tbuckley/cabot-search huggingface dataset:
Students validate problem based learning
Authors: J Burke, R G Matthew, M Field, D Lloyd
Journal: BMJ (2006)

EDITOR—In 1993 the General Medical Council recommended that medical schools should develop student centred curriculums to discourage memorising detail in favour of information gathering and problem solving.1 In response, most UK schools 2 have adopted a form of problem based learning, which, compared with traditional courses, at best produces graduates with only marginally better diagnostic acumen.3 This has recently raised concerns about the cost effectiveness of introducing new …
Atypical erosive osteoarthritis and Sjogren's syndrome.
Authors: R Shuckett, M L Russell, D D Gladman
Journal: Annals of the Rheumatic Diseases (1986)

An unusual, destructive form of erosive hand arthropathy is described in five postmenopausal women. Although early clinical and radiological findings were most in keeping with a diagnosis of erosive osteoarthritis (EOA), hand involvement progressed to a distribution intermediate between EOA and rheumatoid arthritis (RA). Although asymptomatic, all patients had features of Sjögren9s syndrome (SS), including keratoconjunctivitis sicca (KCS) and lymphocytic foci in labial biopsy specimens. These cases, which are clinically unlike either RA or EOA, may represent a unique arthropathy associated with sicca features.
Six Cardiac and Vascular Cases: With Remarks and Engravings
Authors: E. Rickards
Journal: BMJ (1881)

THE BRITISH MfEDICAL _OURNAL.Uune II, i88I.of which was covered with a dirty grey-coloured eschar.Serum from vesicles contained a few bacilli; half a drop, given to a rabbit, had no perceptible effect.9 P.M.He had no pain or distress.The tongue was moist.He had taken food moderately.The swelling ha(l extended over the scapula; as far as the middle, it was hard, terminating by a distinct ridge; beyond, it was softer.In front, the swelling bad extended over the chest, and was not so hard as behind.Pulse I I6, soft.After he had been helped up in bed to the sitting position, and lay down again, the pulse was 130, and irregular.Temperature in the left axilla 99.80, in the rectum xo4.i.; respiration 24.May 24tb, 10.30 A.M.He passed a fairly good night; was not rest- less.He had no pain, but some uneasiness over the abdomen, which was relieved by vomiting.He appeared calm and composed.Pulse 130, very small, and difficult to count.Temperature in the left axilla 99.1, in the right axilla 99.8°, in the rectum I02.3'; respiration 22. Serum from vesicles contained ten to twenty bacilli in each field.The contents of two tubes, given to a mouse, were fatal in seventeen and a half hours.9.30 P.M.He had a restless day; passed no urine; his appetite was gone; his face shrunken.The swelling was extending; the extremities were cold; pulse imperceptible; temperature under the tongue 950.He died ten hours afterwards.Serum from the arm con- tained bacilli; two tubes, given to a mouse forty-five hours afterwards, were fatal in sixty-five hours.Post mortemn examination, made by Mr. Kenyon, nine hours after death.The ends of the fingers were of a dark colour.The upper surface of the scrotum had a dark-red colour.The swelling of the arm was much more yielding than during life.The injured part of the fore- arm was removed; the cut surfaces were crowded with small interstitial haemorrhages.There were.no pleural effusions, nor enlargement of bronchial glands.The blood was fluid.There was no s'taining of the endocardium; no subserous petechial spots in the heart.All the viscera were apparently natural.Portions of the internal organs were sent to Professor Greenfield for examination.Serum from the arm contained numerous long motionless bacilli; after keeping two days in a-capillary tube, the bacilli were very long and convoluted.WOOLSORTERS' DISEASE.
Digital Medicine: Health Care in the Internet Era
Authors: Stanley W. Borg
Journal: JAMA (2010)

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
Endothelium‐dependent and ‐independent vasodilation is more attenuated in ischaemic than in non‐ischaemic heart failure
Authors: Magdalena Klosinska, Tomasz Rudzinski, Piotr Grzelak, Ludomir Stefanczyk, Jaroslaw Drozdz, Maria Krzeminska‐Pakula
Journal: European Journal of Heart Failure (2009)
Successful treatment for acrodermatitis continua of Hallopeau using topical calcipotriol
Authors: L. EMTESTAM, U. WEDÉN
Journal: British Journal of Dermatology (1996)

Summary We report a 71 year-old woman who had severe infammatory acrodermatitis continua of Hallopeau. The administration of local remedies, soft X-rays and a number of systemic treatments resulted only in transient and incomplete resolution of the lesions. The pustules, increased skin fragility, tender oedema and erythema were successfully controlled by the local administration of calcipotriol.
THE INCORPORATION OF P32-LABELED ORTHOPHOSPHATE AND GLYCEROL-1-3-C14 INTO THE LIPIDS OF THE POLYVINYL SPONGE GRANULOMA*
Authors: Giles G. Bole
Journal: Journal of Clinical Investigation (1963)

Subcutaneous implantation of polyvinyl alcohol sponge is one technique currently in use to secure weighable samples of inflammatory tissue for microscopic and biochemical analyses.Several re- ports dealing with preliminary characterization of the lipid constituents have been published (1-4).Although size of the sponge prosthesis and dura- tion and site of implantation can affect the lipid content of the tissue (4-6), when these factors are carefully controlled, lipids constitute 15%o of the tissue dry weight.In granulomas 21 to 42 days of age, the phospholipids are high, cholesterol low, and triglycerides intermediate in concentration.During the period of inflammatory tissue organization of the sponge implant, it has been demonstrated that increasing amounts of lipid ac- cumulate (1, 4).The present investigation was done to establish whether these lipids are derived predominantly from the blood, synthesized by the inflammatory cells in situ, or represent progressive accumulation of debris from cells destroyed during the early exudative phase of inflammation.A comparative study of incorporation of P32 and glycerol-1-3-C14 into lipids by the cells of the polyvinyl sponge granuloma and the liver, under the same experi- mental conditions, is also included in this report.After systemic administration of p32 to intact animals, both tissues incorporate this isotope into tissue phospholipids.Use of these two isotopes in vitro has provided additional information on de novo synthesis of individual phospholipids, and *This study was supported in part by U. S.
Analogy is priming, but relations are not transformations
Authors: Fintan J. Costello
Journal: Behavioral and Brain Sciences (2008)

Abstract Leech et al. make two proposals: that relational priming is central to analogy, and that relations between objects are best represented as transformations of those objects. Although their account of analogy as relational priming is a useful contribution to our understanding of analogical development, in this commentary I show that relations in general cannot be represented by transformations.
The Common Secret: Sexual Abuse of Children and Adolescents
Authors: David L. Chadwick
Journal: JAMA (1985)

This overview of a very dynamic subject fills a major and current need, for there is nothing like it in print. The Kempes have succeeded in compressing an enormous amount of knowledge into a little more than 200 pages and, using a parsimonious but thoughtful style of writing, have said just about everything that can or should now be said about child sexual abuse. Although in the introduction, they claim that the book "is not written as a scholarly text nor is it meant for experts in the field," this book could not have been written except by scholars and there are few workers in the field, however experienced, who will not benefit by reading it. Still, one hopes that the book will be used mainly by those for whom it was written: professional and lay persons who will occasionally encounter sexual abuse but who will not be working in
Leg ulcers in alpha-thalassaemia (haemoglobin H disease)
Authors: T. K. DANESHMEND, R. D. G. PEACHEY
Journal: British Journal of Dermatology (1978)

A case of recurrent leg ulceration associated with alpha-thalassaemia (haemoglobin H disease) is reported. It is suggested that leg ulcers occurring in the thalassaemic syndromes may be due to structural changes in the affected red cells which result in increased cell rigidity, decreased deformability and consequent diminished blood flow in capillary beds that are subjected to venous stasis.
Intention-to-treat analysis of liver transplantation for hepatocellular carcinoma: Living versus deceased donor transplantation
Authors: Prashant Bhangui, Eric Vibert, Pietro Majno, Chady Salloum, Paola Andreani, Joao Zocrato, Philippe Ichai, Faouzi Saliba, Rene Adam, Denis Castaing, Daniel Azoulay
Journal: Hepatology (2011)

Abstract For patients who have cirrhosis with hepatocellular carcinoma (HCC), living donor liver transplantation (LDLT) reduces waiting time and dropout rates. We performed a comparative intention-to-treat analysis of recurrence rates and survival outcomes after LDLT and deceased donor liver transplantation (DDLT) in HCC patients. Our study included 183 consecutive patients with HCC who were listed for liver transplantation over a 9-year period at our institution. Tumor recurrence was the primary endpoint. At listing, patient and tumor characteristics were comparable in the two groups (LDLT, n = 36; DDLT, n = 147). Twenty-seven (18.4%) patients dropped out, all from the DDLT waiting list, mainly due to tumor progression (19/27 [70%] patients). The mean waiting time was shorter in the LDLT group (2.6 months versus 7.9 months; P = 0.001). The recurrence rates in the two groups were similar (12.9% and 12.7%, P = 0.78), and there was a trend toward a longer time to recurrence after LDLT (38 ± 27 months versus 16 ± 13 months, P = 0.06). Tumors exceeding the University of California, San Francisco (UCSF) criteria, tumor grade, and microvascular invasion were independent predictive factors for recurrence. On an intention-to-treat basis, the overall survival (OS) in the two groups was comparable. Patients beyond the Milan and UCSF criteria showed a trend toward worse outcomes with LDLT compared with DDLT ( P = 0.06). Conclusion: The recurrence and survival outcomes after LDLT and DDLT were comparable on an intent-to-treat analysis. Shorter waiting time preventing dropouts is an additional advantage with LDLT. LDLT for HCC patients beyond validated criteria should be proposed with caution. (Hepatology 2011;)
Management of Varicella Exposure in a Neonatal Intensive Care Unit
Authors: Susan V. Lipton
Journal: JAMA (1989)

We describe the management of an exposure to varicella in a neonatal intensive care unit. Thirty-seven hospital staff members with negative histories of varicella were tested by enzyme-linked immunosorbent assay for antibody to varicella zoster; all were seropositive. None were restricted from clinical duties, were given varicella-zoster immune globulin, or developed disease. Although only 1 of 38 cord serum samples from normal term infants was seronegative, 10 of 22 neonatal intensive care unit infants were seronegative. The high rate of seronegativity among these patients was related to chronological age older than 2 months and to multiple transfusions of packed red blood cells. This probably reflects natural catabolism of maternal antibody and loss of antibody in serum removed from these infants for diagnostic tests. Infants lacking antibody were given varicella-zoster immune globulin. Antibody levels following administration of varicella-zoster immune globulin were directly related to the dose administered. (<i>JAMA</i>. 1989;261:1782-1784)
PANCREATIC FAT NECROSIS FOLLOWING SUBTOTAL THYROIDECTOMY
Authors: W. Ross Morris
Journal: JAMA (1933)

Pancreatic fat necrosis is a somewhat uncommon condition. Especially is it rare for it to occur following an operative procedure and to be a factor in the production of death in such a case. It would therefore seem that the following case is of sufficient interest to justify its report. Opie<sup>1</sup>states that Wulff (1902) and Fabyan (1907) have each reported cases of pancreatic fat necrosis in which no lesion in the pancreas has been found. Opie suggests in these cases a localized lesion of the pancreas, so slight as to escape notice. Warthin (1904) reported a case of pancreatic fat necrosis about an aberrent gland. The occurrence of fat necrosis produced by intestinal fluid containing the fat-splitting enzyme of the pancreas cannot be excluded. <h3>REPORT OF CASE</h3><h3>History.</h3> —Mrs. A. H., white, aged 56, entered the hospital complaining of goiter and shortness of breath. A goiter had been
Diabetes in Navajo Youth
Authors: Dana Dabelea, Joquetta DeGroat, Carmelita Sorrelman, Martia Glass, Christopher A. Percy, Charlene Avery, Diana Hu, Ralph B. D'Agostino, Jennifer Beyer, Giuseppina Imperatore, Lisa Testaverde, Georgeanna Klingensmith, Richard F. Hamman
Journal: Diabetes Care (2009)

To estimate the prevalence and incidence of diabetes, clinical characteristics, and risk factors for chronic complications among Navajo youth, using data collected by the SEARCH for Diabetes in Youth Study (SEARCH study).The SEARCH study identified all prevalent cases of diabetes in 2001 and all incident cases in 2002-2005 among Navajo youth. We estimated denominators with the user population for eligible health care facilities. Youth with diabetes also attended a research visit that included questionnaires, physical examination, blood and urine collection, and extended medical record abstraction.Diabetes is infrequent among Navajo youth aged <10 years. However, both prevalence and incidence of diabetes are high in older youth. Among adolescents aged 15-19 years, 1 in 359 Navajo youth had diabetes in 2001 and 1 in 2,542 developed diabetes annually. The vast majority of diabetes among Navajo youth with diabetes is type 2, although type 1 diabetes is also present, especially among younger children. Navajo youth with either diabetes type were likely to have poor glycemic control, high prevalence of unhealthy behaviors, and evidence of severely depressed mood. Youth with type 2 diabetes had more metabolic factors associated with obesity and insulin resistance (abdominal fat deposition, dyslipidemia, and higher albumin-to-creatinine ratio) than youth with type 1 diabetes.Our data provide evidence that diabetes is an important health problem for Navajo youth. Targeted efforts aimed at primary prevention of diabetes in Navajo youth and efforts to prevent or delay the development of chronic complications among those with diabetes are warranted.
Antigenic and immunogenic properties of cyanogen bromide peptides from gonococcal outer membrane protein IB. Evidence for the existence of a surface-exposed conserved epitope.
Authors: T Teerlink, H Versantvoort, E C Beuvery
Journal: The Journal of Experimental Medicine (1987)

Two distinct species of gonococcal porin proteins exist that differ with regard to surface exposure. Protein IB, expressed by strains of the WII/III serogroup, has both termini buried in the outer membrane, leaving a central region of the molecule exposed at the cell surface. We have attempted to define this region of protein IB in detail by studying the antigenic and immunogenic properties of peptides derived from protein IB. Treatment of gonococcal protein IB (serotype 5) with cyanogen bromide resulted in cleavage of protein IB into three major fragments of Mr of 15,000, 13,000, and 8,000. The location of these peptides in the intact protein was determined by analysis of partial cleavage products. The 8,000 Mr peptide (CB2) was found to be located in the central region of the protein. Chymotrypsin cleavage of protein IB revealed a cleavage site near one of the cyanogen bromide cleavage sites. Trypsin was found to cleave the protein, either in outer membranes complexes (OMC) or in detergent micelles, in the central CB2 fragment. These results suggest that CB2 is a part of the surface-exposed region of protein IB. Immunization of mice with purified protein IB (serotype 5) induced antibodies against all three CB-peptides. Absorption of the sera with homologous OMC resulted in a complete removal of antibodies against CB2, supplying further evidence for its surface-exposed nature. Antibodies against the 13,000 Mr peptide (CB1) could not be absorbed with intact OMC, suggesting that this peptide is buried within the outer membrane. Antisera raised against CB2 of serotype 5 demonstrated a considerable cross-reactivity with heterologous outer membranes. On the contrary, intact OMC induced mainly type-specific antibodies. These data demonstrate the presence of conserved epitopes on the surface-exposed CB2 peptide. These conserved epitopes are generally not very immunogenic when present in intact OMC.
Suicide after discharge from psychiatric hospitals in Scotland
Authors: C. Stark, D. Hall, F. O'Brien, H. Smith
Journal: BMJ (1995)

EDITOR,--John R Geddes and Ed Juszczak provide information on trends in suicide after discharge from psychiatric hospitals in Scotland.1 They comment that studies in other countries indicate that the peak incidence of suicide and undetermined deaths occurs in the 28 days after discharge. Our data on deaths recorded as E950-959 (suicide and self inflicted injury) confirm that this is also the case in Scotland (figure). Our findings also indicate that, while the …
THE ANATOMIC FINDINGS IN CASES SIMULATING PULMONARY TUBERCULOSIS
Authors: G. Y. RUSK
Journal: JAMA (1924)

We present a group of clinical cases with the postmortem findings as recorded in the Department of Pathology at the University of California. The group comprises cases that were considered clinically as pulmonary tuberculosis, but which proved to be nontuberculous. In one of the seven cases, both the clinical and the gross pathologic diagnosis was tuberculosis, but the microscope disclosed another condition. For the clinical findings given, we are indebted to Dr. Esther Rosencrantz of the University of California Service at the San Francisco Tuberculosis Hospital; to Dr. H. I. Wiel of the University of California Medical Service at the San Francisco Hospital, and to Dr. H. W. Allen, Dr. William J. Kerr and Dr. Ernest H. Falconer of the Medical Service at the University of California Hospital.  Case 1.—Hisotry.  —A Danish dressmaker, aged 45, entered the medical service of the University of California Hospital, March 19, 1918, with
Distalgesic poisoning--cause for concern?
Authors: W O G Taylor
Journal: BMJ (1980)

erythema by absorbing ultraviolet B rays.The efficacy of some of these compounds, however, is being questioned.3Some sun- screens may themselves be phototoxic7-for example, amyl dimethylaminobenzoate (Padi- mate A, Escalol 506).Some can prevent erythema, but not premalignant changes in the epidermis8 -for example, mexenone (2- hydroxy-4-methoxy-4-methylbenzophenone).Furthermore, a 5 °' ethanolic solution of para- aminobenzoic acid (PABA), though an effective sunscreen, cannot protect against druginduced phototoxic reactions. 9Broad-spectrum sunscreens combining a PABA ester with a benzophenone ester appear currently to provide the most protection from ultraviolet light. 9The Council of Europe is currently con- sidering sunscreens and one hopes that in the future proper standardisation and toxicological tests will be required for all sunscreens and tanning aids, studies which would dispel much concern regarding their safety.
Hypoalaninemia: a concomitant of ketotic hypoglycemia
Authors: Anthony S. Pagliara, Irene E. Karl, Darryl C. De Vivo, Ralph D. Feigin, David M. Kipnis
Journal: Journal of Clinical Investigation (1972)

The cause of of ketotic hypoglycemia, the commonest form of hypoglycemia in childhood, is not known. The present study was undertaken to determine whether the primary defect in this condition is a deficiency of gluconeogenic precursor(s) or an abnormality in the hepatic gluconeogenic enzyme system. Plasma glucose, alanine, and insulin and blood beta-hydroxybutyrate (beta-OHB), pyruvate, and lactate levels were determined in eight ketotic hypoglycemic children and seven agematched controls maintained on a normal diet and after being fed a provocative hypocaloric low-carbohydrate diet (1200 kcal/1.73 m(2), 15% carbohydrate, 17% protein, and 68% fat). On a normal diet, overnight fasting plasma alanine (211+/-10 muM) and glucose (68+/-4 mg/100 ml) were significantly lower and blood beta-OHB (1.22+/-0.37 mM) significantly higher in ketotic hypoglycemic children than in controls (alanine, 315+/-15 muM; glucose, 81+/-3 mg/100 ml; beta-OHB, 0.18+/-0.08 mM). All ketotic hypoglycemic children developed symptomatic hypoglycemia (33+/-3 mg/100 ml) and ketosis (beta-OHB, 3.70+/-0.32 mM) 8-16 hr after starting the provocative diet and these changes were associated with a further decline in plasma alanine (155+/-17 muM). Normal children, even after 36 hr on this diet, maintained higher plasma glucose (48+/-2 mg/100 ml) and alanine (225+/-5 muM) and lower beta-OHB levels (2.56+/-0.44 mM). Intravenous infusions of alanine (250 mg/kg) uniformly restored the hypoglycemic plasma glucose levels of ketotic hypoglycemic children to normal. Cortisone acetate (300 mg/m(2)), given orally in three divided doses during feeding of the provocative diet, produced a 3- to 4-fold increase in plasma alanine within 4-6 hr after beginning steroid therapy and completely prevented the development of hypoglycemia and ketosis. Quantitative amino acid profiles were performed and demonstrated that alanine was the only gluconeogenic amino acid which differed significantly between the two groups. Plasma insulin and blood lactate and pyruvate levels did not differ significantly between normal and ketotic hypoglycemic children under all conditions examined. These results support the hypothesis that a deficiency in gluconeogenic precursor (e.g., alanine) rather than a defect in the hepatic gluconeogenic enzyme apparatus represents the most likely factor in the pathogenesis of ketotic hypoglycemia.
The bioethics of stem cell research and therapy
Authors: Insoo Hyun
Journal: Journal of Clinical Investigation (2010)

Discussion of the bioethics of human stem cell research has transitioned from controversies over the source of human embryonic stem cells to concerns about the ethical use of stem cells in basic and clinical research. Key areas in this evolving ethical discourse include the derivation and use of other human embryonic stem cell–like stem cells that have the capacity to differentiate into all types of human tissue and the use of all types of stem cells in clinical research. Each of these issues is discussed as I summarize the past, present, and future bioethical issues in stem cell research.