tbuckley/cabot-search huggingface dataset:
GPs are reluctant to promote patient choice, health minister says
Authors: N. Hawkes
Journal: BMJ (2013)

Many doctors have dragged their heels over offering patients the treatment choices to which they are entitled, a health minister has charged. 

The health minister Earl Howe told a London conference that the government would be acting to deal with the failure of the Choose and Book system to take hold, and criticised general practitioners for their reluctance to promote it.

“Many doctors take every excuse to keep appointments short and simply direct patients to the nearest secondary care provider because that is the easiest way to proceed,” he told a Westminster Health Forum seminar on the future of the NHS on 15 October. “Overall the NHS is not doing enough to address the choice agenda, which is valued by a lot of patients.”

Choose and Book would soon be relaunched under a new title—e-referral—and the government would be reminding patients of their rights to be referred to wherever they wanted, he added. Clinical commissioning groups would have to demonstrate that they …
Depression and Folate Status in the US Population
Authors: Martha S. Morris, Maurizio Fava, Paul F. Jacques, Jacob Selhub, Irwin H. Rosenberg
Journal: Psychotherapy and Psychosomatics (2003)

&lt;i&gt;Background:&lt;/i&gt; Folate deficiency and low folate status have been linked in clinic studies to depression, persistent depressive symptoms, and poor antidepressant response. These relationships have not been demonstrated in general populations. This study examined associations between depression and folate status indicators in an ethnically diverse general US population sample aged 15–39 years. &lt;i&gt;Methods:&lt;/i&gt; Healthy subjects whose red blood cell (RBC) folate concentrations had been measured were determined to have no depression (n = 2,526), major depression (n = 301 ), or dysthymia (n = 121) using a diagnostic interview schedule. Serum concentrations of folate and total homocysteine (tHcy) were also measured. &lt;i&gt;Results:&lt;/i&gt; After adjustment for sociodemographic factors, serum vitamin B&lt;sub&gt;12&lt;/sub&gt; concentration, alcohol consumption over the past year and current status as to overweight and use of vitamin/mineral supplements, cigarettes and illegal drugs, subjects who met criteria for a lifetime diagnosis of major depression had folate concentrations in serum and RBCs that were lower than those of subjects who had never been depressed. Subjects who met criteria for dysthymia alone had lower RBC folate concentrations than never-depressed subjects, but the serum folate concentrations of the two groups were comparable. Serum tHcy concentration was not related to lifetime depression diagnoses. Low folate status was found to be most characteristic of recently recovered subjects, and a large proportion of such subjects were folate deficient. &lt;i&gt;Conclusions:&lt;/i&gt; Low folate status was detectable in depressed members of the general US population. Folate supplementation may be indicated during the year following a depressive episode.
Should Alcoholics Compete Equally for Liver Transplantation?
Authors: Alvin H. Moss
Journal: JAMA (1991)

The circumstances of liver transplantation are unique among organ transplantation because of the dire, absolute scarcity of donor livers and the predominance of one disease--alcohol-related end-stage liver disease--as the principal cause of liver failure. We propose that patients who develop end-stage liver disease through no fault of their own should have higher priority for receiving a liver transplant than those whose end-stage liver disease results from failure to obtain treatment for alcoholism. We base our proposal on considerations of fairness and on whether public support for liver transplantation can be maintained if, as a result of a first-come, first-served approach, patients with alcohol-related end-stage liver disease receive more than half the available donor livers. We conclude that since not all can live, priorities must be established for the use of scarce health care resources.In 1990, the Health Care Financing Administration recommended that Medicare coverage for liver transplantation be offered to patients with alcoholic cirrhosis who are abstinent, and that the same eligibility criteria be used for patients with alcohol-related end-stage liver disease (ARESLD) as for patients with other causes of end-stage liver disease (ESLD). Moss and Siegler argue against this policy, proposing that patients who develop ESLD through no fault of their own have a higher priority for receiving a transplant than patients whose ESLD results from a failure to obtain treatment for alcoholism. They base their proposal on considerations of fairness and on whether public support for liver transplantation can be maintained if over half the available donor livers, which are in scarce supply, go to patients with ARESLD.
A Health Policy Agenda for the American People
Authors: Bruce E. Balfe
Journal: JAMA (1986)

In 1982, the Health Policy Agenda for the American People was initiated by the American Medical Association to develop a long-term, comprehensive plan for addressing major health care issues in the United States. In phase 1 of the project, 41 issue areas were identified as critical to the future of health care in this country. In phase II, currently in progress, policy proposals are being developed to respond to these issue areas. The intention of this project is to provide a common basis for responding to health care issues as they arise today and in the years to come.
CAN THE PROGNOSIS OF INFANTILE ANEMIAS BE BASED SOLELY ON THE BLOOD PICTURE?
Authors: A. A. ABALLI
Journal: JAMA (1926)

We find in infantile anemias two types easily distinguishable, from a clinical and a hematologic point of view. The first corresponds to the age limits from birth to the end of the child's second year; i. e., it comprises the life periods designated by Marfan as new-born, suckling and early infancy. The second clinical type corresponds to later stages of life, from the second year to the beginning of puberty. The second type can be readily adapted to the data we possess on the blood lesions of the adult and do not strictly belong to the pediatrician.  The peculiarities that the infant presents in relation to anemia are inherent in its anatomic condition and in the state of development of its blood-forming organs, as well as in the physical and chemical conditions of its tissues, corresponding to the first period of life. We will study this syndrome especially in this
"Eye" in Sport
Authors: C. F. Green
Journal: BMJ (1911)

<h3>Background:</h3> With the introduction of laparoscopic antireflux surgery (LARS) for gastro-oesophageal reflux disease (GORD) along with the increasing efficacy of modern medical treatment, a direct comparison is warranted. The 3-year interim results of a randomised study comparing both the efficacy and safety of LARS and esomeprazole (ESO) are reported. <h3>Methods:</h3> LOTUS is an open, parallel-group multicentre, randomised and controlled trial conducted in dedicated centres in 11 European countries. LARS was completed according to a standardised protocol, comprising a total fundoplication and a crural repair. Medical treatment comprised ESO 20 mg once daily, which could be increased stepwise to 40 mg once daily and then 20 mg twice daily in the case of incomplete GORD control. The primary outcome variable was time to treatment failure (Kaplan–Meier analysis). Treatment failure was defined on the basis of symptomatic relapse requiring treatment beyond that stated in the protocol. <h3>Results:</h3> 554 patients were randomised, of whom 288 were allocated to LARS and 266 to ESO. The two study arms were well matched. The proportions of patients who remained in remission after 3 years were similar for the two therapies: 90% of surgical patients compared with 93% medically treated for the intention to treat population, p = 0.25 (90% vs 95% per protocol). No major unexpected postoperative complications were experienced and ESO was well tolerated. However, postfundoplication complaints remain a problem after LARS. <h3>Conclusions:</h3> Over the first 3 years of this long-term study, both laparoscopic total fundoplication and continuous ESO treatment were similarly effective and well-tolerated therapeutic strategies for providing effective control of GORD.
Cross reaction to a Christmas tree.
Authors: A W MacFarlane
Journal: BMJ (1987)

Cross reaction to a Christmas tree I report on a patient who is resigned to having an artificial Christmas tree this year.Her experience with a real one last year gave her mbre than just the needle. Case reportA 26 year old woman was referred during Advent 1986, having woken with an itchy rash on the face and dorsa of the hands two days previously.The rash had initially been attributed either to her soap powder or,to recent use of a household spray.Oni exami ntion she had acute eczema of the face and, hands, extending slightly up the forearms.She recalled no previous dermatological problems other than that she had been allergic to Elastoplast as a child.
The truth about big tobacco in its own words
Authors: S. A Glantz
Journal: BMJ (2000)

Education and debate pp 362, 366, 371 

The recent completion of the “first draft” of the human genome was big news because it promised understanding of the causes, treatment, and prevention of human disease. There is, however, another map that holds as much promise for curbing disease: depositories containing millions of pages of previously secret tobacco industry documents. Unlike bacteria, fungi, and viruses that spread disease, however, the tobacco industry employs sophisticated lawyers and public relations experts—and even scientists—to distort the scientific and political process.1 2 These documents give us our first clear understanding of how the tobacco contagion works.

The industry has for decades denied the obvious—that nicotine is addictive, that smoking and second hand smoke cause a wide variety of diseases, and that cigarette advertising recruits children and keeps adults smoking. It has used this wall of rhetoric to provide cover for the actions of politicians designed to protect the tobacco industry at the expense of public health.

In 1998, as part of the settlement of a lawsuit filed …
BLASTOMYCOSIS OF THE PROSTATE, EPIDIDYMIS AND LEG
Authors: Bransford Lewis
Journal: JAMA (1930)

Blastomycosis was first described by Gilchrist in 1896. It has since been reported from most countries of the world. In the United States it appears to be of more frequent occurrence in the Mississippi Valley region. It is not infrequent in the experience of dermatologists in St. Louis. The particular interest in the case reported here was the localization of blastomycetes in the prostate and epididymis, and the subsequent course following prostatectomy and the use of iodides. The prognosis of systemic blastomycosis is grave. Our patient made a rapid and complete symptomatic recovery We are aware, however, that localized foci of the organism may still be present, and future trouble from this source is not beyond a possibility. <h3>REPORT OF CASE</h3> In the case reported here the lesions on the skin when one of us was called into consultation consisted of an oval ulcer, 3 by 1½ inches, on the
Guideline-Adherent Care vs Quality Care in Cancer Patients: Twins or Distant Cousins?
Authors: Ronald C. Chen
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
Calcium citrate ameliorates the progression of chronic renal injury
Authors: Liliana Gadola, Oscar Noboa, María Natalia Márquez, María José Rodriguez, Nicolás Nin, José Boggia, Alejandro Ferreiro, Silvia García, Virginia Ortega, María Luisa Musto, Paolo Ponte, Pablo Sesser, Carlos Pizarrosa, Silvana Ravaglio, Ana Vallega
Journal: Kidney International (2004)
Evidence based diagnosis: We may need to be open to new ideas
Authors: Huw Llewelyn
Journal: BMJ (2006)

Evidence based diagnosis We may need to be open to new ideasEditor-If evidence based diagnosis is still in the dark ages, as Delamothe writes, 1 then so is evidence based treatment.The doctor's job is to choose the right treatment.If the diagnosis is wrong then the treatment will be wrong.Inaccurate diagnoses will also affect clinical trials.A treatment may be "evidence based" because it has worked in a published study, but some patients who would have responded might have been left out because of diagnostic inaccuracy while some patients with no prospect of responding might have been included incorrectly. 2vidence based diagnosis is about convincing others using shared rules of evidence that a diagnosis (and its implications in terms of treatment) should be accepted by others.Evidence is gathered from the individual and from groups of patients. 3Evidence based diagnosis means specifying the individual's facts in addition to pointing to facts relating to that diagnosis in the literature. 4ayes's theorem uses unconditional initial prior probabilities.Diagnostic leads are based on conditional probabilities and are used to initiate diagnostic thought processes. 4owever, closely related theorems can be used to interpret diagnostic leads, which allow doctors to reason with diagnostic evidence in a more familiar way, 3 thus reducing misunderstandings. 5So to improve evidence based diagnosis we also need to collect better data on diagnostic leads.The published evidence given for a diagnosis and any related actions cannot realistically be assembled when actually seeing a patient.A draft evidence based rationale might be prepared in advance.It would have to be capable of being accessed in seconds to provide evidence in support of a suspected diagnosis and decision arrived at by using kindness, imagination, and common sense.It could be put into context by inserting the patient's details into the draft evidence summoned up from a computer.If we are to make progress and allow evidence based diagnosis to emerge from the dark ages then in addition to doing more of the same, we may also have to be receptive to new ideas.
British Thoracic Society corrects damaging impression
Authors: E. Neville
Journal: BMJ (2003)

EDITOR—Seaton's personal view, “There's none so blind as the double blind”. Discuss, is customarily amusing and challenging.1 It is regrettable, therefore, that his references to the British Thoracic Society and pharmaceutical industry “sponsorship” of its guidelines are incorrect and present a picture that is both misleading and damaging.

The society does not receive funding for the preparation of its guidelines, accepting funding only for printing and distribution costs.

#### BTS policy on guidelines

1.  Chairmen of guidelines committees should not have shares in a pharmaceutical company or be retained as a consultant with a company. Before appointment their current and recent (three years) involvement with commercial organisations will be reviewed by the chairman and three other members of the Executive …
On the Treatment of Partial Trichiasis by Electrolysis
Authors: A. Benson
Journal: BMJ (1882)

How the splitting-up of the sulphates in the intestines is effected, and in what combination the acid passes into the blood, is beyond the scope of the present communication.VACCINATION.-Mr.T. II.Hughes, Public Vaccinator of the Ombersley district of the Droitwich Union, has received (for the fourth time) the Government grant for efficient vaccination in his district.
Liquor bilirubin levels in normal pregnancy: a basis for accurate prediction of haemolytic disease.
Authors: E. D. Morris, J. Murray, C. R. Ruthven
Journal: BMJ (1967)

Oxygen and Carbon Dioxide Electrodes-Flenley et al.Mel range 20-100 mm.Hg and Po2 with an accuracy of + or -S mm.Hg in the range 0-200 mm.Hg.If the operator is less skilled and uses only gas calibration, the range of uncertainty doubles.The assessment was carried out over the range 0-200 mm.Hg for Po2 and 20-100 mm.Hg for Pco0.
Vascular reactivity after balloon angioplasty in an atherosclerotic rabbit.
Authors: P J La Veau, I J Sarembock, S L Sigal, T L Yang, M D Ezekowitz
Journal: Circulation (1990)

Alterations in vessel wall reactivity (VR) at or adjacent to the dilation site after balloon angioplasty (BA) may vary according to the inflation protocol and the time after angioplasty and may influence outcome. In 64 atherosclerotic rabbit femoral arteries, we evaluated VR after BA with intravenous ergonovine (ERGO) (40 micrograms/min for 5 minutes) and intra-arterial nitroglycerin (NTG) (2,500 micrograms single bolus) 24-72 hours and 28 days after BA. Comparisons were made with atherosclerotic, nonangioplastied, age-matched controls. BA was standardized to three 1-minute inflations, each 1 minute apart. For each balloon size, 2.5- (appropriate size) or 3.0-mm (oversized) vessels were allocated to either 5 or 10 atm inflation pressure. For the analysis, four groups were compared: Group 1, 3.0/5; group 2, 3.0/10; group 3, 2.5/5, and group 4, 2.5 mm/10 atm. Angiographic diameters were measured at, proximal, and distal to the lesion at baseline, 10 minutes after ERGO, and 5 minutes after NTG. Angiograms were measured with electronic calipers by two blinded observers. All segments of control vessels vasoconstricted to ERGO and vasodilated to NTG (p less than 0.05 versus baseline), indicating a normal response. At 24-72 hours after dilatation, the angioplasty sites for all inflation pressure/balloon size combinations were not responsive to either ERGO or NTG. All segments distal to the dilatation sites vasoconstricted to ERGO and dilated to NTG (p less than 0.05 versus baseline), indicating a normal response. Proximal segments of vessels dilated with a 2.5-mm balloon (appropriate size) responded positively to both stimuli (p less than 0.05). Those vessels dilated with a large balloon (3.0 mm) were nonreactive in the segment proximal to the angioplasty site. Twenty-eight days later angioplasty sites dilated with a 2.5-mm balloon (appropriately sized) regained reactivity; however, segments dilated with a large balloon (3.0 mm) remained unresponsive. All proximal segments, including those from vessels dilated with a large balloon, reacted positively. All distal segments reacted appropriately. Restenosis rates were not different between the over- and appropriately sized balloon groups. These data demonstrate that immediately after angioplasty, vessels lose reactivity at the dilatation site. Those vessels dilated with the smaller-size balloon (2.5 mm) regained reactivity. For large balloons, reactivity is not regained at 28 days. For segments proximal to the site of dilatation, transient loss of reactivity is seen only when a large balloon is used. Thus, acute closure originating at the site of dilatation is not a result of spasm.(ABSTRACT TRUNCATED AT 400 WORDS)
THIORIDAZINE (MELLARIL) ON REGRESSED SCHIZOPHRENIC PATIENTS
Authors: ODIE T. UDDYBACK, CALVIN H. CHEN
Journal: American Journal of Psychiatry (1962)

The improvement of patients under thioridazine therapy is considered significant in view of the severity and chronicity of their illness and their failure to respond to all previous therapies. An important advantage of thioridazine over chlorpromazine and trifluoperazine is the low incidence of side effects. Because of the results obtained, we feel that further trial of thioridazine (Mellaril) on regressed patients is warranted.
Dermatitis Cruris Pustulosa et Atrophicans in India
Authors: K. C. Kandhari
Journal: British Journal of Dermatology (1968)

Journal Article Dermatitis Cruris Pustulosa et Atrophicans in India Get access K. C. Kandhari K. C. Kandhari All India Institute of Midicl Sciences, New Delhi, India Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 80, Issue 10, 1 October 1968, Pages 694–695, https://doi.org/10.1111/j.1365-2133.1968.tb11925.x Published: 01 October 1968
Protection from thymic epithelial cell injury by keratinocyte growth factor: a new approach to improve thymic and peripheral T-cell reconstitution after bone marrow transplantation
Authors: Dullei Min, Patricia A. Taylor, Angela Panoskaltsis-Mortari, Brile Chung, Dimitry M. Danilenko, Catherine Farrell, David L. Lacey, Bruce R. Blazar, Kenneth I. Weinberg
Journal: Blood (2002)
Surgeon volume and early complications after primary total hip arthroplasty
Authors: K. Michaelsson
Journal: BMJ (2014)

Surgeons who do at least 35 procedures a year seem safer than surgeons who do fewer

Within the past 50 years, total hip arthroplasty has developed from a procedure with a low success rate to one of the main achievements in surgery and has even been designated the operation of the century.1 The tipping point came during the 1960s, when Sir John Charnley designed and developed a unique well functioning prosthesis and used acrylic bone cement to fix the components. Early (already good) results with this prosthesis have been further improved by later devices. Clinical outcomes are now excellent, and over 95% of modern hip prostheses survive for at least 10 years. Complications do occur, however, and include instability, aseptic loosening, periprosthetic fracture, infection, and occasionally death. Although rare, complications do not happen completely at random, and various patient, surgical, and prosthetic factors have been associated with higher risk.

The linked Canadian register study (doi:10.1136/bmj.g3284) further explores the role of surgeon volume—the number of procedures conducted annually by individual surgeons.2 More specifically, the authors were looking for a volume threshold above which risk of early complications was low for adults having a first total hip replacement for osteoarthritis—the …
Letter: Nutmeg poisoning.
Authors: G S Venables, D Evered, R Hall
Journal: BMJ (1976)

colleagues that routine pelvimetry should be performed only postpartum or after a caesarean section, difficult forceps delivery, or perinatal death.Is it not possible that if we had known about that nasty pelvis before we would not have traumatised or killed the baby delivering it vaginally but have made the correct decision to deliver it abdominally?Surely for a risk of only 1 in 30 000 it is well worth while having this extra piece of information with WMhich to program our personal computer.
Direct comparison of transcardiac difference between brain natriuretic peptide (BNP) and N‐terminal pro‐BNP in patients with chronic heart failure
Authors: Takayoshi Tsutamoto, Hiroshi Sakai, Chitose Ishikawa, Masanori Fujii, Toshinari Tanaka, Takashi Yamamoto, Hiroyuki Takashima, Masato Ohnishi, Atsuyuki Wada, Minoru Horie
Journal: European Journal of Heart Failure (2007)