer patients, especially at the time of diagnosis, is clinically important before deciding future management strategies. An empirical antibiotics policy would be useful in these patients.
A physiologically based pharmacokinetic model for 2,4-toluenediamine leached from polyurethane foam-covered breast implants.
Authors: H M Luu, J C Hutter, H F Bushar
Journal: Environmental Health Perspectives (1998)

Physiologically based pharmacokinetic (PBPK) modeling was used to assess the low-dose exposure of patients to the carcinogen 2, 4-toluenediamine (2,4-TDA) released from the degradation of the polyester urethane foam (PU) used in Meme silicone breast implants. The tissues are represented as five compartments: liver, kidney, gastrointestinal tract, slowly perfused tissues (e.g., fat), and richly perfused tissues (e.g., muscle). The PBPK model was fitted to the plasma and urine concentrations of 2,4-TDA and its metabolite 4-AAT (4-N-acetyl-2-amino toluene) in rats given low doses of 2, 4-TDA intravenously and subcutaneously. The rat model was extrapolated to simulate oral and implant routes in rats. After adjusting for human physiological parameters, the model was then used to predict the bioavailability of 2,4-TDA released from a typical 4.87-g polyester urethane foam implant found in a patient who weighed 58 kg with the Meme and had the breast implant for 10 years. A quantitative risk assessment for 2,4-TDA was performed and the polyester urethane foam did present an unreasonable risk to health for the patient.