tbuckley/cabot-search huggingface dataset:
Middle-Ear Problems in Childhood
Authors: Francis W. Davison
Journal: JAMA (1966)

Before discussing some of the disease entities encountered in children, I would like to comment on methods of examination. If one is to have any concept of what is taking place in the middle ear, he must be able to visualize accurately the tympanic membrane. The best source of illumination is a head mirror or preferably a head light, which can be worn over one eye to provide axial illumination. Use of the head light leaves the examiner with two hands unencumbered, one to use the speculum with a magnifier ( ×2) attached and the other hand free to use a curette for removing wax or semisolid debris. If there is fluid exudate, it can be removed with a cotton-tipped applicator or preferably a No. 15 gauge aspirating tip if suction is available. The examiner should select the largest size speculum which will fit comfortably in the ear canal. The magnifier
Trust tells woman she cannot have her stored ovary tissue because of law change
Authors: C. Dyer
Journal: BMJ (2012)

A woman who had an ovary removed and tissue from it frozen 12 years ago before undergoing chemotherapy for cancer has been told that she cannot have it transplanted at the moment because UK rules on processing tissue changed in 2007 and became much more stringent.

Kate Oliver, 28, had the ovary removed at Leeds Centre for Reproductive Medicine at the age of 16 after she was told that treatment for Ewing’s sarcoma would probably leave her infertile.

She says she was told that all she had to do was contact the centre, now part of Leeds Teaching Hospitals NHS Trust, when she wanted to have a baby and the process would be put in train. …
alphaStreptococci and recurrences of otitis media
Authors: V.-P. Joki-Erkkila
Journal: BMJ (2001)

Medicine information leaflets fail concordance testEditor-Two initiatives about the use of medicines reflect the growing movement towards involving patients in their health care.The first is concordance, which promotes a model of prescribing based on negotiated agreements that respect the patient's perspective. 1 The second is a European directive requiring mandatory patient leaflets with all medicines. 2Manufacturers must produce these comprehensive leaflets, including all datasheet information, in a form understandable to patients.Unfortunately, concordance and such mandatory leaflets seem to be mutually incompatible.Concordance requires that patients be fully informed about their medicines in the widest sense.Perversely, the mandatory leaflets are in most senses narrow and undermine concordance.Firstly, patients only receive the information when they open their medicines.Any information throwing doubt on the appropriateness of the drug therefore comes too late.Secondly, patients need to know the various options for treatment.Currently leaflets include only information about the drug in question.Thirdly, patients need balanced information, but the leaflets present mainly negative information, such as side effects.Other problems exist.Recent research found that nearly a fifth of patients failed to notice the package leaflet.Of those who recalled receiving a leaflet, only two fifths read some of it and two tenths all of it. 3Unlike computer generated pharmacy leaflets (which are used in the United States and Australasia), the leaflets cannot be individualised. 3 Computer generation allows pharmacists to use leaflets as aides mémoire and go through them with patients.The electronic form also gives options for providing access to partially sighted people. 4 Surgery computers are already able to print condition-specific leaflets at doctors' desks. 5 They could be adapted as decision making aids for patients and hence facilitate concordance.The doctor makes a diagnosis and supplies a leaflet, which includes all treatment options.Having read and digested this information, the patient returns to make a decision jointly with the prescriber.This may reduce misunderstandings but might increase the number of consultations.But common conditions such as hypertension already necessitate multiple consultations before long term treatment options are decided.The introduction of comprehensive medicine leaflets is an important development in the provision of information, but the opportunity has been lost to support concordance in medicine taking, which is now endorsed by the NHS Plan.The inadequacies of such leaflets mean that they may become a legal backstop, with patients accessing more relevant, individualised, and wideranging information generated electronically.European law needs amending to reflect this.
Ear piercing and children's rights
Authors: D G Dunlop, M McCabe, R Evans, P Richmond
Journal: BMJ (1994)

EDITOR, - Over 12 months at our accident and emergency department in Cardiff we saw 32 cases of embedded earrings, mostly in children. Nine of the 32 cases showed signs of infection and these were all in the younger age groups. All patients presenting with an embedded earring required a minor surgical procedure under local anaesthetic to remove the retained piece. In a survey of ear …
Lipids and other risk factors selected by discriminant analysis in symptomatic patients with supra-aortic and peripheral atherosclerosis.
Authors: G B Vigna, M Bolzan, F Romagnoni, G Valerio, E Vitale, G Zuliani, R Fellin
Journal: Circulation (1992)

Different patterns of risk factors might be related to the involvement of specific vascular districts by atherosclerosis. In this sense, many investigations have addressed coronary artery disease, whereas extracoronary atherosclerosis has received less extensive attention.Vascular risk factors, with particular attention to lipid parameters (total cholesterol [TC]; triglycerides; high density lipoprotein cholesterol [HDL-C], HDL2 and HDL3 cholesterol [HDL2-C, HDL3-C]), were evaluated by means of univariate and multivariate (discriminant) analysis in a group of 169 patients (128 men and 41 women; mean ages, 58 +/- 7 and 62 +/- 7 years, respectively) with clinically and angiographically demonstrated atherosclerosis of the supra-aortic trunk and/or lower limbs. Patients with coronary artery disease were excluded from this study. The control group consisted of 140 age- and sex-matched individuals. By univariate analysis, smoking was more closely associated with peripheral atherosclerosis, whereas blood pressure was higher in patients with supra-aortic disease. Unrecognized diabetes mellitus was a frequent finding in patients with peripheral disease. The percentage of hyperlipidemias was fourfold higher in patients than in control subjects, with differences consisting of higher triglycerides and lower HDL-C, HDL2-C, and HDL3-C concentrations. By discriminant analysis, high correct classification (CC) rates were achieved in the various patient subgroups on the basis of variables selected from the statistical function. In male patients with peripheral disease, the variables HDL-C, smoking, diastolic blood pressure, uric acid, and glucose, in that order, yielded a CC in 90.4% of the cases; in female patients, smoking, TC/HDL-C, and body mass index gave a CC rate of 95.9%. In men with cerebral disease, the selected variables TC/HDL-C, diastolic blood pressure, and TC yielded a CC of 90.7%; in women, uric acid, TC/HDL-C, and fibrinogen levels produced a CC rate of 89.2%.Risk profiles in atherosclerosis of the supra-aortic trunks and lower limbs seem to differ in relation to gender and circulatory district involved. The importance of lipid parameters, in particular HDL-C, HDL2-C, and TC/HDL-C, as extracoronary risk factors is further confirmed.
CD5+ B-Cells at the Onset of Type I Diabetes and in the Prediabetic Period
Authors: Rebecca A Smerdon, Mark Peakman, Munther J Hussain, F Sue Wong, Peter J Watkins, R David G Leslie, Diego Vergani
Journal: Diabetes Care (1994)

OBJECTIVE B-cells expressing CD5 are associated with the production of autoantibodies and are present at increased levels in several autoimmune diseases. The aim of this study was to investigate the relationship of these cells to the development of type I diabetes and the presence of organ and non-organ-specific autoantibodies. RESEARCH DESIGN AND METHODS We measured percentage levels of CD5+ B-cells in patients with recent-onset (n = 34) and long-standing (n = 21) type I diabetes and in a cohort of 18 identical twins of patients with type I diabetes studied prospectively, 8 of whom became diabetic (prediabetic twins) during the study; the rest remained nondiabetic after at least 7 years and are now unlikely to develop the disease. Forty-seven healthy individuals were studied as control subjects. RESULTS Percentage levels of total B-cells (CD20+) and the proportion expressing CD5 were increased in patients with recent-onset (P &amp;lt; 0.001 for both) but not long-standing type I diabetes compared with control subjects. Percentage levels of CD20+ B-cells were increased in prediabetic twins throughout the prediabetic period (P &amp;lt; 0.05), and there was an increased proportion of CD5-expressing B-cells that failed to reach statistical significance (P = 0.08). Percentage levels of CD20+ B-cells and the proportion expressing CD5 were normal throughout the study in twins remaining nondiabetic. No relationship between percentage levels of CD5+ B-cells and islet cell antibody, thyroid autoantibodies, or non-organ-specific autoantibodies was found. CONCLUSIONS These results show an increase in B-cell percentage levels at the diagnosis of type I diabetes, which is because of an expansion of the CD5+ subset. These changes are also evident in twins throughout the prediabetic period, which suggests that they are related to the processes that lead to diabetes.
Surgical Treatment of Progressive Hydrocephalus: By Means of a Ventriculocardiac Shunt Using the Spitz-Holter Valve System
Authors: Anthony J. Raimondi
Journal: JAMA (1967)

This book presents both a critical analysis of the author's personal experience and an objective evaluation of the surgical procedures used by others in the treatment of hydrocephalus. He makes an attempt to correlate the surgical technique with the physiology of cerebral-spinal fluid circulation and the realities which one must face in undertaking the treatment of this disease: time to operate, indications for surgery, surgical technique, complications which one may expect, the functional results, and the maintenance of these hydrocephalic children. The bibliography is pertinent, the illustrations are clear and well described, and the text contains a meaningful introduction and a straightforward summary. The author's success in accomplishing his stated purpose of presenting a critical analysis of the ventriculocardiac shunt, using the Spitz-Holter valve, makes this comprehensive, though concise, monograph excellent reading for those who are interested in the surgery of hydrocephalus.
Moving from Data on Deaths to Public Health Policy in Agincourt, South Africa: Approaches to Analysing and Understanding Verbal Autopsy Findings
Authors: Peter Byass, Kathleen Kahn, Edward Fottrell, Mark A. Collinson, Stephen M. Tollman
Journal: PLoS Medicine (2010)

Peter Byass and colleagues compared two methods of assessing data from verbal autopsies, review by physicians or probabilistic modeling, and show that probabilistic modeling is the most efficient means of analyzing these data
Marked suppression of secondary hyperparathyroidism by intravenous administration of 1,25-dihydroxy-cholecalciferol in uremic patients.
Authors: E Slatopolsky, C Weerts, J Thielan, R Horst, H Harter, K J Martin
Journal: Journal of Clinical Investigation (1984)

Current evidence suggests that administration of 1,25(OH)2D3 to patients with chronic renal insufficiency results in suppression of secondary hyperparathyroidism only if hypercalcemia occurs. However, since the parathyroid glands possess specific receptors for 1,25(OH)2D3 and a calcium binding protein, there is considerable interest in a possible direct effect of 1,25(OH)2D3 on parathyroid hormone (PTH) secretion independent of changes in serum calcium. Recent findings indicate substantial degradation of 1,25(OH)2D3 in the intestine, therefore, it is possible that while oral administration of the vitamin D metabolite increases intestinal calcium absorption, the delivery of 1,25(OH)2D3 to peripheral target organs may be limited. We therefore compared the effects of orally or intravenously administered 1,25(OH)2D3 on the plasma levels of 1,25(OH)2D3 and the effects of these two modes of treatment on PTH secretion. Whereas oral administration of 1,25(OH)2D3 in doses adequate to maintain serum calcium at the upper limits of normal did not alter PTH levels, a marked suppression (70.1 +/- 3.2%) of PTH levels was seen in all 20 patients given intravenous 1,25(OH)2D3. Temporal studies suggested a 20.1 +/- 5.2% decrease in PTH without a significant change in serum calcium with intravenous 1,25(OH)2D3. In five patients the serum calcium was increased by the oral administration of calcium carbonate, the decrement in serum i-PTH was only 25 +/- 6.65% when compared with 73.5 +/- 5.08% (P less than 0.001) obtained by the administration of intravenous 1,25(OH)2D3. Thus, a similar serum calcium achieved by intravenous 1,25(OH)2D3 rather than calcium carbonate has a greater suppressive effect in the release of PTH. These studies indicate that 1,25(OH)2D3 administered intravenously rather than orally may result in a greater delivery of the vitamin D metabolite to peripheral target tissues other than the intestine and allow a greater expression of biological effects of 1,25(OH)2D3 in peripheral tissues. The use of intravenous 1,25(OH)2D3 thus provides a simple and extremely effective way to suppress secondary hyperparathyroidism in dialysis patients.
Prophylaxis of Recurrent Rheumatic Fever
Authors: Alvan R. Feinstein
Journal: JAMA (1965)

To compare different modes of action of penicillin in preventing recurrences of rheumatic fever, one group of young rheumatic patients received oral penicillin repetitively in high, "therapeutic" dosage for the first ten days of each month, but no "prophylactic" dosage thereafter. The other group received monthly injections of benzathine penicillin, which acts both "therapeutically" to eradicate streptococci during the immediate period after injection, and "prophylactically" for the remainder of the month. The attack rates for streptococcal infections and rheumatic recurrences with the intermittent "therapeutic" oral regimen were significantly higher than the same rates with the injections or with previously tested oral regimens in which low, "prophylactic" doses were given daily throughout the month. The results suggest that both the intermittent "therapeutic" and the continuous "prophylactic" actions of penicillin are needed for the most effective form of antirheumatic prophylaxis.
The Future of Medicine
Authors: John S. Millis
Journal: JAMA (1969)

As representative of the universities and medical schools of the United States, I congratulate the University of Nebraska Medical Center on the important occasion of its 100th anniversary. But may I remind you that, when a university or a medical school achieves an age of 100 years, a century, it really only attains its majority. This can be compared, perhaps, with attaining the age of 21 for the individual. You see, therefore, that the University of Nebraska Medical Center has merely gone through infancy and part of the teens. It is an occasion to rejoice about, but it is not an occasion to feel any pangs of incipient senility. I am reminded of the fact that the span of years that has been covered by the history of this university and this medical school has been a very exciting century within the area of medicine and medical education. It has
Experts Promote Adoption of Chest Pain Guidelines by Emergency Departments
Authors: M. Mitka
Journal: JAMA (2005)

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
Value of joint scintigraphy in the prediction of erosiveness in early rheumatoid arthritis.
Authors: T T Mottonen, P Hannonen, J Toivanen, A Rekonen, M Oka
Journal: Annals of the Rheumatic Diseases (1988)

The value of scintigraphy in predicting development of new erosions in small peripheral joints was studied by visual evaluation of scintigrams and by three computerised methods. In 13 patients with newly diagnosed rheumatoid arthritis a total of 387 joints were examined clinically, scintigraphically, and radiographically. The follow up period was 24 months. Four eroded joints in three patients were found at the onset. Of the joints which were to become eroded, 46/47 were scintigraphically active at all the check ups. Erosions were detected earlier in foot joints than in finger joints. New erosions were especially prone to appear in joints with persisting and high scintigraphic activity. On the contrary, inactive joints by repeated scanning never eroded. Scintigraphic and clinical activity and radiographic erosiveness correlated significantly with each other. The sensitivity and specificity of visual scintigraphic assessment and the relative pixel activity method proved to be superior to the region of interest methods and clinical evaluation for prediction of erosiveness.
Fat in Fibrosis
Authors: Anna P. Lam, Cara J. Gottardi
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Imai and colleagues (6) reported an autopsy case of bronchioloalveolar carcinoma accompanied by multiple pulmonary cysts and suggested that extension of tumor cells along alveolar walls destroyed the septa to form centrilobular emphysematous cysts.On the other hand, Hasegawa and colleagues (7) reported a case of bilateral thin-walled pulmonary cysts due to metastatic soft tissue sarcoma and speculated that microscopic cavitary metastasis within normal lung parenchyma represented an early stage of the macroscopic cystic lesions, and that a check-valve mechanism was responsible for their formation.In our case, the cysts appeared in areas that had been normal on previous CT scans and demonstrated progression with marked enlargement.Histologically, tumor cells extended along alveolar walls around the cysts, and the terminal bronchioles were narrowed by the tumor.Given these findings, either of the mechanisms described above may have contributed to cyst formation in this case.
Pulmonary tuberculosis follow-up.
Authors: C J Stewart
Journal: BMJ (1970)

Uterus in a Male SIR,-A man aged 40 was admitted in July 1967 with a reducible right inguinal hernia and an undescended left testis.The right testis, normal in size and consistency, was present in the scrotum.Exploration of the right inguinal canal revealed a completely patent processus vaginalis with the testis inside the sac.On applying traction to the testis, an oval mass,
An exploration of reported mortality from cutaneous squamous cell carcinoma using death certification and cancer registry data
Authors: R.F. Rose, A. Boon, D. Forman, W. Merchant, R. Bishop, J.A. Newton-Bishop
Journal: British Journal of Dermatology (2013)

Background Cutaneous squamous cell carcinoma (cSCC) is increasing in incidence but mortality rates are low. Identifying high-risk tumours is important when rationalizing clinical review for patients with cSCC. Objectives To assess the accuracy of death certification in cases of reported fatal cSCC and to identify risk factors for fatal cSCC. Methods A retrospective, observational study of cases of fatal cSCC over 11 years (1993–2004) in Leeds, identified in cancer registry and death certification data. Results Fifty-eight patients were recorded by the registry as having fatal cSCC in this period. Review of case notes and pathology specimens, where available (34 cases), confirmed that 21/34 patients had died of cSCC. Five were on the ear and none on the lip. Four patients had been treated for leukaemia or lymphoma and one was a renal transplant recipient. On pathology review five patients proved to have had malignant adnexal tumours rather than cSCC, and one a melanoma. In addition, three patients had disease of the ear canal or vulva. Conclusions A proportion of deaths were falsely attributed to cSCC as a result of inaccurate histological diagnosis. Some fatalities were related to tumours in sites known to be at higher risk, and a significant proportion was postulated to be related to immunosuppression. In those cases attributed to cSCC in which this could be assessed, the majority were American Joint Committee on Cancer stage 2 and only 24% were in high-risk sites.
Erythromycin in Staphylococcal Infections
Authors: Calvin M. Kunin
Journal: JAMA (1975)

<h3>To the Editor.—</h3> This is a response to the letter by Murray D. Kuhr, MD, entitled "Logistics of Staphylococcal Drug Resistance" (230:1125, 1974). He notes that in his hospital most strains of staphylococci are sensitive to erythromycin, and because of relatively low cost, he uses it for soft tissue infections caused by this organism. I am also concerned about drug costs, but in my opinion, erythromycin would be a poor choice over penicillinase-resistant penicillins or penicillin G or V for sensitive strains. My opinion is based on the extensive experience with erythromycin prior to the development of new penicillins. Excessive use of erythromycin led to rapid emergence of resistant strains, failed to eradicate severe staphylococcal infection, and was even associated with emergence of resistance during therapy. One wonders about the need for any antibiotic in superficial staphylococcal infection, but occasionally their infections may produce rapidly fulminant generalized sepsis. For this reason
Neurochemical Regulation of Oxytocin Secretion in Lactation*
Authors: WILLIAM R. CROWLEY, WILLIAM E. ARMSTRONG
Journal: Endocrine Reviews (1992)

THE nonapeptide oxytocin (OT) is an excellent example of a messenger molecule with diverse physiological actions as well as modes of delivery to its target cells (1, 2). After release from neurosecretory terminals in the neurohypophysis, OT exerts effects as a hormone carried by the systemic circulation to distant target organs, perhaps the most important of which are the mammary gland and uterus (1). In addition, OT may serve as a hypophyseotropic factor, released from nerve terminals in the median eminence into the pituitary portal vasculature, to affect anterior pituitary secretion (2–7), as a peptidergic neurotransmitter or neuromodulator acting within the central nervous system to influence a variety of neuroendocrine, behavioral, and autonomic functions (2, 8–13), and as a paracrine regulatory peptide in the ovary and testis (14–18). Although its most widely investigated physiological actions across all of these modalities are related to reproduction, including the processes of lactation and maternal care, OT also appears to participate in a variety of physiological responses to physical and metabolic challenges.