tbuckley/cabot-search huggingface dataset:
Diagnosis of Myocardial Infarction by Emergency Department Physicians-Reply
Authors: Andrew J. Doorey
Journal: JAMA (1993)

To the Editor.  —In their article on thrombolytic therapy, Doorey et al 1 state that the accuracy of electrocardiographic (ECG) diagnosis has been improved with the official electrocardiographer interpretation compared with that by emergency department physicians (EDPs). They suggest that ECGs be faxed to electrocardiographers for accurate readings in order to increase the number of eligible patients for thrombolytic therapy in the setting of possible acute myocardial infarction (AMI). However, the studies cited do not support such statements. In the study by Lee et al, 2 readings by the EDPs were compared with those of electrocardiographers. These were not prospective blinded interpretations. Electrocardiographers had both subsequent clinical course information and evolving ECGs at their disposal. Their readings were more accurate as would be expected with the 20/20 vision of hindsight. The study in no way supports the notion that the accuracy of ECG readings was improved in real time. The
Lawyer threatens action against GMC after undercover staff attended confidential discussions with her client
Authors: C. Dyer
Journal: BMJ (2014)

A solicitor has threatened legal action against the General Medical Council (GMC) after discovering that she and her client, who had made a complaint against a doctor, were shadowed on GMC premises by undercover security guards.

Melinda Nettleton alleged that her client’s case was prejudiced by the presence of the guards, whose real identity was known to the doctor, the barristers, and the committee deciding the outcome of the case—but not to her or her client. 

Nettleton claimed that the man and woman, who said that they were doing work experience, listened in on conversations between her and her client, which should have been protected by legal privilege. The GMC admitted having used security …
OBSTETRICAL PRACTICE IN CIVIL WAR TIMES
Authors: Gordon W. Jones
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Occupational and Environmental Health History
Authors: Rose H. Goldman
Journal: JAMA (1981)

Occupational and environmental diseases frequently masquerade as routine medical disorders. Yet environmental factors rarely enter into the clinician's differential diagnosis. This article provides a sequence of steps that can be used by the practicing physician for detecting occupational diseases: Step 1: Routine screening questions for all patients (List of job titles? Exposure to fumes, dusts, chemicals, loud noise, or radiation? Temporal relationship of the chief complaint to activities at work or at home?). Step 2: Consideration of sources of exposure (workplace or home surroundings). Step 3: Identification and handling of the hazardous agent. Step 4: Follow-up, consultation, and resolution of the problem. Equipped with this approach, the clinician can play an important role in the detection and prevention of occupational- and environmental-related diseases. (<i>JAMA</i>1981;246:2831-2836)
Nitrogen dioxide exposure impairs the frequency of the mucociliary activity in healthy subjects
Authors: R Helleday, D Huberman, A Blomberg, N Stjernberg, T Sandstrom
Journal: European Respiratory Journal (1995)

In previous studies, we have reported bronchoalveolar lavage (BAL) findings following single and repeated exposures to NO2. Here, we present the first data on measurements of the frequency of the mucociliary activity in healthy subjects following exposure to NO2. Twenty four healthy nonsmoking volunteers underwent fibreoptic bronchoscopy, during which mucociliary activity was measured using an in vivo method based on a two-way fibreoptic system, to obtain baseline data. Two weeks later, the subjects were reinvestigated following NO2 exposure. Eight volunteers were investigated 45 min after a 20 min exposure to 1.5 ppm NO2 (Group A); eight subjects 45 min after a 20 min exposure to 3.5 ppm NO2 (Group B); and eight subjects 24 h after a 4 h exposure to 3.5 ppm NO2 (Group C). No activity was detected in Group A or B 45 min after exposure, in contrast to the easily identifiable mucociliary activity waves at the reference bronchoscopy. In group C, a significant elevation of the frequency of the mucociliary activity waves was seen at 24 h. It is concluded that short-term exposure to NO2 in man produces a significant reduction in the mucociliary activity 45 min after exposure. The effect ceases within 24 h. Further studies are needed to evaluate the effects of repeated exposures with NO2 on mucociliary activity in man.
821-1 Should beta-blockers be used before angiotensin converting enzyme inhibitors in patients with chronic heart failure? Meta-analysis of the prognostic benefit conferred by beta-blockers in patients not receiving ACE inhibitors
Authors: Henry Krum, Steven Haas, Jalal Ghali, Edward Gilbert, Phillipe Lechat, Mary-Ann Lukas, Milton Packer, Ellen Roecker, Patricia Verkenne, Hans Wedel, John Wikstrand
Journal: Journal of the American College of Cardiology (2004)
On the Pain of Ataxy and its Relief
Authors: J. Althaus
Journal: BMJ (1871)

In this case the patient had been vaccinated when an infant, and the arm showed three fairly good cicatrices.This fact does not corroborate a statement made at the Clinical Society a few weeks ago, to the effect that a purpurous eruption in small-pox after vaccination has no unfa- vourable import; for here it clearly indicated a very malignant form of disease.
Cytohormonal Findings and High Estrogen Levels
Authors: Alexander Meisels
Journal: JAMA (1967)

To the Editor:—  In reply to an inquiry, Inhorn ( 199 :348, 1967) stated that cytohormonal findings of relatively high estrogen levels after menopause could be explained either by infection, vaginal abnormalities, or certain neoplasms, or else by the cytopathologist's faulty criteria for cytohormonal determination.  I would like to point out that in a recent cytohormonal study of a large group of women after menopause ( Acta Cytol  10 :49, 1966) I reported that about half had estrogen levels comparable to those found during the reproductive years. Only 21% of the 5,920 patients in this group ever showed actual atrophy. These results, as well as those of many other workers in this field, have demonstrated that adequate estrogen levels, presumably maintained through adrenocortical activity, are rather frequent and should not be considered an exceptional finding in the postmenopausal woman. I believe this point deserves to be stressed in view of the present
Case of Congenital Hydronephrosis: Nephrotomy and Drainage: Recovery
Authors: J. T. Shirlaw
Journal: BMJ (1901)

IA D O EH OI 3Enuckation of Muscle from Ut. Sheath Outwards.-The inner divided ed e oaf te sheath is picked up with dissecting forceps, and, by means of the hiandle of' the knife and the 'forefinger, the inner part of the muscle 'is readily enucleated from its attachments to the sheath anteriorly, inter- nally, and posteriorly.Care must be taken that, at the level of the fold of Douglas, posteriorly and for an inch or so above, the deep epigastric vessels be carried outwards on the under surface of the muscle.In the
Inhibition of protein kinases A and C demonstrates dual modes of response in human eosinophils stimulated with platelet-activating factor
Authors: Takumi Takizawa, Masahiko Kato, Hirokazu Kimura, Masato Suzuki, Atsushi Tachibana, Hideru Obinata, Takashi Izumi, Kenichi Tokuyama, Akihiro Morikawa
Journal: Journal of Allergy and Clinical Immunology (2002)
Immune insufficiency during GVHD is due to defective antigen presentation within dendritic cell subsets
Authors: Kate A. Markey, Motoko Koyama, Rachel D. Kuns, Katie E. Lineburg, Yana A. Wilson, Stuart D. Olver, Neil C. Raffelt, Alistair L. J. Don, Antiopi Varelias, Renee J. Robb, Melody Cheong, Christian R. Engwerda, Raymond J. Steptoe, Hayley S. Ramshaw, Angel F. Lopez, Javier Vega-Ramos, Andrew M. Lew, Jose A. Villadangos, Geoffrey R. Hill, Kelli P. A. MacDonald
Journal: Blood (2012)
Adjuvant Therapy in Patients With Resected Poor-Risk Head and Neck Cancer
Authors: Jacques Bernier, Jan B. Vermorken, Wayne M. Koch
Journal: Journal of Clinical Oncology (2006)

In patients with locally or regionally advanced head and neck carcinomas, postoperative radiotherapy has historically been the adjuvant therapy applied for patients with prognostically worrisome pathologic features. Any improvement in therapeutic index achieved by adding cytotoxic agents to postoperative radiotherapy remained controversial. However, two recent randomized trials, conducted in parallel in Europe and the United States, produced level I evidence regarding improved efficacy in this setting for the concurrent administration of chemotherapy and radiotherapy. High-dose cisplatin and irradiation can now be considered the standard therapeutic approach for resected poor-risk disease. The presence of positive margins and/or nodal extracapsular spread in the surgical specimens are the subgroups that appear to benefit in the most significant way from the addition of chemotherapy to radiation. Many questions regarding the optimization of adjuvant treatments still remain unanswered, especially with respect to improvement of patient compliance, integration of novel drugs targeting both locoregional and systemic control, and modulation of treatment intensity according to risk levels.
Immature <i>Plasmodium falciparum</i> gametocytes in bone marrow
Authors: Abbas Hashim Abdulsalam, Nafila Sabeeh, Barbara J. Bain
Journal: American Journal of Hematology (2010)

A 50-year-old Iraqi man presented with splenomegaly and pyrexia of unknown origin. A bone marrow aspirate was done as part of the investigations and unexpectedly showed Plasmodium falciparum parasites. Malaria had not been suspected as this condition is now rare in Iraq but it subsequently transpired that the patient had recently visited Pakistan. The gametocytes that are observed in the bone marrow differ from those that are observed in the blood, being less mature [1]. The immature gametocytes that are seen include some that are sail-shaped, spindle-shaped or oval (top) rather than the crescent-shaped macrogametocyte and sausage-shaped microgametocyte that are usually observed in the blood. This reflects the fact that gametocytes develop in the internal organs, including the bone marrow, rather than in the circulating blood. Photographs of the bone marrow of this patient show sail-shaped (left), spindle-shaped (centre) and oval (right) immature gametocytes. Some mature gametocytes were also present.
Coagulation defects and altered hemodynamic responses in mice lacking receptors for thromboxane A2.
Authors: D W Thomas, R B Mannon, P J Mannon, A Latour, J A Oliver, M Hoffman, O Smithies, B H Koller, T M Coffman
Journal: Journal of Clinical Investigation (1998)

Thromboxane A2 (TXA2) is a labile metabolite of arachidonic acid that has potent biological effects. Its actions are mediated by G protein-coupled thromboxane-prostanoid (TP) receptors. TP receptors have been implicated in the pathogenesis of cardiovascular diseases. To investigate the physiological functions of TP receptors, we generated TP receptor-deficient mice by gene targeting. Tp-/- animals reproduce and survive in expected numbers, and their major organ systems are normal. Thromboxane agonist binding cannot be detected in tissues from Tp-/- mice. Bleeding times are prolonged in Tp-/- mice and their platelets do not aggregate after exposure to TXA2 agonists. Aggregation responses after collagen stimulation are also delayed, although ADP-stimulated aggregation is normal. Infusion of the TP receptor agonist U-46619 causes transient increases in blood pressure followed by cardiovascular collapse in wild-type mice, but U-46619 caused no hemodynamic effect in Tp-/- mice. Tp-/- mice are also resistant to arachidonic acid-induced shock, although arachidonic acid signifi-cantly reduced blood pressure in Tp-/- mice. In summary, Tp-/- mice have a mild bleeding disorder and altered vascular responses to TXA2 and arachidonic acid. Our studies suggest that most of the recognized functions of TXA2 are mediated by the single known Tp gene locus.
BASELINE SYSTOLIC BLOOD PRESSURE AND OUTCOMES IN PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION - RESULTS FROM THE I-PRESERVE TRIAL
Authors: Inderjit S. Anand, Scott J. Hetzel, Alan B. Miller, Peter E. Carson, William H. Gaasch, Markus Haass, William C. Little, Jose Lopez-Sendon, Barry M. Massie, John J. McMurray, Agata Ptaszynska, John R. Teerlink, Michel White, Michael R. Zile
Journal: Journal of the American College of Cardiology (2010)
Progressive improvement in pulmonary vascular resistance after percutaneous mitral valvuloplasty.
Authors: M J Levine, J S Weinstein, D J Diver, A D Berman, R M Wyman, M J Cunningham, R D Safian, W Grossman, R G McKay
Journal: Circulation (1989)

Percutaneous mitral valvuloplasty has been proposed as a nonsurgical technique for treating high-risk patients with mitral stenosis who are deferred from mitral valve replacement. The effect of this technique on patients with pulmonary hypertension, however, has not been fully evaluated. Accordingly, serial assessment of pulmonary vascular resistance was made in 14 patients with critical mitral stenosis and pulmonary hypertension (pulmonary vascular resistance greater than 250 dynes.sec/cm5 or mean pulmonary artery pressure greater than 40 mm Hg or both) who underwent percutaneous balloon dilatation of the mitral valve. Balloon valvuloplasty was performed with either one (n = 10) or two (n = 4) balloons through the transseptal approach, and it resulted in significant improvement in mean mitral gradient (from 18 +/- 4 to 9 +/- 4 mm Hg, p less than 0.001), systemic blood flow (from 3.7 +/- 1.2 to 5.0 +/- 2.2 l/min, p less than 0.001), and calculated mitral valve area (from 0.7 +/- 0.2 to 1.6 +/- 0.7 cm2, p less than 0.001). Immediately after balloon mitral valvuloplasty, pulmonary vascular resistance fell from 630 +/- 570 to 447 +/- 324 dynes.sec/cm5. Repeat catheterization 7 +/- 4 months after valvuloplasty showed further improvement of pulmonary hypertension in 12 of the 14 patients, with a mean pulmonary vascular resistance for the group as a whole of 280 +/- 183 dynes.sec/cm5, p less than 0.005. In two patients, mitral valve restenosis to a mitral valve area less than 1.0 cm2 was associated with a return of pulmonary hypertension to predilatation values.(ABSTRACT TRUNCATED AT 250 WORDS)
Variability in Bone Mass Measurement-Reply
Authors: Robert R. Recker
Journal: JAMA (1993)

In Reply.  —Drs Kannus and Sievanen question the statistical significance of the findings of gain of bone mass in the third decade of life in women because of the wide range of the 95% CIs. In addition, they asked for a parametric statistical analysis of the results because of their skepticism about the validity of median values and nonparametric tests. The mean slopes (percentage per decade ±SD) were 4.82%±21.17% and 2.96%±18.32% for forearm bone mineral content and bone mineral density, respectively, 5.54%± 15.70% and 6.06%±15.07% for spinal bone mineral content and bone mineral density, respectively, and 12.62%±14.17% for whole body bone mineral content.  In fact, we performed parametric tests ( t  test) of the mean slopes and found them all to show significant increases in bone mass during the third decade. However, the tests of normality showed that the data were not normally distributed. While the t test is fairly robust,
Oral contraceptives and myocardial infarction in young women: a further report.
Authors: J I Mann, M Thorogood, W E Waters, C Powell
Journal: BMJ (1975)

14 myocardial infarction patients in Wesse, England, between 31-44 years were investigated to determine if there was a correlation between myocardial infarction and oral contraceptive use. Data were combined and compared with that of a similar previous study in 1968-1972 of 58 women in 2 areas of England and Wales. Compared with the control group, a significantly higher proportion of infarction patients displayed histo ries of oral contraceptive use during the month prior to myocardial infarction (MI) who were using oral contraceptives in the month prior to admission to those not currently using them was an estimated 4.2:1. This ratio includes other risk factors such as cigarette smoking and hypertension. The removal of these risk factors for MI decreases the risk ratio for oral contraceptive users to 3.1:1. The results from the Wessex region investigation were similar to the expected results from England and Wales but because numbers were so small, they are statistically insignificant. The findings confirm that an association exists between oral contraceptive use and myocardial infarction in young women.
Hypopituitarism after extracranial irradiation: evidence for hypothalamic origin.
Authors: R G Larkins, F I Martin
Journal: BMJ (1973)

by improving tissue perfusion and causing activated platelets to return to their normal morphology (Gilroy et al., 1969). Haemoconcentration, which may be accompanied by cerebral oedema, is a feature of severe decompression sickness, and plasma expansion alone has been used successfully in two cases (Brunner et ah, 1964). In the present case the initial packed cell volume was 48%, suggesting haemoconcentration and cerebral oedema, and thus mannitol was given. The use of heparin in fat embolism has been described (Cobb et al., 1968), its actions on lipoprotein lipase and plate lets probably being the most important. Heparin has also been used successfully as adjuvent therapy to recompression in five cases (Barth?l?my, 1963). Also rapidly decompressed dogs when treated with heparin (2 mg/kg) have shown 100% survival, while the controls died (Pauley and Cockett, 1970). In the present case 100% oxygen was given to counteract the patient's arterial hypoxaernia, which may have been caused by microemboli in the pulmonary circulation, and to increase the capillary-alveolar diffusion gradient for nitrogen elimin ation. At present, recompression is the only generally accepted treatment for type II decompression sickness. The rationale for medical treatment of such cases, however, is supported by the successful management of this patient.
An Ethical Debate: A legal comment
Authors: R. Francis
Journal: BMJ (1995)

The concern that elective ventilation of an unconscious patient before death occurs may be unlawful is well founded and echoes the views of academic commentators.1 2

There is a distinction between the rights in respect of a dead body and a living patient. After death, provided the statutory requirements are complied with,3 it is lawful to remove organs for donation. Failure to comply with those requirements may be a criminal offence4 5 or a tort, but when removal of organs is so justified, postmortem steps to preserve the body for that purpose …
Functional Significance of Wnt Inhibitory Factor-1 Gene in Kidney Cancer
Authors: Kazumori Kawakami, Hiroshi Hirata, Soichiro Yamamura, Nobuyuki Kikuno, Sharanjot Saini, Shahana Majid, Yuichiro Tanaka, Ken Kawamoto, Hideki Enokida, Masayuki Nakagawa, Rajvir Dahiya
Journal: Cancer Research (2009)

Abstract Wnt inhibitory factor-1 (WIF-1) has been identified as one of the secreted antagonists that bind Wnt protein. WIF-1 has been described as a tumor suppressor in various types of cancer. However, the molecular function of WIF-1 gene has never been examined in human renal cell carcinoma (RCC). Therefore, we hypothesized that WIF-1 functions as a tumor suppressor gene and overexpression of this gene may induce apoptosis and inhibit tumor growth in RCC cells. Immunohistochemistry and real-time reverse transcription-PCR revealed that WIF-1 was significantly downregulated in RCC samples and RCC cell lines, respectively. Bisulfite sequencing of the WIF-1 promoter region in RCC cell lines showed it to be densely methylated, whereas there was no methylation of WIF-1 promoter in normal kidney. Significant inhibition of cell growth and colony formation in WIF-1–transfected cells compared with controls were observed. WIF-1 transfection significantly induced apoptosis and suppressed in vivo tumor growth. Also, Wnt signaling activity and β-catenin expression were reduced by WIF-1 transfection. In conclusion, this is the first report documenting that the WIF-1 is downregulated by promoter methylation and functions as a tumor suppressor gene by inducing apoptosis in RCC cells. [Cancer Res 2009;69(22):8603–10]
Should Perimenopausal Women Be Screened for Osteoporosis?
Authors: STEVEN R. CUMMINGS
Journal: Annals of Internal Medicine (1986)

The increasing availability of noninvasive methods for measuring bone mass raises the issue of whether perimenopausal women should routinely have such measurements to identify those at risk for osteoporotic fractures of the hip, wrist, and spine. Although the mortality and morbidity caused by hip fractures would warrant routine screening, measurement of bone mass has uncertain value in assessing the risk for hip fracture. Wrist fractures generally cause only transient disability, and measurement of bone mass may not reliably predict risk. Measurements of bone density of the spine might be better able to assess a woman's risk for vertebral fractures, but the value of screening depends on whether the findings would affect a woman's decision about using estrogen therapy after menopause. Serial measurements of bone mass to estimate a woman's rate of bone loss are relatively imprecise, increase the cost of screening, and have at best a limited role in screening women to assess risk for osteoporotic fractures.
Welsh GPs resign from community hospitals
Authors: Roger Dobson
Journal: BMJ (2004)

Twenty seven GPs providing services at a Welsh community hospital have resigned.

The move by the GPs at Chepstow Community Hospital comes in the wake of concerns over the lack of a national deal in Wales on pay and conditions for GPs who provide services for 50 of the 60 community hospitals in the principality.

GPs in other areas of Wales may follow the action of the Chepstow doctors, which has helped to highlight concerns about the way GPs have been funded for working in community hospitals. Many GPs have already sent letters saying that they want to stop working in these hospitals.

“This is …
ULBPs, Novel MHC Class I–Related Molecules, Bind to CMV Glycoprotein UL16 and Stimulate NK Cytotoxicity through the NKG2D Receptor
Authors: David Cosman, Jürgen Müllberg, Claire L. Sutherland, Wilson Chin, Richard Armitage, William Fanslow, Marek Kubin, N.Jan Chalupny
Journal: Immunity (2001)
The value of data
Authors: Barend Mons, Herman van Haagen, Christine Chichester, Peter-Bram 't Hoen, Johan T den Dunnen, Gertjan van Ommen, Erik van Mulligen, Bharat Singh, Rob Hooft, Marco Roos, Joel Hammond, Bruce Kiesel, Belinda Giardine, Jan Velterop, Paul Groth, Erik Schultes
Journal: Nature Genetics (2011)