tbuckley/cabot-search huggingface dataset:
The Proper Definition of the General Internist
Authors: Gerry N. Boccarossa
Journal: Annals of Internal Medicine (1993)

Letters1 September 1993The Proper Definition of the General InternistGerry N. Boccarossa, MD and Susan G. Boccarossa, MDGerry N. Boccarossa, MDSearch for more papers by this author and Susan G. Boccarossa, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-5-199309010-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As general internists practicing in a rural area, we feel that the position paper [1] on the development and need for well-trained general internists does not address the fundamental issues. First, the definition of a general internist is unclear. Is it what an internist is supposed to be, what an internist is perceived to be, or what an internist does in daily practice? The latter varies by region and community. An internist in a suburb in the Northeast is partly defined by what subspecialists do. Board certification in cardiology may be required to read hospital electrocardiograms or ...REFERENCE1. Federated Council for Internal Medicine. General internal medicine and general internists: recognizing a national need. Ann Intern Med. 1992; 117:778-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByA Distinguishing FeatureA distinguishing feature 1 September 1993Volume 119, Issue 5Page: 439-440KeywordsElectrocardiographyHealth carePerceptionResidencyRural areasSub-specialty careTraditional medicineVentilators Issue Published: 1 September 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Persecution of academics in Turkey
Authors: I. Marks, J. Bicknell, K S Bluglass, M. Bond, S. Brandon, R H Cawley, D Eccleston, G. Edwards, J L Gibbons, P. J Graham, S R Hirsch, R E Kendell, I Kolvin, W A Lishman, R H S Mindham, I. Oswald, E S Paykel, K Rawnsley, M. Roth, F H Stone, D Taylor, W H Trethowan, A Wakeling, J P Watson
Journal: BMJ (1984)

risk of giving double the usual starting dose of a new agent in conjunction with the underlying benorylate should have been considered potentially dangerous.That these patients were both in their 70s should have invited particular care.Regardless of the attributes, or otherwise, of Osmosin or any new anti-inflammatory agent, it is unfortunate that a new drug should fall into disrepute as a result of inadequate attention to dosage, unwarranted polypharmacy, or lack of concern for the patient's age.
ACUTE AND MID-TERM RESULTS FROM A FIM/APPROVAL TRIAL OF A 2ND GENERATION TRANSFEMORAL AORTIC BIOPROSTHESIS FOR THE TREATMENT OF PATIENTS WITH SEVERE AORTIC STENOSIS
Authors: Helge Möllmann, Patrick Diemert, Joerg Kempfert, Hendrik Treede, Eberhard Grube, Georg Nickenig, Stephan Baldus, Dimytri Siqueira, Thomas Walther, Alexandre Abizaid
Journal: Journal of the American College of Cardiology (2014)
Management of Recalled Pacemakers and Implantable Cardioverter-Defibrillators
Authors: Mitesh S. Amin, David B. Matchar, Mark A. Wood, Kenneth A. Ellenbogen
Journal: JAMA (2006)

ContextLimited information exists to direct clinical management after an implantable device has been put under advisory. A better understanding of the risks and benefits of device replacement compared with continued clinical follow-up would be helpful to clinicians.ObjectiveUsing the tools of decision analysis, to determine the best management approach (immediate device replacement vs continued monitoring) in the setting of a device advisory.DesignA decision model was constructed to evaluate the risks and benefits associated with immediate device replacement compared with continued monitoring.Main Outcome MeasuresVariables considered included indications for device implantation, anticipated course following device failure, device failure rates from the advisory ranging from 0.0001% to 1.0% per year, and device replacement mortality rates ranging from 0.10% to 1.00% per procedure. Device replacement was preferred to continued follow-up when replacement led to greater patient survival.ResultsThe decision to replace a recalled device depends primarily on the advisory's estimated device failure rate and the likely effects of device failure on mortality. Procedural mortality is an important secondary factor, while patient age and remaining generator life have the least influence on the decision. For pacemaker-dependent patients, advisory device failure rates exceeding 0.3% warrant device replacement in most situations. In patients with implantable cardioverter-defibrillators for primary or secondary prevention, a failure rate associated with an advisory of 3.0% is needed to favor replacement in most cases, decreasing to close to 1.0% as procedural mortality rates decrease to 0.1% or risk of fatal arrhythmias increase to near 20% per year. In cases of pacemaker implantation for non–life-threatening situations (eg, carotid sinus hypersensitivity), most device advisories do not warrant device replacement.ConclusionsThe decision to replace a device under advisory is determined primarily by the incidence of device malfunction and the likely effects of device failure. This analysis provides a framework for managing recalled devices in the context of device, patient, and institutional characteristics.
Finding My Way to Electronic Health Records
Authors: Regina Benjamin
Journal: New England Journal of Medicine (2010)

The recent oil spill off the Gulf Coast may prove to be one of the great environmental challenges of our lifetime. It is yet another devastating blow to the Gulf region, a place I call home. My heart goes out to the people there who are concerned about how this latest disaster will affect their livelihood and their health. Though the full effects of the spill remain to be seen, already the health needs of Gulf Coast inhabitants are increasing during this time of crisis. Physicians in the area will need to adapt and find innovative ways to efficiently deliver . . .
HIV Development Assistance and Adult Mortality in Africa
Authors: Eran Bendavid, Charles B. Holmes, Jay Bhattacharya, Grant Miller
Journal: JAMA (2012)

<h3>Context</h3>The effect of global health initiatives on population health is uncertain. Between 2003 and 2008, the US President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative ever devoted to a single disease, operated intensively in 12 African focus countries. The initiative's effect on all-cause adult mortality is unknown.<h3>Objective</h3>To determine whether PEPFAR was associated with relative changes in adult mortality in the countries and districts where it operated most intensively.<h3>Design, Setting, and Participants</h3>Using person-level data from the Demographic and Health Surveys, we conducted cross-country and within-country analyses of adult mortality (annual probability of death per 1000 adults between 15 and 59 years old) and PEPFAR's activities. Across countries, we compared adult mortality in 9 African focus countries (Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, Tanzania, Uganda, and Zambia) with 18 African nonfocus countries from 1998 to 2008. We performed subnational analyses using information on PEPFAR's programmatic intensity in Tanzania and Rwanda. We employed difference-in-difference analyses with fixed effects for countries and years as well as personal and time-varying area characteristics.<h3>Main Outcome Measure</h3>Adult all-cause mortality.<h3>Results</h3>We analyzed information on 1 538 612 adults, including 60 303 deaths, from 41 surveys in 27 countries, 9 of them focus countries. In 2003, age-adjusted adult mortality was 8.3 per 1000 adults in the focus countries (95% CI, 8.0-8.6) and 8.5 per 1000 adults (95% CI, 8.3-8.7) in the nonfocus countries. In 2008, mortality was 4.1 per 1000 (95% CI, 3.6-4.6) in the focus countries and 6.9 per 1000 (95% CI, 6.3-7.5) in the nonfocus countries. The adjusted odds ratio of mortality among adults living in focus countries compared with nonfocus countries between 2004 and 2008 was 0.84 (95% CI, 0.72-0.99; P = .03). Within Tanzania and Rwanda, the adjusted odds ratio of mortality for adults living in districts where PEPFAR operated more intensively was 0.83 (95% CI, 0.72-0.97; P = .02) and 0.75 (95% CI, 0.56-0.99; P = .04), respectively, compared with districts where it operated less intensively.<h3>Conclusions</h3>Between 2004 and 2008, all-cause adult mortality declined more in PEPFAR focus countries relative to nonfocus countries. It was not possible to determine whether PEPFAR was associated with mortality effects separate from reductions in HIV-specific deaths.
Role of the Protein Kinase C-ε–Raf-1–MEK-1/2–p44/42 MAPK Signaling Cascade in the Activation of Signal Transducers and Activators of Transcription 1 and 3 and Induction of Cyclooxygenase-2 After Ischemic Preconditioning
Authors: Yu-Ting Xuan, Yiru Guo, Yanqing Zhu, Ou-Li Wang, Gregg Rokosh, Robert O. Messing, Roberto Bolli
Journal: Circulation (2005)

Although Janus kinase (JAK)-mediated Tyr phosphorylation of signal transducers and activators of transcription (STAT) 1 and 3 is essential for the upregulation of cyclooxygenase-2 (COX-2) and the cardioprotection of late preconditioning (PC), the role of Ser phosphorylation of STAT1 and STAT3 in late PC and the upstream signaling mechanisms responsible for mediating Ser phosphorylation of STAT1 and STAT3 remain unknown.In mice preconditioned with six 4-minute coronary occlusion/4-minute reperfusion cycles, we found that (1) ischemic PC activates the Raf1-mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase kinase (MEK) 1/2-p44/42 MAPK signaling pathway, induces phosphorylation of STAT1 and STAT3 on the Ser-727 residue, and upregulates COX-2 expression; (2) pSer-STAT1 and pSer-STAT3 form complexes with pTyr-p44/42 MAPKs in preconditioned myocardium, supporting the concept that Ser phosphorylation of these 2 factors is mediated by activated p44/42 MAPKs; and (3) activation of the Raf-1-MEK-1/2-p44/42 MAPK-pSer-STAT1/3 pathway and induction of COX-2 during ischemic PC are dependent on protein kinase C (PKC)-epsilon activity, as determined by both pharmacological and genetic inhibition of PKCepsilon.To our knowledge, this is the first study to demonstrate that ischemic PC causes Ser phosphorylation of STAT1 and STAT3 and that this event is governed by PKCepsilon via a PKCepsilon-Raf1-MEK1/2-p44/42 MAPK pathway. Furthermore, this is the first report that COX-2 expression in the heart is controlled by PKCepsilon. Together with our previous findings, the present study implies that STAT-dependent transcription of the genes responsible for ischemic PC is modulated by a dual signaling mechanism that involves both JAK1/2 (Tyr phosphorylation) and PKCepsilon (Ser phosphorylation).
Does the outcome of the tidal breathing and dosimeter methods of assessing bronchial responsiveness in children with asthma depend on age?
Authors: D Birnie, G W thoe Schwartzenberg, W C Hop, E E van Essen-Zandvliet, K F Kerrebijn
Journal: Thorax (1990)

As minute volume increases with age, a study was carried out to determine whether the measurement of bronchial responsiveness to pharmacological agents with the tidal breathing technique in children might be influenced by age. Bronchial responsiveness to histamine administered by tidal breathing was therefore compared with that produced with a dosimeter in 25 children with asthma aged 5-18 years. Bronchial responsiveness was defined as the concentration of histamine that caused a 40% rise in pulmonary resistance (PC40) measured by random noise forced oscillation at 6 Hz. Values of PC40 measured by the tidal breathing method were lower than those obtained with the dosimeter method, presumably owing to differences in the dose administered and variations in the pattern of breathing. The difference between the two methods was not related to age, however. It is concluded that the tidal breathing and the dosimeter methods are both suitable for the measurement of bronchial responsiveness in children of various ages and that both can be used in longitudinal studies.
Relation of immune response to development of central nervous system lesions in virus infections of man.
Authors: H. E. Webb, C. E. Smith
Journal: BMJ (1966)

There seems to be a case for presenting a more fully developed version of the ideas put forward in a letter to the British Medical Journal (Webb and Smith, 1964) concerning the pos sible causation of central nervous system (C.N.S.) lesions in virus infections. This somewhat speculative article has there fore been written in the hope of stimulating thought, discussion, and further research by clinicians, virologists, and immuno logists. When large numbers of sera from human populations are tested, antibody to viruses, such as poliomyelitis or Japanese encephalitis, which typically cause C.N.S. disease, is often found in people with no history of C.N.S. illness. Inapparent infec tion rates with such viruses vary from 99.9% for poliomyelitis and Japanese encephalitis to about 90 % for eastern and western encephalitis. Perhaps the major feature of meningoencephalitis in man which therefore requires explanation is why only a very small proportion of such infections actually cause a clinically recognizable C.N.S. disturbance. When there is a C.N.S. involvement the illness is funda mentally biphasic: a mild, often missed, febrile illness is fol lowed by a quiescent period which may vary from 1 to 14 days, and then by the C.N.S. disturbance. The initial phase may even be afebrile. The picture in man is perhaps best seen in European biphasic meningoencephalitis, but Kyasanur Forest disease virus in experimental animals (Webb and Chatterjea, 1962) and humans (Webb and Lakshmana Rao, 1961) and Langat virus in humans (Webb et al., 1966) also cause biphasic illnesses. There is a similar course of events in many other virus infections, including poliomyelitis (Horstmann et al., 1954).
Sequela of Measles.
Authors: Ghislani Durant
Journal: JAMA (1897)

(IN ANSWER TO DR. STIMSON'S QUERY.) New York, March 25, 1897. <h3>To the Editor:</h3> —In 1619, attention was called by Sennert as to the occurrence of arthritis as a complication of scarlet fever and measles, and almost all the specific fevers. At the present day the frequency with which this complication occurs is universally recognized. Dr. Samson is of opinion that the importance of measles as a predisposing cause of endocarditis has not been sufficiently taken into account, and he is inclined to assign to that fever a share in the predisposition of articular rheumatism. Those who possess a rheumatic tendency are most liable to suffer from rheumatism when attacked by scarlatina or measles. Yours truly,
Cite the workers.
Authors: D. Macauley
Journal: BMJ (1992)

This study describes the surgical technique and intra- and postoperative complications associated with the use of a radiofrequency bipolar coagulator in a series of 18 Piver type III-IV radical hysterectomies performed in cervical cancer patients. Preliminary vessel-by-vessel dissection of the lateral parametria was possible in 17 out of 18 (94%) cases, and a direct application of a radiofrequency bipolar coagulation instrument was performed to coagulate the posterior and anterior parametrial tissues in all cases. We were able to easily coagulate isolated vessels up to 5 mm of maximal diameter. In no case were clamps or hemoclips necessary to complete hemostasis. We did not observe any parametrial vessel damage or heat-related injury of the surrounding normal tissue. The median size of the parametria removed was 44 mm (range 31–58) and nodes were detected in 15 cases (83%). Median operative time and estimated blood loss for the whole procedure including systematic pelvic and aortic lymphadenectomy was 250 min (range 200–410) and 550 ml (range 400–2500), respectively. Median follow-up time was 9 months (range 5–13). No complications specifically related to the use of radiofrequency coagulation were found. In conclusion the radio-frequency coagulation with this instrument appears to be a safe technique that is particularly useful in reducing blood loss and operative time without affecting radicality in patients undergoing radical hysterectomy.
Echocardiographic Assessment of the Effects of Surgery and Propranolol on the Dynamics of Outflow Obstruction in Hypertrophic Subaortic Stenosis
Authors: PRAVIN M. SHAH, RAYMOND GRAMIAK, ALLAN G. ADELMAN, E. DOUGLAS WIGLE
Journal: Circulation (1972)

The long-term effects of surgery (ventriculomyotomy) and oral propranolol therapy were assessed by echocardiographic recordings in 51 studies conducted on 37 patients with hypertrophic subaortic stenosis. The incidence and severity of echocardiographic findings in 19 patients treated with propranolol and in 18 not so treated showed no significant differences. Likewise these findings were unaltered by administration of propranolol in 12 patients who were studied both while they were on the drug and while they were not. In contrast, of 14 patients studied after surgery, only one had persistently abnormal mitral valve motion, two had inconstant abnormality, and 11 had no abnormality at rest. The echocardiographic findings correlated well with independent postoperative hemodynamic assessment. The echocardiographic studies provide a noninvasive objective method for longitudinal evaluation of patients with hypertrophic subaortic stenosis (HSS).
The Power of Video Recording
Authors: Martin A. Makary
Journal: JAMA (2013)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
ABC of allergies: Perennial rhinitis
Authors: I S Mackay, S R Durham
Journal: BMJ (1998)

Perennial rhinitis may be defined clinically as an inflammatory condition of the nose characterised by nasal obstruction, sneezing, itching, or rhinorrhoea, occurring for an hour or more on most days throughout the year. In one study in London of adults between the ages of 16 and 65 years, the prevalence of rhinitis was 16%; of these, 8% had perennial symptoms, 6% perennial and seasonal symptoms, and 2% seasonal symptoms alone. As with asthma, both seasonal and perennial rhinitis seem to be increasing.

### Non-allergic, non-infective rhinitis*

*Poorly understood and more difficult to identify specific causes

Allergic rhinitis —Perennial allergic rhinitis can …
864 Inhibition of poly(ADP-ribose) polymerase (PARP) protects mice from cholestatic liver injury
Authors: P FICKERT, M TRAUNER, A FUCHSBICHLER, G ZOLLNER, M WAGNER, R ZENZ, Z ZSENGELLER, C SZABO, H DENK
Journal: Hepatology (2003)

This review focuses on various components of bile acid signaling in relation to cholangiocytes. Their roles as targets for potential therapies for cholangiopathies are also explored. While many factors are involved in these complex signaling pathways, this review emphasizes the roles of transmembrane G protein coupled receptor (TGR5), farnesoid X receptor (FXR), ursodeoxycholic acid (UDCA) and the bicarbonate umbrella. Following a general background on cholangiocytes and bile acids, we will expand the review and include sections that are most recently known (within 5–7 years) regarding the field of bile acid signaling and cholangiocyte function. These findings all demonstrate that bile acids influence biliary functions which can, in turn, regulate the cholangiocyte response during pathological events.
Tumor-initiating capacity of CD138− and CD138+ tumor cells in the 5T33 multiple myeloma model
Authors: E Van Valckenborgh, W Matsui, P Agarwal, S Lub, X Dehui, E De Bruyne, E Menu, C Empsen, L van Grunsven, J Agarwal, Q Wang, H Jernberg-Wiklund, K Vanderkerken
Journal: Leukemia (2012)
In vitro chelating, cytotoxicity, and blood compatibility of degradable poly(ethylene glycol)-based macromolecular iron chelators
Authors: Nicholas A.A. Rossi, Ibrahim Mustafa, John K. Jackson, Helen M. Burt, Sonja A. Horte, Mark D. Scott, Jayachandran N. Kizhakkedathu
Journal: Biomaterials (2008)
The Blood-Service Complex in New Jersey
Authors: Martin Goldfield
Journal: JAMA (1972)

Examination of the patterns of collection, distribution, and wastage of blood in New Jersey between 1963 and 1969 discloses a progressively increasing failure of volunteer donor collection agencies to satisfy demands for these products, largely due to the fact that falling in-hospital collections have outpaced increases in community and Red Crossaffiliated regional banks. As a result, the proportion of all blood supplied by commercial banks has increased steadily. Efforts to diminish wastage, though laudable, can not be expected to contribute significantly to reducing present deficits in volunteer blood collections. The existing blood-service complex is made up of a very large number of uncoordinated elements, and the relative contribution of various elements probably differs greatly in different areas of the country. Remedies, in turn, will probably have to be sought on a regional, rather than national, basis.
Overt testicular disease at diagnosis of childhood acute lymphoblastic leukemia: lack of therapeutic role of local irradiation
Authors: N Hijiya, W Liu, J T Sandlund, S Jeha, B I Razzouk, R C Ribeiro, J E Rubnitz, S C Howard, E P Kyzer, D S Redd, C Cheng, G K Rivera, M M Hudson, M V Relling, C-H Pui
Journal: Leukemia (2005)
RESPIRATORY COMPLICATIONS FOLLOWING SURGICAL OPERATIONS DURING A FOUR-YEAR PERIOD
Authors: D. C. Aikenhead
Journal: BMJ (1930)

JOIv 516 ~~~~~~~~~~~~~~~~~~~~~~~~~~~T he seasonal character of the waves suggested that they might correspond to periods of general lowering of the individual resistance to infection.Dr. H. Kerr, miiedical officer of health for Newcastle, provided a list of deaths of both sexes occurring from influenza, and pneumonia during the years 1925 to 1930.There is a marked similarity between the death cusve and the sepsis curve (see Chart 2).
Not Persons but Principles; Not Words but Actions.
Authors: S. Solis-Cohen
Journal: JAMA (1894)

Philadelphia, Feb. 20,1894. <h3>To the Editor:</h3> —Your correspondent, " Constancy," objects to the language in which I criticised the action of theJournalin disobeying the order of theAssociationand the provision of the Code prohibitory of nostrum advertising. I am unaware of anything "unprofessional" in my remarks, —but, be that as it may, if my letter is worth noticing at all, the question is not as to the literary merit of my style, but as to the justness of my contention; not as to my words but as to the Trustees' acts. While I am perfectly willing to be criticised, I do not desire to obtrude, or have others obtrude, my personality into what should be a discussion of principles. Let us avoid side issues of all kinds and stick to the main point. The facts are undisputed, that: 1, the Code and, by resolution at Detroit, theAssociation