tbuckley/cabot-search huggingface dataset:
Extensive mucinous metaplasia of the vulva arising within Zoon's vulvitis
Authors: M.A. Thomson, R.A. Carr, R. Ganesan, F. Humphreys
Journal: British Journal of Dermatology (2007)

Conflicts of interest: none declared. Sir, Mucinous metaplasia of the genital skin is a rare entity characterized by mucin‐containing cells within or replacing the stratified squamous epithelium. We report a case of extensive mucinous metaplasia of the vulva with haemosiderin deposition arising within Zoon's vulvitis. We discuss the pathogenesis and differential diagnosis of mucinous epithelium in the lower genital tract. A 67‐year‐old woman initially presented with a small, well‐demarcated, red/brown macule on the labia minora. A biopsy from 1995 (Fig. 1) had been reported as lichen sclerosus and serial biopsies from 2002–2004 confirmed chronic inflammation, without neoplasia, but did not give a specific diagnosis for the inflammatory process. On review in 2005, she now had a 10‐year history of vulval soreness which had not responded to conjugated oestrogen cream and potent topical steroids. The lesions had gradually enlarged to involve the inner aspects of both labia minora, the clitoral hood and one side of the introitus (Fig. 2a). The differential diagnosis included purpura secondary to lichen sclerosus, Zoon's vulvitis, extramammary Paget's disease, vulval intra‐epithelial neoplasia and melanoma.
[349] DIFFERENTIAL EFFECTS OF CONTROLLED PREOPERATIVE HEPATIC INFLAMMATORY RESPONSE ON LIVER REGENERATION AFTER PARTIAL HEPATECTOMY
Authors: P. Ananian, E. Gregoire, A. Liprandi, Y. Berda-Haddad, C. Monserrat, J. Hardwigsen, P. Campan, Y.P. Le Treut, R. Gerolami
Journal: Journal of Hepatology (2007)
Can the Practice of Retainer Medicine Improve Primary Care?
Authors: Thomas S. Huddle
Journal: Annals of Internal Medicine (2012)

Letters6 March 2012Can the Practice of Retainer Medicine Improve Primary Care?Thomas S. Huddle, MD, PhD and Robert M. Centor, MDThomas S. Huddle, MD, PhDFrom University of Alabama at Birmingham, Birmingham, AL 35294.Search for more papers by this author and Robert M. Centor, MDFrom University of Alabama at Birmingham, Birmingham, AL 35294.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-5-201203060-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Zwelling and Dr. Umbehr describe experiences with retainer practice that comport with the highest standards of medical ethics and professionalism as they have been traditionally understood.Dr. Van Zoeren argues that primary care physician shortages make integrated practice a better alternative. Dr. Webster and Dr. Donohoe press an ethical case against retainer medicine, elements of which were alluded to in Dr. Lo's editorial (1).Dr. Webster's and Dr. Donohoe's contention that retainer medicine breaches the social contract between our profession and society is unsupported. To our knowledge, society has not (so far) stipulated to physicians that, in ...References1. Lo B. Retainer medicine: why not for all? [Editorial]. Ann Intern Med. 2011;155:641-2. [PMID: 22041955] LinkGoogle Scholar2. Huddle TS. Perspective: Medical professionalism and medical education should not involve commitments to political advocacy. Acad Med. 2011;86:378-83. [PMID: 21248605] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Thomas S. Huddle, MD, PhD; Robert M. Centor, MDAffiliations: From University of Alabama at Birmingham, Birmingham, AL 35294.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0928. Drs. Huddle and Centor have not now nor ever participated in retainer medicine and have no future plans to do so. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRetainer Medicine: An Ethically Legitimate Form of Practice That Can Improve Primary Care Thomas S. Huddle and Robert M. Centor Retainer Medicine: Why Not for All? Bernard Lo Can the Practice of Retainer Medicine Improve Primary Care? Marcy Zwelling Can the Practice of Retainer Medicine Improve Primary Care? Josh J. Umbehr Can the Practice of Retainer Medicine Improve Primary Care? Douglas M. Van Zoeren Can the Practice of Retainer Medicine Improve Primary Care? James Webster Can the Practice of Retainer Medicine Improve Primary Care? Martin T. Donohoe Metrics 6 March 2012Volume 156, Issue 5Page: 401KeywordsConflicts of interestForecastingHealth careHealth disparitiesMedical ethicsPatientsPrimary care physicians ePublished: 6 March 2012 Issue Published: 6 March 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
High risk groups are still not being vaccinated
Authors: Rakesh Aggarwal, Piyush Ranjan
Journal: BMJ (2005)

Monitoring global health Problems are primarily nationalEditor-Murray et al urge for improved global reporting of health data. 1 They also highlight the difficulty of showing national decision makers that good health data can strongly support decision making.Why is this?A reason may be that data are always subject to interpretation.The article by Murray et al is a case in point.They want to establish "an independent monitoring organisation," arguing that the World Health Organization is not fit to undertake the job because of tension between advocacy, monitoring, and evaluation.But evidence that it is this tension that leads to poor monitoring by WHO is weak, at best.In reality, the problems of global health reporting are primarily national (and subnational).The fact that the sum of deaths claimed by different programmes is greater than the actual number of deaths reflects epidemiological methods and the current limitations in global health reporting, more than any WHO failure.The global burden of disease project was limited by these issues, but it was undertaken as effectively in WHO as in any other organisation.Not only are there problems in capacity, understanding the value of surveillance, and coverage of health services.The reporting of health events can be politically sensitive or even economically damaging.It is therefore likely that political interference will continue (whoever collects the data) until governments can be shown that honesty pays.It is perhaps this failure that needs to be dealt with rather than setting up yet another organisation without a proper analysis of the reasons (and locus) for failures in global health reporting.
Building Physician Work Hour Regulations From First Principles and Best Evidence
Authors: Kevin G. Volpp
Journal: JAMA (2008)

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
JC virus infects the enteric glia of patients with chronic idiopathic intestinal pseudo-obstruction
Authors: M Selgrad, R De Giorgio, L Fini, R F Cogliandro, S Williams, V Stanghellini, G Barbara, M Tonini, R Corinaldesi, R M Genta, R Domiati-Saad, R Meyer, A Goel, C R Boland, L Ricciardiello
Journal: Gut (2008)

<h3>Background and aim:</h3> Chronic idiopathic intestinal pseudo-obstruction (CIIP) is characterised by severe impairment of intestinal propulsive motility that mimics bowel obstruction. JC virus (JCV) is a polyomavirus that can infect brain glial cells causing a fatal disease, but may also be found throughout the normal gastrointestinal tract. The hypothesis that JCV infects the myenteric plexuses of patients with CIIP was tested. <h3>Methods:</h3> 10 patients with CIIP and 61 normal specimens (30 ascending colon and 31 ileum) from patients with uncomplicated colon cancer were studied. DNA was extracted from the myenteric plexuses, and JCV T antigen (TAg) DNA and the viral regulatory region were detected by PCR and sequencing. Immunohistochemistry was performed to detect JCV viral protein expression, neuronal and glial markers. Fluorescence in situ hybridisation was performed for cellular localisation of the JCV infection. <h3>Results:</h3> Clinical studies demonstrated neurogenic impairment, and pathological analyses showed neuropathy in each patient with CIIP. JCV TAg DNA was found in the myenteric plexuses of 8/10 (80%) of the patients with CIIP and 3/31 (9.7%) of the control patients (p&lt;0.001). All samples were JCV Mad-1 strains. Seven of the 10 CIIP specimens expressed both JCV TAg and the JCV viral protein VP1, while none of the controls expressed either. JCV infection co-localised with glial fibrillary acidic protein expression, a marker of enteric glial cells. <h3>Conclusion:</h3> JCV infection occurs in the myenteric plexuses of patients with CIIP. The JCV localisation in enteroglial cells suggests a possible pathological role for this virus in enteric neuropathy.
Acute renal failure from contrast medium: Beware patients taking metformin…
Authors: John A Sayer
Journal: BMJ (2006)

Editor-Last year Hern et al published an editorial on knife crime and clearly the problem has not gone away. 1 A quick search of the Times website finds 90 hits on the single search term "stabbing" in the past three months alone.Several recent deaths have fuelled the perception that forensic knife injuries have become an epidemic, resulting in a knife amnesty and government discussion of new punitive measures.An increase in such injuries is supported by data from regional police forces and the Home Office, with 1200 reported attacks in London last year and 30% of homicides caused by knife injury. 2 Crimes defined as "more serious wounding or other act endangering life" almost doubled nationally from 1995 to 2005. 3 We audited forensic knife injuries at this hospital, one of Europe's busiest emergency departments, to establish the size of this problem in a representative urban area (east London).We extracted data on forensic knife injuries (excluding deliberate self harm) from a detailed prospectively recorded database of all trauma calls from July 2004 to June 2006 (these reflecting more severe injuries).Overall there were 309 forensic knife injuries; 259 patients were admitted, 184 were operated on, and eight died.The chest was the most common area injured (183/309 patients, 6/8 deaths).Most patients were men (297/309), and mean age was 28 (range 15-74).To give a measure of changing incidence over a longer time of a greater range of severity of injury, we also performed an audit of all cases coded as "stabbing" on the patient administration system during the 10 year period from July 1997 to June 2006 (figure).Over both periods, the data show an increase in the overall incidence of stabbings.Furthermore, increased need for surgical intervention in the prospective study may reflect increasing severity of injury.These data therefore seem to support the general perception that knife injuries are increasing.
FAK silencing inhibits leukemogenesis in BCR/ABL‐transformed hematopoietic cells
Authors: Yi Le, Luhong Xu, Jiayun Lu, Jianpei Fang, Valentina Nardi, Li Chai, Leslie E. Silberstein
Journal: American Journal of Hematology (2009)

Focal adhesion kinase (FAK) is constitutively activated and tyrosine phosphorylated in BCR/ABL-transformed hematopoietic cells, but the role it plays during leukemogenesis remains unclear. Here, we examined the effects of RNA interference-mediated FAK silencing on leukemogenesis induced by a BCR/ABL-transformed cell line. Transduction of BCR/ABL-BaF3 cells with FAK shRNA inhibited FAK expression and reduced STAT5 phosphorylation, but induced caspase-3 activation. In vitro studies showed that treatment with FAK shRNA resulted in impaired cell proliferation and colony formation, while increasing cell apoptosis. Mice that received transplants of BCR/ABL-BaF3 cells with FAK shRNA displayed significantly prolonged survival time and diminished leukemia progression. In addition, FAK silencing enhanced in vitro and in vivo efficacy of ABL tyrosine kinase inhibitor imatinib in BCR/ABL-BaF3 cells. Our results suggest that FAK is critical for leukemogenesis and might be a potential target for leukemia therapy.
Ocular injuries due to alkaline substances
Authors: A M O'Driscoll, P Shah, R K Aggarwal, P B Chell, M W Hope-Ross, P J McDonnell
Journal: BMJ (1995)

EDITOR,—Within the past few weeks several people with severe ocular chemical injuries have presented to the accident and emergency department at Birmingham and Midland Eye Hospital. The wounds have been due to deliberate splashing of alkaline substances into the victims' eyes. Robbery and violent assault seem to have been the motives in most cases.

In …
Corticosteroids in rheumatoid arthritis: is a trial of their 'disease modifying' potential feasible?
Authors: M A Byron, J R Kirwan
Journal: Annals of the Rheumatic Diseases (1986)

After three decades of experience the use of corticosteroids to treat rheumatoid arthritis (RA) remains a matter of personal taste and generates much debate.Although their role in life threatening complications is apparently acceptable, one stan- dard text1 suggests that less than 5% of patients with predominantly articular disease will require them, and in a recent survey British rheumatologists reported using corticosteroids only 'occasionally' or 'very infrequently'.2However, when making clinical decisions a physician's opinion does not necessarily reflect his clinical practice.3Recent studies have found that 24 of 100 consecutive RA patients seen at one British hospital were taking a mean daily dose of 5-6 mg of prednisolone2 and that 15% of outpatients seen at a Dutch clinic were also receiving steroid treatment.4 EFFECT OF STEROIDSAlthough corticosteroids are very effective in dimin- ishing pain, swelling, and stiffness, to maintain
Neural Blockade in Clinical Anesthesia and Management of Pain
Authors: Honorio T. Benzon
Journal: JAMA (1988)

In 1980, Cousins and Bridenbaugh edited a 749-page book on local anesthetics, nerve blockade, and pain control. It has become the standard textbook on the subject primarily because of its superior quality. It is also the only book that encompasses all three subjects. This second edition has 1171 pages; two new chapters have been added, and three chapters have been subdivided into two or three subchapters. This review attempts to answer several questions: Does the new edition contain current information, and does it discuss significant topics overlooked in the first edition? Do the added chapters continue the excellence of the first edition? Finally, for those who have the first edition, is it worth buying the second edition? The authors have succeeded in their difficult task of improving an exceptional book. The new chapters are well written, comprehensive, and uniformly upto-date. Recent developments such as the carbonation and alkalinization of local
Five-Year Follow-up of Bilateral Stimulation of the Subthalamic Nucleus in Advanced Parkinson's Disease
Authors: Paul Krack, Alina Batir, Nadège Van Blercom, Stephan Chabardes, Valérie Fraix, Claire Ardouin, Adnan Koudsie, Patricia Dowsey Limousin, Abdelhamid Benazzouz, Jean François LeBas, Alim-Louis Benabid, Pierre Pollak
Journal: New England Journal of Medicine (2003)

Although the short-term benefits of bilateral stimulation of the subthalamic nucleus in patients with advanced Parkinson's disease have been well documented, the long-term outcomes of the procedure are unknown.We conducted a five-year prospective study of the first 49 consecutive patients whom we treated with bilateral stimulation of the subthalamic nucleus. Patients were assessed at one, three, and five years with levodopa (on medication) and without levodopa (off medication), with use of the Unified Parkinson's Disease Rating Scale. Seven patients did not complete the study: three died, and four were lost to follow-up.As compared with base line, the patients' scores at five years for motor function while off medication improved by 54 percent (P<0.001) and those for activities of daily living improved by 49 percent (P<0.001). Speech was the only motor function for which off-medication scores did not improve. The scores for motor function on medication did not improve one year after surgery, except for the dyskinesia scores. On-medication akinesia, speech, postural stability, and freezing of gait worsened between year 1 and year 5 (P<0.001 for all comparisons). At five years, the dose of dopaminergic treatment and the duration and severity of levodopa-induced dyskinesia were reduced, as compared with base line (P<0.001 for each comparison). The average scores for cognitive performance remained unchanged, but dementia developed in three patients after three years. Mean depression scores remained unchanged. Severe adverse events included a large intracerebral hemorrhage in one patient. One patient committed suicide.Patients with advanced Parkinson's disease who were treated with bilateral stimulation of the subthalamic nucleus had marked improvements over five years in motor function while off medication and in dyskinesia while on medication. There was no control group, but worsening of akinesia, speech, postural stability, freezing of gait, and cognitive function between the first and the fifth year is consistent with the natural history of Parkinson's disease.
Changing Patterns of Sedation and Monitoring Practice during Endoscopy: Results of a Nationwide Survey in Switzerland
Authors: L. T. Heuss, F. Froehlich, C. Beglinger
Journal: Endoscopy (2005)

Background and Study Aims: Little is known about how practices in sedation and in monitoring during gastrointestinal endoscopy and the complication rates of sedation have changed over time. The aim of this nationwide survey was to assess the present practice among Swiss gastroenterologists, with a particular focus on the use of propofol, and to compare the results with similar data obtained in 1990. Patients and Methods: At the end of 2003 a questionnaire (similar to the one used in 1990) was sent to all 249 Swiss gastroenterologists. The response rate was 72.3 %. Data from 179 953 endoscopies performed during the previous 12 months were analyzed for the study. Results: In 2003 sedation was used in 78 % of esophagogastroduodenoscopies and colonoscopies (compared with 60 % in 1990), with midazolam being the most commonly used medication. The drugs were mostly administered by the endoscopy nurse, via an intravenous cannula. Oximetry monitoring was used in more than 95 % of examinations (compared with 2.5 % in 1990). The overall sedation-related morbidity was 0.18 % and the mortality rate was 0.0014 %. Of the 180 respondents, 77 (43 %) reported that they been using propofol regularly for a median time period of 23 months. The 62 respondents (34 %) who used propofol without the assistance of an anesthesiologist had performed a total of 82 620 procedures. The morbidity (defined as the need for bag-ventilation) in this group of patients was 0.19 % and no deaths were reported. Conclusions: The use of sedation in gastrointestinal endoscopy has markedly increased over the last 13 years and the use of electronic monitoring has become standard practice. A significant percentage of Swiss gastroenterologists report that they use propofol, mainly in a hospital setting.
The Wernicke-Korsakoff Syndrome: A Clinical and Pathological Study of 245 Patients, 82 With Post-Mortem Examinations
Authors: Donald W. Goodwin
Journal: JAMA (1972)

ABSTRACT In 1881 Carl Wernicke described three patients who had delirium, ocular disturbances, and ataxia, but little else in common. One was a seamstress poisoned by sulfuric acid; two were alcoholic men. At autopsy, all were found to have similar brain lesions. Wernicke announced the discovery of a  disease. He called it hemorrhagic polioencephalitis. Others called it Wernicke's disease, showing what three cases can do for you if you are a well-known German professor.Six years later a well-known Russian professor, S. S. Korsakoff, also discovered a new disease, psychosis polyneuritica, which became known as Korsakoff's psychosis. It occurred in alcoholics (but not exclusively) and differed from Wernicke's disease in that the course was chronic rather than acute, and was characterized chiefly by amnesia.The possibility that Wernicke and Korsakoff had discovered the same disease was appreciated by neither. A few years later, Wernicke's assistant, Bonhoeffer, did see a connection.
Specialization, Subspecialization, and Subsubspecialization in Internal Medicine
Authors: Christine K. Cassel, David B. Reuben
Journal: New England Journal of Medicine (2011)

Over the past 75 years, many medical and surgical specialties have emerged. In this Sounding Board article, the authors outline the history of medical and surgical specialization and subspecialization and frame the issues faced by the public and the profession.
Induction of CXCR3- and CCR5-associated chemokines during acute hepatitis C virus infection
Authors: Marija Zeremski, Giles Hooker, Marla A. Shu, Emily Winkelstein, Queenie Brown, Don C. Des Jarlais, Leslie H. Tobler, Barbara Rehermann, Michael P. Busch, Brian R. Edlin, Andrew H. Talal
Journal: Journal of Hepatology (2011)
Back Pain: The History and Physical Examination
Authors: Michael I. Weintraub
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Deyo et al<sup>1</sup>minimized the most critical question: "Are these symptoms of low back pain related to litigation?" This is of fundamental importance since this segment of the population accounts for a disproportionate amount of cost, greater than 80%.<sup>2</sup>Despite the fact that chronic pain is the leading cause of disability in the United States, it has never been considered as a disease entity because of its many causes. However, it becomes apparent that this is a distinct symptom complex when ligitation is lurking in the background. In a prior study,<sup>3</sup>the contemporary profile of typical chronic pain sufferers is of patients who were disabled out of proportion to their initial injury or physical findings, over-investigated, moody, manipulative, litigious, and therapeutically unresponsive. A recent study of a cohort of 210 patients with chronic pain syndrome in litigation (worker's compensation cases excluded) was tabulated in
Hepatitis E Vaccine — Ready for Prime Time?
Authors: Krzysztof Krawczynski
Journal: New England Journal of Medicine (2007)

Large outbreaks of hepatitis E virus (HEV) infection were first recognized as a distinct clinical entity in the early 1980s.1,2 Outbreaks continue and involve thousands of patients in certain geographic regions of the world, including the Indian subcontinent, northwest China, and the Central Asian Republics (the former Soviet Union) — areas where HEV infection is endemic.3 HEV is transmitted predominantly through the fecal–oral route, and most reported outbreaks of infection have been related to the consumption of fecally contaminated drinking water; person-to-person transmission of the disease appears to be uncommon. There is a high attack rate in adults and . . .