tbuckley/cabot-search huggingface dataset:
Precise estimation of postpartum haemorrhage: difficulties and importance.
Authors: H. A. Brant
Journal: BMJ (1967)

The accepted definition of postpartum haemorrhage is an estimated blood loss of at least 500 ml. after vaginal delivery. Estimation of blood loss is often unreliable, for few attendants have a clear appreciation of the appearance of 500 ml. of blood soaked into linen and the other accoutrements of delivery. Because of the failure to recognize the extent of haemorrhage, its true importance in maternal morbidity and mortality tends to be missed. Several methods have been used in attempts to measure blood loss accurately. Gatch and Little (1924) extracted haemoglobin and measured it as acid haematin by photometric comparison with a series of acid haematin solutions prepared by diluting the patient's venous blood. Pilcher and Sheard (1937) used the spectrophotometer to measure oxy haemoglobin concentrations. Coller et al. (1944) compared preand post-delivery haemoglobin and plasma protein con centrations. Gahres et al. (1962) used chromium-51-labelled red cells to compare the red cell mass before and after delivery, while Spoerel and Heagy (1962) used radioiodinated serum albumin to compare plasma volumes before and after delivery. Murdoch (1958) attempted complete collections in calibrated receptacles. The aim of the present investigation was to measure the amount of bleeding at vaginal delivery. In order to prevent confusion the estimate made by the attendant will be referred to as the recorded blood loss. The loss determined subse quently by calculation, using the washing-machine extraction method, is referred to as the measured loss.
In war-torn Balkans, US military medical support nears 2-year mark
Authors: P. Gunby
Journal: JAMA (1994)

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
HIPPOCRATES AND THE NEWLY-DISCOVERED HEALTH TEMPLE OF COS: Abstract of a Lecture delivered at the Royal Institution
Authors: R. Caton
Journal: BMJ (1906)

AFTER exhibiting three portraits of Hippocrates and giving a brief sketch of his work at Cos, his influence in freeing medicine from ancient superstition, his marvellous powers of observation and scientific insiglht, and his lofty conception of the aims which ought to characterize the physician, Dr. Caton showed photographs of Cos and of the ancient tree under whicil, according to tradition, Hippocrates was accustomed to give medical advice and counsel to the people in the town of Cos.He thein traced the sacred way whichl leads to the Asklepieion, or Health r TM Da
Causes and Severity of Ischemic Stroke in Patients With Internal Carotid Artery Stenosis
Authors: Henry J. M. Barnett
Journal: JAMA (2000)

Therapeutic trials generally have not distinguished outcomes of stroke according to cause.To determine whether stroke and subsequent disability was of large-artery, lacunar, or cardioembolic origin in patients with different degrees of symptomatic and asymptomatic carotid stenosis.Observational study of prospective data collected from the North American Symptomatic Carotid Endarterectomy Trial between 1987 and 1997.A total of 2885 patients from 106 sites in the United States and abroad (median age, 67 years; 70% male) who had symptomatic internal carotid artery stenosis.Risk of stroke from each of the 3 causes at 5 years by territory and degree of stenosis.During an average follow-up of 5 years, 749 patients had 1039 strokes, including 112 of cardioembolic, 211 of lacunar, 698 of large-artery, 17 of primary intracerebral hemorrhage, and 1 of subarachnoid hemorrhage origin. The 5-year risk of first stroke after entry into the trial in any territory was 2.6% of cardioembolic cause, 6.9% of lacunar cause, and 19.7% of large-artery cause. The proportion of cardioembolic strokes in the territory of the symptomatic artery was 12.0% and 6.9% in 60% to 69% and 70% to 99% arterial stenosis, respectively; large-artery strokes predominated (78.4%) at 70% to 99% arterial stenosis. With 70% to 99% arterial stenosis, the proportion of strokes of cardioembolic and lacunar origin was 43.5% and 21.6% in asymptomatic and symptomatic arteries, respectively. A total of 67.6% of cardioembolic, 16.7% of lacunar, and 33.0% of large-artery strokes in the territory of the asymptomatic artery were disabling or fatal.Our data suggest that approximately 20% and 45% of strokes in the territory of symptomatic and asymptomatic carotid arteries with 70% to 99% stenosis, respectively, are unrelated to carotid stenosis. The cause of subsequent strokes in similar types of patients should be considered when making treatment decisions involving carotid endarterectomy for patients with asymptomatic carotid stenosis, since lacunar and cardioembolic strokes cannot be prevented by endarterectomy.
Transtracheal Oxygen Therapy for Refractory Hypoxemia
Authors: Kent L. Christopher
Journal: JAMA (1986)

Eight patients with chronic severe and refractory hypoxemia were treated with a new transtracheal oxygen catheter. All patients demonstrated an arterial oxygen partial pressure of less than 55 mm Hg on high-flow nasal cannula therapy. Refractory hypoxemia was successfully treated in all eight patients following initiation of transtracheal oxygen therapy at 2.5 to 6.0 L/min. Arterial oxygen partial pressure was 50% greater and oxygen flow requirements were 72% less with transtracheal oxygen. There were no complications related to the procedure and oxygen flow rates up to 6 L/min were well tolerated. Although four patients died, four remain clinically stable with adequate oxygenation at up to 20 months' follow-up. All eight patients experienced an improvement in quality of life with transtracheal oxygen.
Avoidance of Errors Related to Renal Depth During Radionuclide Evaluation of Renal Perfusion
Authors: GARY R. CONRAD, CARL A. WESOLOWSKI
Journal: Clinical Nuclear Medicine (1988)

Quantitative renal imaging is subject to errors related to varying renal depth. Lateral projection images, ultrasound, and geometric mean calculations can be utilized to measure renal depth or to correct for variations in the attenuation of renal activity. However, each of these methods is time consuming and each has the potential for introducing additional errors. As an alternative, the authors propose the use of quantitative indices that are insensitive to the effects of attenuation. This report illustrates how transit-time-distribution (TTD) parameters can be used to assess renal perfusion independent of varying renal depth.
Peroxisome Proliferator-Activated Receptor-γ Coactivator 1α (PGC-1α): Transcriptional Coactivator and Metabolic Regulator
Authors: Pere Puigserver, Bruce M. Spiegelman
Journal: Endocrine Reviews (2003)

Investigations of biological programs that are controlled by gene transcription have mainly studied the regulation of transcription factors. However, there are examples in which the primary focus of biological regulation is at the level of a transcriptional coactivator. We have reviewed here the molecular mechanisms and biological programs controlled by the transcriptional coactivator peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α). Key cellular signals that control energy and nutrient homeostasis, such as cAMP and cytokine pathways, strongly activate PGC-1α. Once PGC-1α is activated, it powerfully induces and coordinates gene expression that stimulates mitochondrial oxidative metabolism in brown fat, fiber-type switching in skeletal muscle, and multiple aspects of the fasted response in liver. The regulation of these metabolic and cell fate decisions by PGC-1α is achieved through specific interaction with a variety of transcription factors such as nuclear hormone receptors, nuclear respiratory factors, and muscle-specific transcription factors. PGC-1α therefore constitutes one of the first and clearest examples in which biological programs are chiefly regulated by a transcriptional coactivator in response to environmental stimuli. Finally, PGC-1α’s control of energy homeostasis suggests that it could be a target for antiobesity or diabetes drugs.
Oesophageal motility and gastro-oesophageal reflux before and after healing of reflux oesophagitis. A study using 24 hour ambulatory pH and pressure monitoring.
Authors: R Timmer, R Breumelhof, J H Nadorp, A J Smout
Journal: Gut (1994)

In this study 24 hour oesophageal pH and pressure monitoring was used to assess oesophageal motility and acid clearance in 27 patients with reflux oesophagitis (Savary-Miller grades I-IV), before and after healing of oesophagitis. After the first 24 hour study patients were treated with omeprazole 40 mg for 8-24 weeks. After endoscopically verified healing and withdrawing omeprazole for four days 24 hour monitoring was repeated. A total of 106,630 pressure events was analysed. No significant differences were found for any of the motility variables, especially the number and the type of contractions, the peristaltic amplitude, duration, and propagation velocity did not show any changes. Separate analysis of motility variables before and after healing in the low and high grade oesophagitis groups yielded similar results. Oesophageal motor response to reflux was investigated by analysis of all contractions occurring in the two minute period after the onset of each reflux episode. Both motor response and oesophageal acid exposure (% time pH &lt; 4, number of reflux episodes) did not change after healing of oesophagitis, thus implying that acid clearance remained unchanged. These results indicate that impaired motility in reflux oesophagitis is either an irreversible consequence of oesophageal inflammation, or a (pre-existent) factor in its pathogenesis.
HIF-1 inhibition decreases systemic vascular remodelling diseases by promoting apoptosis through a hexokinase 2-dependent mechanism
Authors: Caroline M. Lambert, Mélanie Roy, Geneviève A. Robitaille, Darren E. Richard, Sébastien Bonnet
Journal: Cardiovascular Research (2010)

Vascular remodelling diseases are characterized by the presence of proliferative and apoptosis-resistant vascular smooth muscle cells (VSMC). There is evidence that pro-proliferative and anti-apoptotic states are characterized by metabolic remodelling (a glycolytic phenotype with hyperpolarized mitochondria) involving Akt pathway activation by circulating growth factors. Hypoxia-inducible factor-1 (HIF-1) is involved in different vascular diseases. Since this transcription factor is implicated in metabolic responses, we hypothesized that HIF-1 activity could be involved in vascular remodelling in response to arterial injury. Our findings indicate that growth factors, such as platelet-derived growth factor (PDGF), activate the Akt pathway (measured by immunoblot) in human carotid artery VSMC. Activation of this pathway increased HIF-1 activation (measured by immunoblot), leading to increased glycolysis in VSMC. Expression and mitochondrial activity of hexokinase 2 (HXK2), a primary initiator of glycolysis, are increased during HIF-1 activation. The mitochondrial activity of HXK2 in VSMC led to the hyperpolarization of mitochondrial membrane potential (measured by tetramethylrhodamine methyl-ester perchlorate) and the suppression of apoptosis (measured by TUNEL assay and 3 activity), effects that are blocked by HIF-1 inhibition. Additionally, HIF-1 inhibition also decreased VSMC proliferation (proliferating cell nuclear antigen and Ki-67 assays). In vivo, we demonstrate that localized HIF-1 inhibition, using a dominant-negative HIF-1α adenoviral construct, prevented carotid artery post-injury remodelling in rats. We propose that HIF-1 is centrally involved in carotid artery remodelling in response to arterial injury and that localized inhibition of HIF-1 may be a novel therapeutic strategy to prevent carotid stenosis.
RADIUM IN ADEQUATE DOSAGE IN THE TREATMENT OF CANCER
Authors: DOUGLAS QUICK
Journal: JAMA (1927)

In the few years in which radium has been actively used in the treatment of malignant diseases, it has been subject to very severe criticism. Probably a good deal of this criticism has been warranted. The work is new and in the beginning was, of necessity, empiric. The tissue reactions, in effective dosages, have always been severe. With increasing experience, the severity of these reactions is being much better avoided, relieved or controlled.  Those who had hoped that radium might prove to be the cure for cancer have been disappointed. It has, however, contributed tremendously to the study and treatment of this group of diseases. Improvement in methods of irradiation is dependent on and necessitates more careful histologic and biologic investigation. One must distinguish between radiosensitive and radioresistant tumors.  In spite of the fact that radium is not a specific remedy for cancer, it has come to occupy a well
Tests for Coronary Artery Disease
Authors: Lyle Broemeling, C.H. Mielke
Journal: Annals of Internal Medicine (1999)

Letters21 December 1999Tests for Coronary Artery DiseaseLyle Broemeling, PhD and C.H. Mielke Jr., MDLyle Broemeling, PhDWashington State University; Spokane, WA 99201 (Broemeling)Washington State University; Spokane, WA 99201 (Mielke)Search for more papers by this author and C.H. Mielke Jr., MDWashington State University; Spokane, WA 99201 (Broemeling)Washington State University; Spokane, WA 99201 (Mielke)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-12-199912210-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Garber and Solomon (1) compared the cost-effectiveness of various noninvasive diagnostic tests for coronary artery disease. It is of interest that the study results depended on the estimated levels of sensitivity and specificity relative only to coronary angiography and not to determination of disease by intravascular ultrasonography. We also noted that electron-beam computed tomography was not included in their comparison of diagnostic tests.Our experience with this test in the Spokane Heart Study has been good. We believe that when the cost ($200 to $400 per patient) and the test's sensitivity and specificity (see Table 2 of ...References1. Garber IS, Solomon NA. Cost-effectiveness of alternative test strategies for the diagnosis of coronary artery disease. Ann Intern Med. 1999;130:719-28. LinkGoogle Scholar2. Fiorino AS. Electron-beam computed tomography, coronary artery calcium, and evaluation of patients with coronary artery disease. Ann Intern Med. 1998;128:839-47. LinkGoogle Scholar3. Rumberger JA, Brundage BH, Rader DJ, Kondos G. Electron beam computed tomographic coronary calcium screening: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc. 1999;74:243-52. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Lyle Broemeling, PhD; C.H. MielkeJr., MDAffiliations: Washington State University; Spokane, WA 99201 (Broemeling)Washington State University; Spokane, WA 99201 (Mielke) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Alternative Test Strategies for the Diagnosis of Coronary Artery Disease Alan M. Garber and Neil A. Solomon Tests for Coronary Artery Disease Alan M. Garber and Neil A. Solomon Metrics 21 December 1999Volume 131, Issue 12Page: 980KeywordsAngiographyComputed axial tomographyHeartLongitudinal studiesPatientsSpecificityStable coronary artery diseaseUltrasound imaging ePublished: 15 August 2000 Issue Published: 21 December 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Coronary heart disease prevention: insights from modelling incremental cost effectiveness
Authors: T. Marshall
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objective</b> To determine which treatments for preventing coronary heart disease should be offered to which patients by assessing their incremental cost effectiveness. <b>Design</b> Modelling study <b>Data sources</b> Cost estimates (for NHS) and estimates of effectiveness obtained for aspirin, antihypertensive drugs, statins and clopidogrel. <b>Data synthesis</b> Treatment effects were assumed to be independent, and cost per coronary event prevented was calculated for treatments individually and in combination across patients at a range of coronary risks. <b>Results</b> The most cost effective preventive treatments are aspirin, initial antihypertensive treatment (bendrofluazide and atenolol), and intensive antihypertensive treatment (bendrofluazide, atenolol and enalapril), whereas simvastatin and clopidogrel are the least cost effective (cost per coronary event prevented in a patient at 10% coronary risk over five years is £3500 for aspirin, £12 500 for initial antihypertensives, £18 300 for intensive antihypertensives, £60 000 for clopidogrel, and £61 400 for simvastatin). Aspirin in a patient at 5% five year coronary risk costs less than a fifth as much per event prevented (£7900) as simvastatin in a patient at 30% five year risk (£40 800). <b>Discussion</b> A cost effective prevention strategy would offer aspirin and initial antihypertensive treatment to all patients at greater than 7.5% five year coronary risk before offering statins or clopidogrel to patients at greater than 15% five year coronary risk. Incremental cost effectiveness analysis of treatments produces robust, practical cost effectiveness rankings that can be used to inform treatment guidelines.
Effects of transplacental exposure to chlorinated phenols.
Authors: J H Exon, L D Koller
Journal: Environmental Health Perspectives (1982)

Female rats were exposed to 0, 5, 50 or 500 ppm of 2-chlorophenol (2-CP) or pentachlorophenol (PCP). The study was designed to produce progeny which were exposed to the chlorophenolic compounds both prenatally and postnatally. Percent conception, litter size, birth weight, and number of stillbirths was determined at parturition. Hematologic parameters and body weights of the progeny were recorded at weaning age (3 weeks). Effects on reproduction were observed in both the 2-CP and PCP-exposed groups, as indicated by decreased litter sizes and increased number of stillborn. The data indicate that these chlorinated phenolic compounds may be feto- or embryotoxic at high doses. Effects on hematologic parameters were not observed. Further study involving transplacental and chronic exposures to these chlorophenolic compounds appears warranted.
The place of liver transplantation in the treatment of severe alcoholic hepatitis
Authors: Parul Dureja, Michael R. Lucey
Journal: Journal of Hepatology (2010)

Although most patients with alcoholic liver disease experience positive outcomes following liver transplantation, data on the outcome after liver transplantation in patients with severe alcoholic hepatitis are limited. Furthermore, predicting which patients with severe alcoholic hepatitis will maintain sobriety after transplantation is especially difficult. We review the arguments in favour and against extending liver transplantation to selected patients with severe alcoholic hepatitis. In conclusion, we propose that liver transplantation should be a rescue option for occasional patients with severe alcoholic hepatitis who meet the following criteria: those with severe alcoholic hepatitis that has failed medical management, who fulfil all other standard criteria for transplantation, including a thorough psychosocial assessment, yet who are unlikely to survive a mandatory 6-month abstinence period.
Principles of Anesthesiology
Authors: Leonard W. Walts
Journal: JAMA (1966)

In this first of a projected two volume work, Dr. Collins has written comprehensively on the principles of anesthesia. He presents 74 chapters grouped into sections covering fundamental practices, regional anesthesia, and physiologic and pharmacologic considerations.  second volume, to be called The Practice of Anesthesiology, will cover material concerning what to do and when to do it.   outstanding attribute of the book is the excellent illustrations. Selecting from other books, papers, and scientific exhibits, Dr. Collins presents a remarkable collection.  Among the better chapters in the book are those dealing with the uptake and distribution of anesthetic gases, fundamental physics, nerve blocks, and physiological considerations.  A fundamental fault is the lack of editing. I found multiple errors in spelling, punctuation, decimal point placement, and numerals. Sentences are frequently repeated, some are out of context; sometimes entire paragraphs are out of place. While some errors are obvious and therefore
Four-Year Outcome of a Prospective Randomised Trial Comparing Bipolar Plasmakinetic and Monopolar Transurethral Resection of the Prostate
Authors: Riccardo Autorino, Rocco Damiano, Giuseppe Di Lorenzo, Giuseppe Quarto, Sisto Perdonà, Massimo D’Armiento, Marco De Sio
Journal: European Urology (2009)
High Court quashes a GMC decision for third time in a month
Authors: C. Dyer
Journal: BMJ (2012)

The High Court has quashed a decision of the General Medical Council’s interim orders panel and criticised its reasoning, in the third such case in a month.

Judge Mark Pelling revoked an order imposing conditions on Fazal Hussain’s practice pending a full hearing of misconduct allegations against him by the UK medical regulator.

The judge said, “It seems to me barely arguable that the continued imposition of these conditions can fulfil the requirement of proportionality.”

His judgment at the High Court in Manchester was delivered at the end of September but has only just been published. It came within a month of two High Court decisions in September and October lifting interim suspensions on doctors that were held to have been backed by flawed reasoning.

The conditions, originally imposed on Hussain in June 2011 and renewed most recently in June 2012, seemed …
Preliminary TI-201 SPECT for Assessment of Treatment Efficacy in Three Patients With Pancreatic Cancer
Authors: KAZUYOSHI SUGA, TAKESHI FUJITA, TAISHI NAKADA, SHIGERU YONESHIRO, HIROMICHI UCHISAKO, KAZUYA NISHIGAUCHI, TAKASHI NAKANISHI, YUICHIRO HAMADA
Journal: Clinical Nuclear Medicine (1993)

To evaluate treatment efficacy, TI-201 SPECT was performed in three patients with pancreatic cancer. In all of the patients, the degree of TI-201 uptake by tumor, evaluated from the tumor-liver uptake ratio of TI-201 activity, correlated well with alterations in serum level of a tumor marker (CA 19-9, DUPAN-2) after treatment. One of the patients showed no tumor shrinkage on CT after treatment; however, TI-201 SPECT demonstrated reduced uptake in the tumor coupled with a decreased level of CA 19-9. These results suggest that TI-201 SPECT may become a new tool for assessing the efficacy of treatment in pancreatic cancer.