tbuckley/cabot-search huggingface dataset:
Psychiatric Symptoms in Relationship to the Intensity of Anxiety
Authors: Stanley Lesse
Journal: Psychotherapy and Psychosomatics (1974)

Anxiety is a highly organized psychophysiologic process that follows definitive patterns that are predictable in a vast majority of patients. In a study of 624 patients over a period of 18 years I found that the vast majority of patients, no matter what the nature of the original stress, demonstrate definite evidence of mounting anxiety before there is any evidence of other clinical psychiatric symptoms and signs. Four components of anxiety were studied on a quantitative basis, namely: (1) motor (tension); (2) affective; (3) autonomic, and (4) verbal. The various secondary psychiatric symptoms and signs in almost all instances begin to manifest themselves only after there is a definite appearance of the affective component independent of the type of stress. The vast majority of patients show essentially the same sequence of symptom appearance with each bout of anxiety in response to the same or different types of stress. The intensity of anxiety must first be decreased before symptoms or a succession of symptoms disappear. The various components of anxiety are not ameliorated simultaneously in response to various therapies. The pattern of improvement does not depend upon the nature of the therapy. Only the rate of improvement is dependent upon the type of therapy employed. A symptom or sign does not disappear until the affective component of anxiety is decreased below a certain threshold. The last symptom or sign to appear is usually the first symptom or sign to disappear as the level of anxiety is reduced.
Tories reveal plans for reducing NHS costs and funding residential care for elderly people
Authors: O. Ellis
Journal: BMJ (2009)

The Conservatives’ shadow health secretary, Andrew Lansley, has pledged to cut NHS administration costs by £1.5bn (€1.6bn; $2.4bn) in the next four years.

Speaking at the party’s conference in Manchester this week, Mr Lansley promised to reduce spending on health service bureaucracy, which he estimated at £4.5bn. He said that primary care trusts, strategic health authorities, health “quangos,” and the Department of Health would all face cuts, with savings being passed on to frontline services.

Mr Lansley committed a future Conservative government to improving patients’ choice, abolishing political targets, and transferring power “out from the centre, into the hands of health …
Docetaxel Consolidation Therapy Following Cisplatin, Vinorelbine, and Concurrent Thoracic Radiotherapy in Patients with Unresectable Stage III Non-small Cell Lung Cancer
Authors: Ikuo Sekine, Hiroshi Nokihara, Minako Sumi, Nagahiro Saijo, Yutaka Nishiwaki, Satoshi Ishikura, Kiyoshi Mori, Iwao Tsukiyama, Tomohide Tamura
Journal: Journal of Thoracic Oncology (2006)
DUODENAL OBSTRUCTION DUE TO PRESSURE OF SUPERIOR MESENTERIC VESSELS
Authors: Richard C. Shrum
Journal: JAMA (1952)

Chronic obstruction of the duodenum is a condition rarely encountered in adults, though an occasional case of obstruction due to pressure by the superior mesenteric vessels appears in the literature.1It is entirely possible that this obstruction is brought about by numerous factors, such as (1) the branching of the superior mesenteric artery off the aorta in an unusually low position, (2) a short vessel, or (3) visceroptosis. The condition is naturally not found in quadrupeds, because in them the mesentery is directed ventrally, whereas in man it is directed caudally. Today, with adequate roentgenologic aid, this condition is a recognized clinical and pathological entity, and its correction in most cases is satisfactorily accomplished by surgery.  REPORT OF A CASE  Patient S. S., a 66-year-old white woman, was admitted to the St. Joseph Hospital on the service of Dr. Fred W. Rankin with the chief complaint of weakness of
Health action zones
Authors: B. Jacobson, L. Yen
Journal: BMJ (1998)

Reducing inequalities in health and moving away from the competitive market in health care are both important elements of government policy. Health action zones, mentioned in last month's white paper1 but announced beforehand, are one means of implementing these objectives.2 Is the health action zone initiative likely to succeed in its challenging aims of creating and sustaining partnerships to reduce inequalities and improve the clinical effectiveness and cost effectiveness of services?

Health action zones are intended to “bring together all those contributing to the health of the local population to develop and implement a locally agreed strategy for improving the health of local people.” Health authorities and others are expected to bid jointly to run zones; no more than 10 bids will succeed, the schemes starting from April and planned to run for five to seven years. The guidance mentions resources only obliquely, though it does offer other possibilities for support.2 These include changing the rules for joint use of resources-for example, pooling resources across health and …
Junior doctors' shifts and sleep deprivation: New on-call rotas do not work
Authors: Nicholas Akerman
Journal: BMJ (2005)

<h3>Background</h3> Therapeutic hypothermia (HT) delays the cytokine response in infants with neonatal encephalopathy (NE). <h3>Objective</h3> To determine if HT delayed the C-reactive protein (CRP) response and altered white blood cell (WBC), neutrophil and platelet count course during the first week of life in infants with NE. <h3>Design</h3> Retrospective cohort study. <h3>Setting</h3> Regional neonatal intensive care unit, UK. <h3>Patients</h3> 104 term infants with NE (38 normothermia (NT) and 66 HT) born between 1998 and 2010. Infants not exposed to prenatal sepsis risk factors were classified as group ‘A’ and exposed infants to group ‘B’. CRP &gt;10 mg/L was defined as significant response. <h3>Main outcome measures</h3> Time to CRP &gt;10 mg/L, peak CRP, WBC, neutrophil and platelet count. <h3>Results</h3> Blood cultures were negative in all the infants. In babies who had CRP response, HT delayed time to CRP &gt;10 mg/L (median (95% CI): group A, HT: 36 h (28.3 to 48.0); NT: 24 h (0.0 to 24.0); p=0.001; group B, HT: 30 h (15.2&nbsp;to 56.8); NT: 12 h (0.0 to 24.0); p=0.009) and time to peak CRP (median (95% CI): group A, HT: 60 h (60.0 to 72.0); NT: 36 h (0.0 to 48.0); p=0.001; group B, HT: 84 h (62.1 to 120.0); NT: 24 h (0.0 to 36.0); p=0.001). Compared with NT, HT was associated with reduction in slope of CRP elevation by 0.5 (95% CI 0.04 to&nbsp;0.97), WBC by 2.18×10<sup>9</sup>/L (95% CI 0.002 to&nbsp;4.35) and platelet count by 32.3×10<sup>9</sup>/L (95% CI 2.75 to&nbsp;61.8) independent of exposure to sepsis risk, meconium aspiration and severity of asphyxia. <h3>Conclusions</h3> Therapeutic hypothermia delayed the initiation of CRP and its peak response, and depressed the WBC and platelet count compared with NT.
Clinical evaluation of CAP System and RAST in the measurement of specific IgE
Authors: E. A. Pastorello, C. Incorvaia, V. Pravettoni, A. Marelli, L. Farioli, M. Ghezzi
Journal: Allergy (1992)

We investigated the diagnostic value of a new in vitro test, Pharmacia CAP System (Pharmacia Diagnostics AB, Uppsala, Sweden), for the quantitative measurement of allergen‐specific IgE antibodies by comparison with RAST in 2 groups of patients, 71 atopic and 48 non‐atopic. In the last 20 years RAST has supplied a good diagnostic tool, but this test presents some problems, the main one being sensitivity. The new test has a solid phase able to bind even very small amounts of specific IgE and an anti‐IgE tracer with very low cross‐reactivity with other immunoglobulins, thus presenting more favourable conditions. From the analysis of our results, Pharmaeia CAP System gave higher sensitivity (94% compared to 88% of RAST) with no loss of specificity (96% for both tests). The reliability of these results is ensured by the proper selection of patients who were all suffering from pollinosis and were clinically diagnosed as certainly hypersensitive to a single pollen. A positive trend was found between severity of asthma and levels of specific IgE for timothy. Pharmacia CAP System appears to identify a larger number of atopic patients than RAST.
Public health doctors call for House of Lords to reject health bill
Authors: Z. Kmietowicz
Journal: BMJ (2011)

More than 400 public health doctors, academics, and specialists are calling on members of the House of Lords to reject the government’s Health and Social Care Bill when it is presented for its second reading there on 11 October.

The letter, published in the Daily Telegraph on 4 October, claims that “the Bill will do irreparable harm to the NHS, individual patients, and to society as a whole” and “will not deliver efficiency, quality, fairness or choice” (http://tgr.ph/rhjJqW).

For the bill to be rejected, a member of the House of Lords must first table a motion calling for rejection, but this has not yet happened. 

The letter criticises in particular the “significantly …
Methods for Evaluating the Clinical Competence of Residents in Internal Medicine: A Review
Authors: Eric S. Holmboe
Journal: Annals of Internal Medicine (1998)

This paper reviews methods commonly used to assess the clinical competence of residents in internal medicine, including the In-Training Examination, medical record audits, rating scales, clinical evaluation exercises, and the use of standardized patients. Studies were identified through a MEDLINE search (1966 to present) and from the bibliographies of relevant articles and were selected for inclusion according to consensus between the authors. Whenever possible, original studies were chosen over reviews and editorials. No single assessment method can successfully evaluate the clinical competence of residents in internal medicine, and educators need to be cognizant of the most appropriate applications and the advantages and disadvantages of the available evaluation tools.A combination of assessment tools provides the best opportunity to evaluate and educate physicians-in-training.
Health conventions in smoke free places have positive economic impact
Authors: Diane Kunyk, Becky Freeman, Stanton Glantz
Journal: BMJ (2004)

EDITOR—Policies have the potential to affect the health of populations positively. After non-smoking policies had been adopted and taxation increased, the New York City Department of Health announced on 14 May 2004, that smoking rates were down 11% from 2002 to 2003—the biggest one year drop ever recorded.1

Scollo et al, in …
Circadian rhythm of serum interleukin-6 in rheumatoid arthritis.
Authors: N G Arvidson, B Gudbjornsson, L Elfman, A C Ryden, T H Totterman, R Hallgren
Journal: Annals of the Rheumatic Diseases (1994)

OBJECTIVES--To test the hypothesis of a diurnal variation in circulating levels of interleukin-6 (IL-6) and/or tumour necrosis factor-alpha (TNF-alpha) in rheumatoid arthritis and other inflammatory connective tissue diseases. METHODS--Serum levels of IL-6 and TNF-alpha were measured at three hour intervals from 7:30 to 22:30 in 48 patients with different rheumatic diseases as well as ten healthy controls. In four of the patients with rheumatoid arthritis, serum IL-6 levels were measured before and after one week of treatment with prednisolone 15-20 mg daily. RESULTS--IL-6 and TNF-alpha could not be detected in serum from healthy controls. However, serum IL-6 levels were substantially increased in patients with rheumatoid arthritis. Furthermore, patients with rheumatoid arthritis showed a statistically significant circadian variation in levels of IL-6. Peak values appeared in the morning and low values in the afternoon and evening. In contrast, levels were low and stable in other connective tissue diseases. Levels of TNF-alpha were low in patients with rheumatoid arthritis and high in patients with other connective tissue diseases, but without circadian rhythm. After treatment with prednisolone, levels of serum IL-6 decreased significantly, but the circadian rhythm remained. CONCLUSIONS--The circadian rhythm of circulating IL-6 might correspond to the circadian rhythm of symptoms in rheumatoid arthritis. The diurnal variation of IL-6, and possibly other cytokines, might explain the conflicting results previously reported on the inter-relationship between circulating IL-6 levels and disease activity in rheumatoid arthritis.
Essentials of Pain Management
Authors: Devi E. Nampiaparampil
Journal: JAMA (2011)

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
Cortical Firing and Sleep Homeostasis
Authors: Vladyslav V. Vyazovskiy, Umberto Olcese, Yaniv M. Lazimy, Ugo Faraguna, Steve K. Esser, Justin C. Williams, Chiara Cirelli, Giulio Tononi
Journal: Neuron (2009)

The need to sleep grows with the duration of wakefulness and dissipates with time spent asleep, a process called sleep homeostasis. What are the consequences of staying awake on brain cells, and why is sleep needed? Surprisingly, we do not know whether the firing of cortical neurons is affected by how long an animal has been awake or asleep. Here, we found that after sustained wakefulness cortical neurons fire at higher frequencies in all behavioral states. During early NREM sleep after sustained wakefulness, periods of population activity (ON) are short, frequent, and associated with synchronous firing, while periods of neuronal silence are long and frequent. After sustained sleep, firing rates and synchrony decrease, while the duration of ON periods increases. Changes in firing patterns in NREM sleep correlate with changes in slow-wave activity, a marker of sleep homeostasis. Thus, the systematic increase of firing during wakefulness is counterbalanced by staying asleep.
Microevolution of the mitochondrial DNA control region in the Japanese brown bear (Ursus arctos) population
Authors: T. Matsuhashi, R. Masuda, T. Mano, M. C. Yoshida
Journal: Molecular Biology and Evolution (1999)

We investigated nucleotide sequences of the mitochondrial DNA control region to describe natural genetic variations and to assess the relationships between subpopulations of the brown bear Ursus arctos on Hokkaido Island, Japan. Using the polymerase chain reaction product-direct sequencing technique, partial sequences (about 930 bases) of the control region were determined for 56 brown bears sampled throughout Hokkaido Island. A sequence alignment revealed that the brown bear control region included a variable sequence on the 5' side and a repetitive region on the 3' side. Phylogenetic trees reconstructed from the 5' variable region (696-702 bases) exhibited 17 haplotypes, which were clustered into three groups (Clusters A, B, and C). The distribution of each group did not overlap with those of the others, and the three different areas were located in separate mountainous forests of Hokkaido Island. Furthermore, most of the phylogenetically close haplotypes within each group were distributed geographically close to each other. In addition, the 3' repetitive region (arrays of 10 bases) exhibited a much faster mutation rate than the 5' variable region, resulting in heteroplasmy. Such mitochondrial DNA divergence in each group could have occurred after the brown bears migrated from the continent to Hokkaido and became fixed in the different areas.
Diagnosis of immediate food allergy
Authors: C. Steele, N. Conlon, J. D. Edgar
Journal: BMJ (2014)

#### Key points

A 10 month old girl with a history of eczema was brought to the emergency department with urticaria and angioedema without respiratory or circulatory features to suggest anaphylaxis (see glossary). Ten minutes before the symptoms appeared she had eaten some lightly cooked (scrambled) egg. The emergency department doctor administered oral antihistamines and instituted close clinical monitoring. Within 30 minutes symptoms had resolved, and the child was discharged after a six hour period of observation. The doctor explained the likely diagnosis of an egg allergy and recommended avoidance of foods containing egg. An appointment with the GP to consider further investigation or onward referral to a paediatric allergy service was advised. When consulting their GP the next day, the parents asked about tests to confirm egg allergy and whether an adrenaline auto-injector was necessary.

Before allergy testing is carried out a focused history is essential (box 1). Urticaria and angioedema (see glossary) are compatible with an immediate hypersensitivity reaction to food but can also occur spontaneously without any allergic trigger. In immediate (IgE mediated) food allergy the allergen exposure should have a close temporal relation with the onset of symptoms.1 …
PEG-transferrin conjugated TRAIL (TNF-related apoptosis-inducing ligand) for therapeutic tumor targeting
Authors: Tae Hyung Kim, Young Gi Jo, Hai Hua Jiang, Sung Mook Lim, Yu Seok Youn, Seulki Lee, Xiaoyuan Chen, Youngro Byun, Kang Choon Lee
Journal: Journal of Controlled Release (2012)
The ATP-sensitive potassium channel blocker glibenclamide prevents renal ischemia/reperfusion injury in rats
Authors: Kenia Pompermayer, Danielle G. Souza, Giovanna G. Lara, Kátia D. Silveira, Geovanni D. Cassali, Anderson A. Andrade, Cláudio A. Bonjardim, Kátia T. Passaglio, Jamil Assreuy, Fernando Q. Cunha, Maria Aparecida R. Vieira, Mauro M. Teixeira
Journal: Kidney International (2005)
Effect of functionalised fluorescence-labelled nanoparticles on mesenchymal stem cell differentiation
Authors: Andrea Tautzenberger, Steffen Lorenz, Ludwika Kreja, Anke Zeller, Anna Musyanovych, Hubert Schrezenmeier, Katharina Landfester, Volker Mailänder, Anita Ignatius
Journal: Biomaterials (2009)
Differential effects of growth hormone and prolactin on murine T cell development and function.
Authors: W J Murphy, S K Durum, D L Longo
Journal: The Journal of Experimental Medicine (1993)

DW/J dwarf mice have a defect in their anterior pituitary and are deficient in growth hormone (GH) and prolactin (PRL). These mice have been demonstrated previously to have a deficiency in CD4/CD8 double-positive thymocytes, which could be corrected by treatment of these mice with recombinant human GH. Since PRL has been implicated in T cell function and human GH can interact with the PRL receptor, DW/J dwarf mice were treated with either ovine GH (ovGH) (20 micrograms/d) or ovine PRL (ovPRL) (20 micrograms/d). The ovine hormones can only bind their own specific receptors in the mouse. After several weeks of treatment, it was found that these two hormones produced markedly contrasting effects on T cells. Phenotypic analysis of the lymphoid organs was performed by flow cytometry and the functional capability of the peripheral T cells was assessed by immunizing the mice and determining the extent of antigen-specific proliferation of T cells obtained from the draining lymph nodes or by determining splenic mitogen responses. The results indicated that ovGH administration to dwarf mice resulted in significant increases in thymic cellularity yet had little effect on peripheral T cell responses. In contrast, the administration of ovPRL resulted in a further decrease in thymic cellularity when compared with untreated dwarf mice. No thymic effects of either ovGH or ovPRL administration were detected on the normal +/? counterparts. However, ovPRL administration resulted in a significant increase in the number and function of antigen-specific peripheral T cells in both immunized dwarf and +/? mice. The adjuvant effects of PRL occurred even though the mice also received complete Freund's adjuvant. These results suggest that neuroendocrine hormones may act in concert in T cell development. GH appears to promote thymocyte proliferation, while PRL appears to decrease thymus size and yet augment the number and function of antigen-specific T cells in the periphery.
Pigmentation in Koreans: study of the differences from caucasians in age, gender and seasonal variations
Authors: K-Y. Roh, D. Kim, S-J. Ha, Y-J. Ro, J-W. Kim, H-J. Lee
Journal: British Journal of Dermatology (2001)

Human skin colour shows variations throughout life, and many extrinsic and intrinsic factors influence melanogenesis. Facultative pigmentation of sun-exposed skin has been suggested to reflect cumulative lifetime ultraviolet (UV) exposure in caucasians. However, pigmentary changes due to various regulatory factors may be different in dark-skinned peoples.To observe the variations in skin colour due to ageing, gender differences and seasonal changes in Koreans with skin type IV or V.Skin pigmentation was measured at five body sites (buttock, glabella, the V of the neck area, inner arm and dorsal forearm) using skin reflectance spectroscopy in 497 subjects (age range 0-87 years) in winter and 311 subjects (age range 0-84 years) in summer. Among these subjects, 110 were assessed in both seasons. Three independent measurements at each site were done and the average value was used as the pigmentation level.Constitutive pigmentation of the buttock was highest in the first decade of life. It then decreased during the second decade and this decreased level was maintained after the third decade. In contrast to caucasians, facultative pigmentation and sun exposure index did not increase with ageing. Gender differences were significant at all body sites after the first decade. Seasonal changes were apparent in dorsal forearm pigmentation. Little difference was seen in forehead pigmentation between summer and winter.Basal melanogenic regulation might not be different between Asians and caucasians. However, the sun exposure index may not represent lifelong cumulative UV exposure in Koreans. Age-, gender- and season-related characteristics of skin pigmentation in Koreans imply that genetically determined basal skin colour plays an important part in characterizing later responsiveness to UV radiation and sex hormones. Understanding differences between races will be helpful in studying the regulatory mechanisms of melanogenesis.
CHRONIC ACETANILID POISONING FROM HARPER'S "BRAIN FOOD."
Authors: L. W. GLAZEBROOK
Journal: JAMA (1907)

Having read with much interest Dr. Wynn's report<sup>1</sup>of a case of acetanilid poisoning, I desire to give an experience somewhat similar which has come to my attention during the last few weeks: <h3>History.</h3> —Mrs. W., aged 45, presented herself at my office for treatment, with a history of general malaise, drowsiness to the extent of falling to sleep while sitting at her work, marked fatigue with little exertion, numbness in her lower extremities, with a certain degree of interference with locomotion, the symptoms having come on gradually during the last few months. She had attributed the condition to "change of life" or malaria. <h3>Examination.</h3> —There was a marked bluish-white palor and general puffiness of the skin, more marked below the eyes; her lips were of a dark blue color and the conjunctivæ a peculiar bluish-red. The nails were a blackish-blue and the veins beneath the tongue were greatly