tbuckley/cabot-search huggingface dataset:
Landmark article Sept 9, 1944: Penicillin treatment of early syphilis: II. By J.F. Mahoney, R.C. Arnold, B.L. Sterner, A. Harris and M.R. Zwally
Authors: J. F. Mahoney
Journal: JAMA (1984)

In a preliminary report<sup>1</sup>the influence of penicillin therapy on the clinical manifestations and serologic reactions of patients with early syphilis was presented. The report was based on the results of a curtailed period of observation of a group of 4 patients. It is our purpose in the present paper to record the findings of post-treatment observation of the original group for periods in excess of three hundred days. It is also desired to record certain items of information which have resulted from the treatment of an additional 100 patients. <h3>REVIEW OF ORIGINAL GROUP</h3> Of the group of 4 patients the records of whom formed the basis for the preliminary report,<sup>1</sup>all have been maintained under observation. It will be recalled that these patients displayed dark field positive lesions of early syphilis at the time of treatment. The therapy consisted of an intramuscular injection of 25,000 units of penicillin
A Tale of Two Patients
Authors: Faith T. Fitzgerald
Journal: Annals of Internal Medicine (2004)

On Being a Doctor1 June 2004A Tale of Two PatientsFaith T. Fitzgerald, MDFaith T. Fitzgerald, MDFrom University of California, Davis, Sacramento, CA 95817.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-11-200406010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Late last year, my 87-year-old mother developed diarrhea. I phoned her doctor's clinic and was answered by a recorded voice that periodically told me, “All of our representatives are busy helping other clients. We appreciate your patience. Your call is important to us. Please hold for our next available representative.” Synthetic music alternated with synthetic messages for 28 minutes before I lost my appreciated patience and hung up. I phoned again later; after a 15-minute hold, in the midst of “Your call is important …,” I was disconnected. I got through on the third try: The first possible appointment was ... Author, Article, and Disclosure InformationAffiliations: From University of California, Davis, Sacramento, CA 95817.Corresponding Author: Faith T. Fitzgerald, MD, University of California, Davis, 4150 V Street, Suite 1100, Sacramento, CA 95817. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 2004Volume 140, Issue 11Page: 929-930KeywordsBloodDiagnostic radiologyDiarrheaNursesRunningTemperatureUrineWheelchairsWhite blood cells ePublished: 1 June 2004 Issue Published: 1 June 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Dark History of White Spots
Authors: Mohammad-Ali Yazdani Abyaneh, Robert Griffith, Leyre Falto-Aizpurua, Keyvan Nouri
Journal: JAMA Dermatology (2014)

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 Dermatology 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 Dermatology journal
Systematic Review: Computed Tomography and Ultrasonography To Detect Acute Appendicitis in Adults and Adolescents
Authors: Teruhiko Terasawa, C. Craig Blackmore, Stephen Bent, R. Jeffrey Kohlwes
Journal: Annals of Internal Medicine (2004)

Background: Although clinicians commonly use computed tomography or ultrasonography to diagnose acute appendicitis, the accuracy of these imaging tests remains unclear. Purpose: To review the diagnostic accuracy of computed tomography and ultrasonography in adults and adolescents with suspected acute appendicitis. Data Sources: The authors used MEDLINE, EMBASE, bibliographies, review articles, textbooks, and expert opinion to retrieve English- and non–English-language articles published from 1966 to December 2003. Study Selection: The authors included prospective studies evaluating computed tomography or ultrasonography followed by surgical confirmation or clinical follow-up in patients at least 14 years of age with suspected appendicitis. Data Extraction: One assessor (for non–English-language studies) or 2 assessors (for English-language studies) independently reviewed each article to abstract relevant study characteristics and results. Data Synthesis: Twelve computed tomography studies and 14 ultrasonography studies met inclusion criteria. Computed tomography had an overall sensitivity of 0.94 (95% CI, 0.91 to 0.95), a specificity of 0.95 (CI, 0.93 to 0.96), a positive likelihood ratio of 13.3 (CI, 9.9 to 17.9), and a negative likelihood ratio of 0.09 (CI, 0.07 to 0.12). Ultrasonography had an overall sensitivity of 0.86 (CI, 0.83 to 0.88), a specificity of 0.81 (CI, 0.78 to 0.84), a positive likelihood ratio of 5.8 (CI, 3.5 to 9.5), and a negative likelihood ratio of 0.19 (CI, 0.13 to 0.27). Verification bias and inappropriate blinding of reference standards were noted in all of the included studies. Limitations: The summary assessment of the diagnostic accuracy for both tests was limited by the small number of studies, heterogeneity among study samples, and poor methodologic quality in the original studies. Conclusions: Computed tomography is probably more accurate than ultrasonography for diagnosing appendicitis in adults and adolescents. Prospective studies that apply gold standard diagnostic testing to all study participants would more reliably estimate the true diagnostic accuracy of these tests.
TONSILLOTOMY WITHOUT HÆMORRHAGE.
Authors: W. C. Jarvis
Journal: JAMA (1883)

[Read to the Section on Ophthalmology, Otology and Laryngology.] The question of hæmorrhage after the excision of enlarged tonsils is still unsettled, and no single method for their removal is universally approved. Those looking to others for advice as to the dangers of the operation, must be bewildered by the extreme difference in opinion held by experts on this subject. There are those who, advocating the ideas of Schmidt and his sympathizers, discourage the use of all sharp instruments as dangerous to life; others, however, accepting the views of MacKenzie, insist upon the indiscriminate removal of enlarged tonsils by the knife. Safety, as we might expect, lies between the two extremes. Experience directed my attention to a middle course, and results demonstrated its advisability. My conclusions, with the reasons for forming them, the following cases will briefly explain: Case i. A laboring man of powerful build, and in the apparent
Apolipoprotein(a) phenotypes, Lp(a) concentration and plasma lipid levels in relation to coronary heart disease in a Chinese population: evidence for the role of the apo(a) gene in coronary heart disease.
Authors: C Sandholzer, E Boerwinkle, N Saha, M C Tong, G Utermann
Journal: Journal of Clinical Investigation (1992)

Elevated lipoprotein(a) (Lp[a]) concentrations are associated with premature coronary heart disease (CHD). In the general population, Lp(a) levels are largely determined by alleles at the hypervariable apolipoprotein(a) (apo[a]) gene locus, but other genetic and environmental factors also affect plasma Lp(a) levels. In addition, Lp(a) has been hypothesized to be an acute phase protein. It is therefore unclear whether the association of Lp(a) concentrations with CHD is primary in nature. We have analyzed apo(a) phenotypes, Lp(a) levels, total cholesterol, and HDL-cholesterol in patients with CHD, and in controls from the general population. Both samples were Chinese individuals residing in Singapore. Lp(a) concentrations were significantly higher in the patients than in the population (mean 20.7 +/- 23.9 mg/dl vs 8.9 +/- 12.9 mg/dl). Apo(a) isoforms associated with high Lp(a) levels (B, S1, S2) were significantly more frequent in the CHD patients than in the population sample (15.9% vs 8.5%, P less than 0.01). Higher Lp(a) concentrations in the patients were in part explained by this difference in apo(a) allele frequencies. Results from stepwise logistic regression analysis indicate that apo(a) type was a significant predictor of CHD, independent of total cholesterol and HDL cholesterol, but not independent of Lp(a) levels. The data demonstrate that alleles at the apo(a) locus determine the risk for CHD through their effects on Lp(a) levels, and firmly establish the role of Lp(a) as a primary genetic risk factor for CHD.
Ultrasonic assessment of the St. Jude prosthetic valve: M mode, two-dimensional, and Doppler echocardiography.
Authors: I R Weinstein, J P Marbarger, J E Pérez
Journal: Circulation (1983)

To determine whether the flow characteristics of aortic and mitral St. Jude Medical valves could be defined noninvasively, we analyzed Doppler transprosthetic flow velocity spectra in 23 relatively asymptomatic patients. Results were interpreted in the framework of M mode and two-dimensional echocardiographic data and were compared with Doppler transvalvular flow velocity spectra from native valves of healthy subjects. Although the morphologic characteristics of Doppler spectra were similar, peak and mean transprosthetic mitral flow velocities were higher than values obtained across native valves (1.38 +/- 0.3 m/sec and 0.73 +/- 0.1 m/sec vs 0.78 +/- 0.1 m/sec and 0.35 +/- 0.06 m/sec, respectively; p less than .001). However, calculated pressure half-times were not different (61.2 +/- 16.9 msec vs 57.2 +/- 13.2 msec; p greater than .05) and calculated transprosthetic mitral gradients were small (2.3 +/- 0.9 mm Hg). Similarly, the morphologic characteristics of aortic Doppler flow spectra in St. Jude and native valves were analogous. However, prosthetic valves exhibited higher peak and mean velocities (p less than .01) and slightly prolonged time-to-peak flow (p = .02). M mode and two-dimensional studies did not show useful quantitative measures of prosthetic function and did not demonstrate evidence of paravalvular leaks, which were detected in four cases by Doppler techniques. Thus Doppler echocardiography provides quantitative information about transprosthetic flow characteristics in patients with implanted St. Jude valves and is useful in identifying patients with prosthetic dysfunction.
Some Surgical Problems Peculiar to the Tropics
Authors: Ben Eiseman
Journal: New England Journal of Medicine (1953)

THOSE who spend a large part of their professional lives practicing surgery in temperate zones and in areas where the standard of living and nutrition is relatively high are often unaware of the many problems foreign to their experience that are encountered in the practice of surgery in the tropics. In a world where rapid transportation continually increases interdependence with formerly remote areas it is interesting and perhaps profitable to overcome this surgical isolationism and to review some of the problems that confront surgeons in a tropical area such as Southeast Asia.‡ A great deal has been written about tropical . . .
Optimal blood stem cell mobilization using 10 μg/kg granulocyte colony‐stimulating factor (G‐CSF) alone for high‐dose melphalan intensification in multiple myeloma: An intrapatient controlled study
Authors: W. Feremans, F. Le Moine, C. Ravoet, M. Lambermont, G. Bastin, J. P. Delville, O. Pradier, E. Dupont, P. Capel
Journal: American Journal of Hematology (1994)

Abstract A recent randomized multicentric French study has shown that intensification with stem cell rescue improves the response rate and progression‐free survival in multiple myeloma. Transplantation with primed peripheral blood stem cells (PBSC) displays a faster hematological recovery, especially for platelets, as compared with a bone marrow stem cell graft. In multiple myeloma, the optimal mobilization method for PBSC is unknown. The present study compares mobilization with cyclophosphamide 4 g/m 2 + G‐CSF 5 μg/kg versus G‐CSF 5 μg/kg alone versus G‐CSF 10 μg/kg alone in two cases of multiple myeloma, using an intrapatient controlled evaluation of the amount of CD34‐positive cells obtained during each leukapheresis. In both cases, the highest CD34‐positive cells yield was obtained with G‐CSF at 10 μg/kg. Despite the low number of cases, this method, devoid of life‐threatening toxicity, might be of greatest interest in multiple myeloma. © 1994 Wiley‐Liss, Inc.
Uncertainties in preserving fertility in cancer treatment
Authors: R. A Anderson, W H. Wallace
Journal: BMJ (2008)

Infertility is one of the more devastating long term effects of cancer treatment in young patients,1 but predicting who is at high risk of infertility is difficult. Patients often did not receive adequate information, but a recent prospective analysis of UK paediatric oncologists showed that risk to fertility was discussed with most children …
A spotlight on electrophysiological remodeling and the molecular biology of ion channels
Authors: Stanley Nattel, Dan M. Roden, Denis Escande
Journal: Cardiovascular Research (1999)

The present special issue of Cardiovascular Research atrial tachycardia, a field receiving a great deal of attention focuses on two tightly linked and increasingly important because of its prime importance for understanding the areas of cardiovascular electrophysiology.It has become determinants of atrial fibrillation (AF).The final review increasingly apparent that the cardiac electrophysiological dealing with remodeling per se is a paper by Saffitz et al. milieu is highly dynamic.Not only do disease states affect[4] regarding gap junction remodeling in relation to the the determinants of cardiac electrical function in profound development of anatomic substrates of arrhythmia.ways, but we now recognise that cardiac arrhythmias canThe second series of review papers discuss developthemselves produce profound changes in the structure and ments in the molecular biology of ion channels.Roden and function of the heart, and that these changes can contribute Kuperschmidt [5] present an up-to-date review of the importantly to the initiation and perpetuation of arrhyth-increasingly complex picture of the relationships between mias.Disease-and arrhythmia-induced changes in cardiac genes and cardiac ion channels.A paper by Balser [6]
Online Identities of Physicians—Reply
Authors: Matthew DeCamp, Thomas W. Koenig, Margaret S. Chisolm
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
The antiarrhythmic efficacy of amiodarone and desethylamiodarone, alone and in combination, in dogs with acute myocardial infarction.
Authors: S Nattel, M Davies, M Quantz
Journal: Circulation (1988)

Antiarrhythmic activity of amiodarone's desethyl metabolite, which accumulates during oral amiodarone therapy, has been postulated to explain the delayed onset of antiarrhythmic effects during long-term amiodarone therapy. To determine their relative antiarrhythmic efficacy, amiodarone and its desethyl metabolite, desethylamiodarone, were administered to mongrel dogs with ventricular tachycardia 24 hr after ligation of the left anterior descending coronary artery. Cumulative doses of amiodarone, desethylamiodarone, a combination of amiodarone and desethylamiodarone, or the vehicle for drug administration were given at 1 hr intervals. Both amiodarone and desethylamiodarone suppressed ventricular arrhythmias in a dose-dependent fashion. The metabolite, however, was more potent with a 50% effective concentration for suppression of premature ventricular complexes of 1.4 mg/liter compared with 4.6 mg/liter for the parent compound. Plasma and myocardial drug concentrations were similar to those measured during long-term amiodarone therapy in man, with desethylamiodarone producing greater myocardial concentrations than amiodarone for a given plasma concentration. Coadministration of the metabolite along with the parent drug resulted in suppression of arrhythmias at lower doses of amiodarone than when the latter was administered alone, and concentration-response analysis indicated an additive antiarrhythmic effect. These experiments suggest that the accumulation of desethylamiodarone that occurs with long-term oral amiodarone therapy contributes importantly to the antiarrhythmic effects of the drug, and may account for the gradual increase in antiarrhythmic action during the course of amiodarone therapy.
The Analysis Of The Correlation Between ER22/23EK Polymorphism Of h-GR/NR3C1 Gene And Occurrence Of Severe Bronchial Asthma In Polish Population
Authors: M.G. Panek, T. Pietras, I. Kupryś-Lipińska, D. Tworek, K. Oszajca, R. Wujcik, P. Górski, J. Szemraj, P. Kuna
Journal: Journal of Allergy and Clinical Immunology (2011)
Points: Extrapyramidal disturbances caused by inappropriate prescribing
Authors: U. Tacke
Journal: BMJ (1987)

s eloquent description of Mary McDaid, dead in bed at 33 (25 July, p 265), set me thinking about where Mary and her like were represented in the evaluation of a shared diabetes care scheme reported by Dr John Day's group (20 June, p 1590)-perhaps among those for whom it was agreed that "improved control could not be achieved" or among the 40-60% of patients who do not consult specialists for diabetes care?The authors do not tell us how many patients fell into each group, nor how they fared over the next two years.The disappointing physical deterioration that occurred over the two years might have been mainly in that group where doctors had settled for poorer blood glucose control.The authors, and others (18 July, p 214), have proposed various solutions to improve the organisation of diabetic care including "greater con- centration on patient advice."Attempts at blanket patient advice have not met with much success in changing patient behaviour, and it would seem rational to tailor the advice to the specific needs of different groups of patients.We should take Mary's statement, that "it was all right for doctors with their fancy talk," into account in her management.Studies of patient outcome would also be better interpreted if they classified patients by their health beliefs and health seeking behaviour as well as their blood glucose values, and took this classification into account in the analysis.
An Evaluation of Reported Poisonings by Acetylsalicylic Acid
Authors: Leon A. Greenberg
Journal: New England Journal of Medicine (1950)

THE salicylates have been used medicinally since ancient times. Hippocrates described them, and their effects are reported in the earliest works of the modern medical period. In recent years the production of just one of the salicylates — acetylsalicylic acid — in the United States has been greater than that of any other medicinal drug intended for internal use — exceeding 9,000,000 pounds in one year. This drug is today among the most widely used of all medicaments, particularly as an analgesic but also as an antipyretic and in the treatment of rheumatic fever. The large amount of acetylsalicylic acid consumed and . . .
Antitrust Enforcement in Health Care
Authors: L. Barry Costilo
Journal: New England Journal of Medicine (1985)

It has been almost a decade since the Federal Trade Commission (FTC) filed an antitrust suit against the American Medical Association (AMA) that successfully challenged a number of anticompetitive ethical restrictions, including restrictions on the corporate or "contract" practice of medicine, on income-sharing arrangements between physicians and nonphysicians, and on truthful advertising and solicitation.1 The resulting controversy, which led the AMA to seek a partial antitrust exemption from Congress, has largely abated. The FTC and the AMA have subsequently been engaged in a constructive dialogue, which recognizes both the need for legitimate physician self-regulation and the responsibility of the FTC . . .
Remarks ON SOME AFFECTIONS OF SPEECH
Authors: Wm. H. Broadbent
Journal: BMJ (1907)

Assistant Medical Officer (Education) of the London County Council, relates a number of interesting examples of speech defects,met with in children.Jn one series it is chifiy in reading that the difficulty occurs.An intelligent boy of 7 years old cannot re- member how to make 1, p, y, g, that is, cannot reproduce the written or printed characters representing the articulate sounds, and reads " It has three birds in it" as " To see best in to," that is, he cannot reproduce the articulate sounds.represented by the printed words.On the one hand, he cannot translate auditory impressions or percep- tions into visual representative characters, and, on the other, cannot translate visual symbols into the appropriate articulate sounds.He recognized words if they were spelt to him; he did difficult sums in mental arithmetic, and when 11,308 was written in numerals gave the number in words.Another boy could not read the smallest words.Said chair " spelt " sister "; made serious mistakes in writing from dictation; did not copy coirectly.He, also, ealculated correctly, and was said to " know all his letters," that is, I suppose, could name them, or perhaps could say the alphabet.A third boy, of 11, good at arithmetic, smart, ready, and trustworthy, spells out "girl" as "vice"; cannot read "mouse," though he recognizes each letter; writes from dictation " a pen and ink " as " a gen and inck."It may be accidental that the two wores which he bungles are nouns, while "and," which has the same number of letters,
The Multivariant Masks of Depression
Authors: STANLEY LESSE
Journal: American Journal of Psychiatry (1968)

Many depressive syndromes are manifested initially in a masked fashion that belies their presence even though the masking process varies, depending upon such factors as the age of the patient, ethnic background, socio-economic and sociophilosophic milieu, heredito-congenital processes, and ontogenic development. The author calls attention to a broad spectrum of clinical patterns that may mask or hide a depressive illness. Particular note is made of depressive syndromes that are hidden by hypochondriacal and psychosomatic complaints; this pattern accounts for many if not most of the depressions that confront the nonpsychiatric physician.