tbuckley/cabot-search huggingface dataset:
What the educators are saying
Authors: Murray Lough
Journal: BMJ (2006)

In a rare editorial on medical education, two authors in the Lancet discuss why the specialty “struggles for recognition.” One reason, they say, is that much of the research lacks rigour; another is that individual studies are insufficiently informed by previous work.

The shaky position of research into medical education is evident in the debate on whether UK universities should include such research in their submissions for the 2008 research assessment exercise. Debate continues on how, and by whom, the submissions will be judged if it is included—and if it isn't, educational researchers' morale and motivation will plummet. Australia is grappling with similar issues with respect to the perceived importance of research into medical education and how much of its health and research funds should be allocated to it.

Chronic underfunding is cited as a further cause of the weak position of medical education research. In the UK there have been calls for 1.5% of the overall budget for medical education to be set aside for research and development. In the US, the Institute of …
Analysis of rates of globin synthesis in normal human fetuses and neonates and in twins
Authors: Merran B. Smith, M. N. Cauchi
Journal: American Journal of Hematology (1982)

The factors responsible for the switch from gamma- to beta-globin synthesis, which occurs in man in the perinatal period, are still unknown. In this study the relationship of fetal maturity (as measured by gestation age and fetal weight) to changing rates of globin synthesis was analyzed. The relationship of rates of erythropoiesis to the switch was also analyzed. Rates of globin chain synthesis were studied in blood from fetuses from 10-41 wk gestation, in neonates up to 6 mo of age, and in a series of twins from 29-40 wk gestation. The beta/gamma-globin synthesis ratio in fetal blood remained relatively constant until 30-34 wk gestation when an increase in beta-globin production was observed. Adult levels of globin synthesis were present in neonates at 6-9 wk after birth. The gamma/alpha-globin synthesis ratio showed a reciprocal change, falling after 30 wk gestation. Globin synthesis ratios in fetuses and neonates from 32-41 wk post-conception showed a significant correlation with age (beta/gamma: p less than 0.001; beta/alpha:p less than 0.001; gamma/alpha: p less than 0.05), and there were significant correlations between the beta/alpha and beta/gamma synthesis ratios and weight (p less than 0.05 for both ratios). Globin synthesis ratios in 12 sets of twins from 29-40 wk gestation were generally within the normal range for gestational age. However, the switch to beta-globin production was more advanced than expected from weight for some of these babies.
ER stress and autophagy: new discoveries in the mechanism of action and drug resistance of the cyclin-dependent kinase inhibitor flavopiridol
Authors: Emilia Mahoney, David M. Lucas, Sneha V. Gupta, Amy J. Wagner, Sarah E. M. Herman, Lisa L. Smith, Yuh-Ying Yeh, Leslie Andritsos, Jeffrey A. Jones, Joseph M. Flynn, Kristie A. Blum, Xiaoli Zhang, Amy Lehman, Hui Kong, Metin Gurcan, Michael R. Grever, Amy J. Johnson, John C. Byrd
Journal: Blood (2012)
Drug for low sexual desire carries significant harms, FDA advisers find
Authors: R. Moynihan
Journal: BMJ (2010)

A committee of advisers to the US Food and Drug Administration has unanimously rejected an application to approve the drug flibanserin for low sexual desire in premenopausal women.

Last month an 11 member advisory committee found that flibanserin’s manufacturer, Boehringer Ingelheim, had failed to show overall efficacy for its drug, which caused worrying side effects, including dizziness, fainting, and accidental injury, leading to almost one in seven women dropping out of clinical trials.

Final approval rests with the FDA, although it is considered unlikely to overturn its advisers’ unanimous rejection.

An experimental drug that affects neurotransmitters, including serotonin, flibanserin previously failed in trials as …
Q fever. A common treatable cause of endemic nonbacterial pneumonia
Authors: D. M. Musher
Journal: JAMA (1968)

In an area known for endemic Q fever, eight of 52 cases of nonbacterial pneumonia were proven to be caused by infection with Coxiella burnettii . Intimate contact with a possible source of infection was excluded in all patients and dust-borne transmission of the rickettsial organism from animal to man was implicated. Symptoms, physical findings, and laboratory and roentgenographic data were similar to those previously described in Q fever and were indistinguishable from those found in viral or mycoplasmal pneumonia. All patients treated with tetracycline showed a dramatic response within 24 hours. Q fever must be considered in the diagnosis whenever nonbacterial pneumonia occurs in late summer or early fall in an area where Q fever is endemic. Early diagnosis and treatment will significantly reduce morbidity.
Prospective Screening of Dyspeptic Patients by Helicobacter pylori Serology: A Safe Policy?
Authors: D. Vaira, V. Stanghellini, M. Menegatti, D. Palli, R. Corinaldesi, M. Miglioli
Journal: Endoscopy (1997)

Endoscopic screening of all dyspeptic patients is not cost-effective, nor is it feasible in many health-care delivery systems. To select the most appropriate candidates, various preendoscopic screening strategies have been proposed, some of which include Helicobacter pylori serology and patient age. We assessed the value of these two criteria in preendoscopic screening of a large series of dyspeptic patients, and compared the results obtained in a referral hospital (university center with an extensive H. pylori research program) with those in nonreferral hospital (participating centers that did not have such a program).Blood samples for determination of anti-H. pylori IgG antibody were collected from patients with uninvestigated dyspepsia undergoing endoscopy at one referral hospital and in 93 nonreferral hospitals throughout Italy. For IgG antibody assay, an in-house enzyme-linked immunosorbent assay (ELISA) technique was used in the referral hospital, while a commercial kit was used in the nonreferral hospitals.A total of 1638 patients were evaluated at the referral hospital (845 men and 793 women, mean age 46.1 years, range 18-89), and 3281 at the nonreferral hospitals (1718 men and 1563 women, mean age 48.8, range 18-96), respectively. If endoscopy had not been performed in patients who were seronegative for H. pylori and younger than 45 years, 19% versus 17.5% of the tests would have been avoided in the referral and nonreferral hospitals, respectively, while six of 304 ulcers (2%) and no cancers would have been missed versus 35 of 557 ulcers (6.3%) and two of 557 cancers (0.3%).A screening strategy based on age and H. pylori serology is a valid means of selecting dyspeptic patients for endoscopy; however, the policy needs further refinement for use in nonreferral hospitals.
Rejected Landmarks: The Smoke Goes On-Reply
Authors: Morton L. Levin
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Olsen's account is quite accurate, except that I was not a visitor at 535 N Dearborn, I had my office there, as director of the newly formed Commission on Chronic Illness. The rejection of the articles by both Levin et al and Wynder and Graham occurred. As it happened, my rejection slip was rerouted from my office in Albany, NY (from which I was on leave), and reached me at 535 N Dearborn. The anecdote regarding my role in persuading the editors to accept both articles has been told often and is referred to in a recent article in<i>Epidemiologic Reviews</i>by Dr Mervyn Susser.<sup>1</sup> An account of the history of the early days of the smoking "controversy," beginning with the skepticism it first received from most of the profession, needs writing. It is of interest that the Wynder and Graham article was at first given
Effect of volume loading, pressure loading, and inotropic stimulation on left ventricular torsion in humans.
Authors: D E Hansen, G T Daughters, E L Alderman, N B Ingels, E B Stinson, D C Miller
Journal: Circulation (1991)

BACKGROUND The transmural distribution of fiber angles and the extent of shortening among obliquely oriented fibers are likely to be major determinants of the twisting motion that accompanies left ventricular (LV) ejection. As such, measurements of torsion may provide useful information about LV contractile function, but other factors, such as ventricular loading conditions, may also regulate this motion. METHODS AND RESULTS Torsion angles (theta i) of midventricular and apical regions were measured relative to a reference minor axis near the base in seven human cardiac allografts from biplane radiographic images of metallic midwall markers. Pressure loading with methoxamine (5-10 muk/kg/min) increased LV end-systolic pressure by 41 +/- 14 mm Hg (p less than 0.0001). Volume loading with normal saline raised LV end-diastolic pressure from 9.9 +/- 5.2 to 19.6 +/- 4.9 mm Hg (p less than 0.0001). These alterations in LV loading conditions were associated with no change in theta i (difference not significant) for any marker site. Inotropic stimulation with dobutamine (5 micrograms/kg/min) increased values of theta i by as much as twofold (p less than 0.05); this response varied considerably depending on marker location, with the middle and apical inferior wall and the apical lateral wall being the most sensitive. When the marker site associated with the largest torsion angle (theta max) was considered in each patient, dobutamine increased theta max in all cases (25.2 +/- 10.5 degrees versus 15.8 +/- 7.7 degrees, p less than 0.001), whereas pressure and volume loading had negligible effects. This 59% increase in theta max was greater than that of conventional load-dependent indexes of LV systolic performance such as stroke volume (16%), ejection fraction (22%), and maximum rate of LV pressure rise (52%). CONCLUSIONS This component of LV motion is relatively insensitive to alterations in preload and afterload, while changes in contractile state influence LV torsion in a regionally heterogeneous manner. Quantification of LV torsion may, therefore, provide a sensitive and relatively load-independent measure of contractile performance that may prove to be useful in the serial assessment of LV function.
PREDICTORS OF LATE TARGET LESION REVASCULARIZATION AFTER ENDEAVOR AND RESOLUTE ZOTAROLIMUS–ELUTING STENT IMPLANTATION: 3D–INTRAVASCULAR ULTRASOUND AND ANGIOGRAPHIC ANALYSES
Authors: Hideki Kitahara, Teruyoshi Kume, Katsuhisa Waseda, Kenji Sakamoto, Ryotaro Yamada, Paul G. Yock, Alan C. Yeung, Peter J. Fitzgerald, Yasuhiro Honda
Journal: Journal of the American College of Cardiology (2013)
Better science not less science
Authors: A G Johnson, J M Simms
Journal: BMJ (1983)

High serum vitamin B12 binding capacity as a marker of the fibrolamellar variant of hepatocellular carcinoma SIR,-We were most interested to read the recent paper by Dr F J Paradinas and others (25 September, p 840), in which the authors suggest that estimation of both serum vitamin B,, and unsaturated vitamin B,, binding capacity may be useful in the investigation and management of such patients.
Endoscopic assessment of oesophageal disease.
Authors: G Little, H R Matthews
Journal: BMJ (1980)

only when there is no appropriate treatment for comparison.Invasive placebo treatment is unlikely ever to be justified. CONCLUSIONSThere is no one best design for all clinical trials.The choice for a specific trial must depend on the seriousness of the con- dition being treated, the nature of the treatments, the response time, the measures of outcome, and so on.The main ethical problem is balancing the interests of the individuals in the study with those of the much larger number who may benefit in the long term.But it is also vital that the research should provide useful results, and this may often be achieved best by a randomised study (double-blind if possible).If it is thought likely that highly favourable early results or a high incidence of side effects would argue in favour of premature termination of the study, then these considerations may be built in, using a sequential design.The ethical difficulties associated with the widespread use of a new treatment without a trial are far greater than those associated with the trial itself.The importance of good design, however, is reflected in the many examples of conflicting results that may be found in series of case-control studies of the same topic.16As a notable example, after 32 studies over 25 years there is still no consensus on the efficacy of anticoagulants following myocardial infarction.11
Thyroid Function Studies in the Nephrotic Syndrome
Authors: M. ALI AFRASIABI
Journal: Annals of Internal Medicine (1979)

Total serum and urinary thyroxine (T4), triiodothyronine (T3), and thyroxine-binding globulin (TBG) as well as serum free T4, thyroid-stimulating hormone (TSH), and T3 resin uptake (T3RU) were measured in seven patients with the nephrotic syndrome. The nephrotic syndrome was defined by proteinuria exceeding 3 g/24 h. All patients were clinically euthyroid. Most values for total serum T4, free T4, T3, T3RU, TBG, and TSH were within normal limits. However, the mean serum T3 and TBG values were significantly lower in patients compared with the control group. The values (mean ± 2 SD) for urinary T4 were 24.3 ± 20.3 in the patient group and 1.5 ± 0.7 µg/24 h in the control group. Urinary T3 values for patients and the control group were 2100 ± 856 and 848 ± 253 ng/24 h respectively. Urinary TBG was 2.1 ± 1.8 mg/24 h in the patients and undetectable in the control group. There was no correlation between daily urinary T3 and T4 and urinary TBG. There was a weak correlation between daily urinary protein excretion and urinary T4 (r = 0.5).
Operative Surgery: Fundamental International Techniques; Vascular Surgery
Authors: Alan T. Marty
Journal: JAMA (1977)

Distilling the best contributions of 21 experts, this internationally recognized atlas boldly ignores that dying breed known as "the occasional vascular surgeon." Illustrations of common operative exposures, for example, merely depict the skin incision and a final sketch of the pertinent vascular anatomy; the reader must know enough anatomy to safely get between the two stages diagramed. The trade-off for this lack of profusely labeled detailing comes in the greater coverage of unusual procedures, eg, the operative relief of superior vena caval obstruction, meralgia paraesthetica, or arterialization of the portal vein. In addition, a range of operative choices not often displayed in surgical atlases is achieved by the frequent inclusion of alternative approaches to each procedure. Hints on how to make things easier abound as well. For instance, during aortoceliac bypass the distal anastamosis is placed on the side of the splenic artery instead of into the less convenient main
Cholesterol: how low is low enough?
Authors: A Rosengren
Journal: BMJ (1998)

Not so very long ago many of us did not realise the importance of cholesterol lowering in patients with coronary disease. After the World Health Organisation's clofibrate trial1 many patients with hyperlipidaemia, with or without manifest coronary disease, were left without cholesterol lowering treatment. Now, after several large placebo controlled trials, the message is clear: patients with coronary disease and high or normal serum cholesterol concentrations benefit from cholesterol lowering treatment, by a 20-40% reduction in coronary events. 2 3 What remains less clear is by how much to lower those concentrations and whether it is the absolute concentration or the percentage reduction that matters most.

Current guidelines recommend a treatment goal for low density lipoprotein cholesterol of 2.6 mmol/l in patients with coronary disease. 4 5 However, statins, the most widely used drugs for cholesterol lowering, reduce cholesterol values not to a specific level but in proportion to pretreatment values. Thus the absolute reduction in concentration will be greater in patients with high initial values, but in these patients …
Treatment of Hidradenitis Suppurativa
Authors: Harry L. ARNOLD
Journal: JAMA (1973)

To the Editor.—  Dennis Shaughnessy and his surgical associates are extrapolating their argument for surgical resection of lesions of hidradenitis suppurativa much too far on the basis of two advanced, neglected cases. Surgery is indicated in such cases, of course, but to resort to it is a confession of failure to have treated the disease properly in its early stages.  Surgery is not indicated in early lesions; most cases can be controlled very well by a relatively brief period of intermittent steroid therapy—intralesional, when feasible; systemic, when not. Infection is a late complication, not a primary cause, of this disease.  The subtitle of this paper should have been A Plea for Operative Treatment in Late Cases.
Colonoscopy for unexplained rectal bleeding.
Authors: E T Swarbrick, D I Fevre, R H Hunt, B M Thomas, C B Williams
Journal: BMJ (1978)

Two hundred and thirty-nine patients underwent colonoscopy for unexplained rectal bleeding. Local anorectal conditions were excluded by digital and proctosigmoidoscopic examinations and results of barium studies were negative for all patients. A cause for bleeding was found in 95 patients. Thirty-nine had adenomatous polyps, 24 had unrecognised inflammatory bowel disease, and most importantly 23 (10% of series) had carcinomas. Forty patients had diverticular disease, but nine of them were found to have an adenomatous polyp and four a carcinoma. Colonoscopy can contribute positively to the investigation and treatment of unexplained rectal bleeding and may prevent unnecessary laparotomy.
Reply to Carsten Stephan et al’s Letter to the Editor re: Felix K.-H. Chun, Markus Graefen, Alberto Briganti, Andrea Gallina, Julia Hopp, Michael W. Kattan, Hartwig Huland and Pierre I. Karakiewicz. Initial Biopsy Outcome Prediction—Head-to-Head Comparison of a Logistic Regression-Based Nomogram versus Artificial Neural Network. Eur Urol 2007;51:1236–43
Authors: Felix K.-H. Chun, Markus Graefen, Alberto Briganti, Andrea Gallina, Julia Hopp, Hartwig Huland, Pierre I. Karakiewicz
Journal: European Urology (2006)
Is the NHS getting better or worse?: Role of information in assessing quality is undervalued
Authors: M. J Rigby
Journal: BMJ (2004)

EDITOR—Smith's editorial on assessing quality of and in the English NHS underscored the essential role of good information at all levels.1 It appeared on the same day that the Nuffield Trust launched a volume of essays on the importance of vision, value, and innovation in health information.2

However, the editorial perpetuated the frequent confusion between information and data and assumed that …
Combined airway and oesophageal stenting in malignant airway–oesophageal fistulas: a prospective study
Authors: F.J.F. Herth, S. Peter, F. Baty, R. Eberhardt, J.D. Leuppi, P.N. Chhajed
Journal: European Respiratory Journal (2010)

Malignant airway-oesophageal fistulas (AEF) are a serious complication of advance oesophageal or lung cancer. The aim of this study was to assess the quality of life before and after stent insertion, and to examine the role of treatment and location of AEF as factors influencing survival in AEF patients managed with airway and/or oesophageal stent insertion. 112 patients with AEF were included prospectively. 83 (74%) patients had advanced lung cancer and 29 (26%) patients had oesophageal cancers. Airway stents were inserted in 65 (58%) patients, oesophageal stents in 37 (33%) patients, and both airway and oesophageal stents in 10 (9%) patients. Seven (6%) patients developed respiratory failure and required transient ventilator support in the intensive care unit (four patients with airway stenting, two patients with double stents and one patient in the oesophageal stenting group). None of the patients developed stent migration or needed stent repositioning. Overall, mean survival was 236.6 days (airway stent 219.1 days, oesophageal stent 262.8 days and combined airway-oesophageal stent 252.9 days). Backward, stepwise regression revealed the site of stent placement (airway and/or oesophagus; p < 0.028), exact location of the fistula in airway (p = 0.011) and additional treatment with chemotherapy and/or radiation (p < 0.001) as independent risk factors predicting increased survival. The mean quality of life score (QoL) was 81 prior to stent insertion and 72 post-stent insertion (p < 0.001). Airway and/or oesophageal stent insertion provides an effective approach to improve the QoL in patients with malignant AEF.
Robert Irvine Wilson
Authors: James Nixon
Journal: BMJ (2008)

Robert Irvine Wilson (“Bob”) was the leading figure in the development of orthopaedic surgery in Northern Ireland. Born in 1915, he was a scholarship pupil at Royal Belfast Academical Institution and later graduated from Queen’s University, Belfast, in 1938. He was a house officer in the Royal Victoria Hospital and married Kathleen at this time. After the outbreak of war he enlisted in the Royal Army Medical Corps and served from 1940 to 1946. He had a very active service career but was always reticent when talking about it. He was attached to 152 Field Ambulance, part of the Irish Brigade, seeing active service with the 8th Army in North Africa, in the assault on Sicily, and in the long battle for Italy. He was demobilised in Austria with the rank of lieutenant colonel.

His war service was notable: he was awarded the military MBE in 1944 for “gallantry and distinguished services in Italy,” and also wore the Africa Star, the Italy Star, and the 1939-45 Star. Always a modest man, this experience guided him in the direction of orthopaedic surgery.

In 1947 he …
A Patient With a Biventricular Pacemaker Presenting With Chest Pain
Authors: Brooks M. Walsh, Rehan Karim, Stephen W. Smith
Journal: JAMA Internal Medicine (2015)

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 Internal Medicine 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 Internal Medicine journal
"THE PASSING OF THE PESSARY"
Authors: William R. Nicholson
Journal: JAMA (1928)

<h3>To the Editor:</h3> —The editorials inThe Journalare of a high order and do a great deal of good through the influence which they undoubtedly have. Therefore I am taking this occasion to express my disapprobation of an editorial on the "Passing of the Pessary," which appears in the number for April 14. This editorial is a wonderful argument against the separation of obstetrics from true gynecology in teaching and practice. As I am in charge of two hospital gynecologic services I am not afraid that it wilt be thought that I am averse to operation whenever there are real indications. Certain statements in this editorial, however, are so at variance with those held by a number of expert obstetricians and gynecologists, and so diametrically opposed to the teaching given in my department in the Graduate School of Medicine of the University of Pennsylvania, which department includes both obstetrics