tbuckley/cabot-search huggingface dataset:
Bipolar Radiofrequency Thermal Ablation of the Soft Palate in Habitual Snorers without Significant Desaturations Assessed by Magnetic Resonance Imaging
Authors: Leif J. J. Bäck, Pekka O. Tervahartiala, Anneli K. Piilonen, Markku M. Partinen, Jukka S. Ylikoski
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Sleep-disordered breathing, including habitual snoring, is a major health problem. Treatment of primary habitual snoring should be individualized using both conservative and active treatment methods. Active surgical interventions are, however, associated with significant morbidity. Therefore, procedures causing far less morbidity should be preferred. Our aim was to assess the efficacy and acceptability of bipolar radiofrequency thermal ablation of the soft palate in habitual snorers without significant desaturations associated with excessive daytime sleepiness. We treated 20 nonobese habitual snorers (median age, 43 years, range 35-63). All the patients had the major site of obstruction at the level of the soft palate, and they were treated on an outpatient basis in two treatment sessions separated by 1 week. The pretreatment and post-treatment symptoms and findings as well as the overall efficacy of the procedure were evaluated by questionnaires, visual analogue scales, and magnetic resonance imaging. All the questionnaires showed a statistically significant change, indicating decreased snoring and daytime sleepiness. The magnetic resonance studies showed that the procedure induced notable T1-signal alterations in the treated tissue, and when compared with the pretreatment images, certain dimensions of the soft palate were significantly changed. Bipolar radiofrequency thermal ablation of the soft palate seems to be well tolerated and effective regarding primary habitual snorers without significant desaturations associated with excessive daytime sleepiness.
Some Imperatives for Clinical Research
Authors: Kenneth I. Shine
Journal: JAMA (1997)

The preeminence of the research university in the United States is based on a policy to support basic science research, research training, and education in the same institution. The success of American medicine, and particularly of its academic health centers, is the result of this combination accompanied by a strong commitment to apply basic research through clinical studies performed during clinical care. America's leadership in health research and health care may be in serious jeopardy because opportunities for clinical research are at significant risk. Between $800 million and $2.5 billion from patient care revenues have been used to underwrite research in our academic health centers.<sup>1,2</sup>Attempts to control expenditures through managed care and reductions in Medicare and Medicaid place increasing pressure on the budgets of these institutions and threaten this source of research support. Studies by the staff at the Association of American Medical Colleges have shown that "medical
ACCIDENTAL OVERDOSE OF PHENOLPHTHALEIN IN A CHILD WITHOUT ILL EFFECTS
Authors: Wilbert Sachs
Journal: JAMA (1935)

W. H. Jr., a boy, aged 3½ years, of Jersey City, was given for the first time on the night of June 24, 1934, one chocolate laxative tablet containing phenolphthalein. The following morning at 8 o'clock the child got to the household medicine cabinet and, finding the tin that contained the tablets, ate all of the remainder contained in the box. One hour later he was discovered by his mother, who noted that his lips and face were smeared with chocolate and that all the tablets were gone. The child had therefore apparently consumed the total contents of the container, altogether forty-eight tablets. Although the child seemed perfectly well, the mother gave him an enema; following this the bowels moved at intervals of half an hour, five times in all. She then took the boy to the Jersey City Medical Center, where he was admitted to the pediatric service.
Role of Renal Angiotensin II Type 1 Receptors in the Genesis of Hypertension
Authors: S.D. Crowley, S.B. Gurley, M.J. Herrera, P. Ruiz, R. Griffiths, A.P. Kumar, H.-S. Kim, O. Smithies, T.H. Le, T.M. Coffman
Journal: Journal of the American Society of Nephrology (2007)

![Figure][1]</img> Eberhard Ritz Feature Editor The late Arthur Guyton had postulated that even in the absence of primary renal disease of the kidney, a change in renal function, more precise, resetting of the BP/natriuresis relationship, is a prerequisite for a persistent rise of BP ([1][2],[2
Serum uric acid concentrations in an urbanized South African Negro population.
Authors: P Beighton, L Solomon, C L Soskolne, B Sweet, G Robin
Journal: Annals of the Rheumatic Diseases (1974)

Small airway dysfunction and remodeling are known to influence the disease control and progression in asthma. We investigated the small airway involvement in asthmatic patients by correlating data derived from computed tomography (CT) and pulmonary function test (PFT). The CT lung scans were acquired at full inspiration and expiration using a portable spirometer to control the respiratory manoeuvers. PFT was performed before and after bronchodilator test with salbutamol 400 mcg, measuring lung volumes and flows, airway resistance (Raw) and single-breath nitrogen washout (SBN<sub>2</sub>W). Up to now, 25 patients with mild-to-moderate asthma were studied. Fifteen had a good control of the disease at the time of the study as reflected by an Asthma Control Test (ACT) score ≥ 20. The mean lumen area (LA), measured in the left lower lobe posterior-basal segmental bronchus (LB10), correlated directly with the forced expiratory volume in 1 sec (FEV1) (r=0.60, p=0.002) and inversely with Raw (r=-0.52, p=0.011). The wall area percent (WA%) in the LB10 correlated inversely with FEV1 (r=-0.55, p=0.004)and directly with Raw (r=0.50, p=0.014). Air trapping, expressed as expiratory Voxel Index -856 HU (%), correlated inversely with FEV1 (r=-0.82, p&lt;0.0001) and directly with both residual volume (RV)(r=0.72, p&lt;0.0001) and the change in N<sub>2</sub> concentration in phase 3 of the SBN<sub>2</sub>W test (r=0.67, p=0.001). A trend toward a significant increase in air trapping was found in the 10 patients with a poor control of the disease in comparison with the 15 patients in good control (p=0.083). These preliminary data show that both CT and PFT including Raw and SBN<sub>2</sub>W provide useful information for the study of the small airways in asthma.
Working with adult survivors of child sexual abuse.
Authors: P. Campling
Journal: BMJ (1992)

Many people who have been sexually abused as children present for help in adult life still suffering the emotional legacy of their traumatic experience.' Increasingly, some present themselves directly as victims of sexual abuse in childhood; others turn up with various psychiatric or gynaecological symptoms or general poor health-the history of sexual abuse comes to light only as treatment continues.In these circumstances, intense feelings may arise between the doctor and patient, which offer insights that can be used to help the patient.An analysis of the doctor-patient relation- ship gives a glimpse of the patient's childhood relationships and how pathological these may have been.An understanding of these may improve the treatment's chance of success, helping the doctor to avoid the pitfalls that can so easily sabotage treatment.Given the highly exploitative and damaging relationships that these patients have experienced, they find it difficult to trust their doctor.2Thus they may respond defensively to anything even slightly reminiscent of abuse-such as an intrusive question or a well intentioned attempt to coerce them into treatment.Patients may seem oversensitive to any suggestion that what they say is not being believed or taken seriously enough.They may feel desperately let down by any perceived neglect such as being kept waiting or having a small detail forgotten.Sometimes they respond with anger; more commonly they simply fail to return for treatment.Particularly important to this group of patients is the gender of the doctor.With male doctors they will mistrust any hint of an erotic dimension to the relationship.They also have a tendency to abdicate power to men and then feel frightened.They are likely to perceive women doctors as not "good enough" and to respond to them with anger, frustration, and disappointment.3Their doctors' care and concern in their problems invokes grief at the lack of adequate nurturing that they received in childhood.Doctors therefore find themselves steering a fine line between being "intrusive" on the one hand and "neglectful" on the other.Many patients grew up in families where normal social roles were grossly distorted; not only do they feel confused about their own role but they also perceive other people as confused in their roles.Some patients were abused before they had developed a consistent sense of themselves as separate people and before they had acquired a vocabulary to describe what was happening.They are particularly prone to being swamped by emotions and physical sensations and experience difficulty putting their problems into words.
Higher ribosomal RNA substitution rates in Bacillariophyceae and Dasycladales than in Mollusca, Echinodermata, and Actinistia-Tetrapoda
Authors: U. Sorhannus
Journal: Molecular Biology and Evolution (1996)

Molecular evolutionary rates within two protistan and three metazoan taxa were estimated using divergence times derived from fossil records. The results indicate that the small-subunit rRNA sequences within Dasycladales (Chlorophyta) and Bacillariophyceae evolved at a rate approximately two to three times faster than that estimated within Echinodermata, Mollusca, and Actinistia-Tetrapoda. It was concluded that this twofold discrepancy demonstrates actual taxonomic differences in the fixation rate of mutations in the small-subunit rRNA.
Environmental correlates of intercity variation in age-adjusted cancer mortality rates
Authors: Leon S. Robertson
Journal: Environmental Health Perspectives (1980)

Factors contributing to urban differences in cancer mortality rates are difficult to specify because of migration and the delay between exposure to carcinogens and manifestations of the disease. Proxy measures for prior migration, motor vehicle emissions, industrial pollution, factors in the water supplies, and climate, explain more than half the intercity variation in age-adjusted cancer mortality rates among 98 cities in the U.S. in 1970. The potential importance of these environmental factors as the “urban factor” in cancer is discussed.
Renin biosynthesis by human tumoral juxtaglomerular cells. Evidences for a renin precursor.
Authors: F X Galen, C Devaux, A M Houot, J Menard, P Corvol, M T Corvol, M C Gubler, F Mounier, J P Camilleri
Journal: Journal of Clinical Investigation (1984)

Renin biosynthesis was studied in a juxtaglomerular cell tumor. The tumoral tissue had a high renin content (180 Goldblatt Units/g of tissue), was heavily stained by immunofluorescence using human renin antiserum, and exhibited numerous characteristic secretory granules by electron microscopy. In one series of experiments, renin biosynthesis was studied in tissue slices, by following the incorporation of radiolabeled amino acids into specific immunoprecipitable renin. Time course studies showed that renin was first synthesized in a high molecular weight form, 55,000 mol wt, i.e., 10,000 mol wt higher than that of active renin, and was then converted into a 44,000-mol wt form. In a second series of experiments renin tumoral cells were cultured. Small, round, birefringent cells obtained after collagenase digestion produced renin in both primary culture and subculture media. After 5 d most of the renin found in the culture medium was inactive, but could be activated by trypsin treatment. The tumoral tissue exhibited a strong renin immunofluorescence and numerous secretory granules were observed by electron microscopy. In contrast, the renin-producing cells isolated from this tumor and grown in culture showed little renin immunofluorescence and no secretory granule could be observed. The renin-producing cells in primary culture and subculture were pulsed with radiolabeled amino acids, and immunoprecipitable radiolabeled renin was found in the culture media, thus demonstrating the actual biosynthesis of the enzyme. This renin was not stored inside cultured cells but was rapidly released into the medium and had a molecular weight of 55,000. No conversion of this inactive high molecular weight renin into the active, 44,000 mol wt form of renin was observed. We postulate the existence of two pathways for the processing, packaging, and secretion of renin in the tumoral cells: in juxtaglomerular cells of tumoral tissue renin is synthesized as a preprorenin and rapidly converted into prorenin (55,000 mol wt), which is in turn packaged in secretory granules where it is processed into active renin (44,000 mol wt) and finally secreted; in the cultured tumoral cells renin is still biosynthesized as a preprorenin molecule and then converted into prorenin, but is neither stored as granules nor processed into active renin. In this case the renin is released in an inactive form.
Genetic Testing and FDA Regulation
Authors: James P. Evans, Michael S. Watson
Journal: JAMA (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 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
Training Generalists To Do Procedures
Authors: William E. Golden
Journal: Annals of Internal Medicine (1993)

Letters1 July 1993Training Generalists To Do ProceduresWilliam E. Golden, MDWilliam E. Golden, MDUniversity of Arkansas for Medical Sciences; Little Rock, AR 72205-7199Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-1-199307010-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the exchange of letters concerning curriculum reform in internal medicine [1], the editors of the supplement [2] chose to rebuff the proposal that generalists be trained in procedures, saying it would only work where specialists are in short supply. Such thinking underscores and reinforces the second-class citizenship of generalists in the internal medicine community.For years, departments of internal medicine have given away the core competencies of the general internist to the subspecialty divisions. The basic curriculum has few explicit expectations of the 3-year trainee. Recently, I visited another medical school and was shocked to hear ...References1. Internal medicine curriculum reform (Letters). Ann Intern Med. 1992; 117:973-5. Google Scholar2. Inui TS, Nolan JP, eds. Internal medicine curriculum reform. Ann Intern Med. 1992; 116(12 pt 2):1041-115. Google Scholar Author, Article, and Disclosure InformationAuthors: William E. Golden, MDAffiliations: University of Arkansas for Medical Sciences; Little Rock, AR 72205-7199 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1993Volume 119, Issue 1Page: 94-95KeywordsMotivationResidencySub-specialty care ePublished: 15 August 2000 Issue Published: 1 July 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
INTRAOPERATIVE CONTRAST ENHANCED ULTRASOUND IN BRAIN TUMOR SURGERY
Authors: F. DiMeco, F. U. Prada, A. Perin, L. Aiani, A. Martegani, L. Solbiati, M. Lamperti, C. Casali, F. Legnani, L. Mattei, A. Saladino, M. Saini
Journal: Neuro-Oncology (2014)

BACKGROUND: Contrast-enhanced ultrasound (CEUS) is a dynamic and continuous modality which offers a real time, direct view of the vascularization patterns and tissue resistance for many organs. Thanks to newer ultrasound (US) contrast agents, CEUS has become a well-established, live-imaging technique in many contexts, but it has never been extensively used for brain imaging. In particular, the use of intraoperative-CEUS (iCEUS) imaging in Neurosurgery is very limited. in this study, we provide the first dynamic and continuous iCEUS evaluation of a variety of brain lesions. METHODS: We evaluated 96 patients undergoing iCEUS imaging in an off-label setting while being operated on for different brain lesions; iCEUS imaging was obtained before resecting each lesion, after intra-venous (IV) injection of ultrasound contrast-agent (UCA). A semi-quantitative, offline postoperative inter-observer analysis was performed, in order to visualize each brain lesion and characterize its perfusion features in correlation with histopathology. RESULTS: In all cases, the brain lesion was visualized intra-operatively with iCEUS; the afferent and the efferent blood vessels were identified, allowing to evaluate the time and the features of the arterial and venous phases and facilitating the surgical strategy. iCEUS also proved to be useful in highlighting the lesion as compared to standard B-mode. Specific perfusion patterns were identified according to histopathology. No adverse effects were observed. CONCLUSIONS: Our study is the first large-scale implementation of iCEUS in Neurosurgery as a dynamic and continuous real time imaging tool for brain surgery, providing a first iCEUS characterization of different brain masses. iCEUS ability to highlight and characterize brain tumor provides the neurosurgeon with important information, anytime during a surgical procedure, in order to refine and optimize the surgical strategy and, possibly, to further understand tumor biology. SECONDARY CATEGORY: Clinical Neuro-Oncology.
Puerperal Convulsions in Union Houses
Authors: R. Storrs
Journal: BMJ (1843)

<h3>Objectives</h3> This study was designed to evaluate the effect of rehabilitation in preventing decreased functional status (FS) after community-acquired pneumonia (CAP) in elderly patients. <h3>Design</h3> This was a retrospective observational study. <h3>Setting</h3> Multicentre study was conducted in two medical facilities from January 2016 to December 2018. <h3>Participants</h3> Hospitalised patients with CAP aged over 64 years were enrolled. FS was assessed by the Barthel Index (BI) (range, 0–100, in 5-point increments) at admission and before discharge and graded into three categories: independent, BI 80–100; semidependent, BI 30–75; and dependent, BI 0–25. Multivariable analysis of factors contributing to decreased FS was conducted with two groups: with a decrease of at least one category (decreased group) or without a decrease of category (maintained group). <h3>Primary and secondary outcome measures</h3> The primary outcome was the effect of rehabilitation in preventing decreased FS. The secondary outcomes were factors associated with decreased FS. <h3>Results</h3> The maintained and decreased groups included 400 and 138 patients, respectively. A high frequency of rehabilitation therapy was observed in the decreased group (189 (47.3%) vs 104 (75.4%); p&lt;0.001). Multivariable analysis showed that the factors affecting FS were aspiration pneumonia, Pneumonia Severity Index (PSI) category V, length of stay and age (OR 2.66, 95% CI 1.58 to 4.49; OR 1.92, 95% CI 1.29 to 3.44; OR 1.05, 95% CI 1.04 to 1.07; and OR 1.05, 95% CI 1.02 to 1.09, respectively). After adjusting for factors contributing to decreased FS, rehabilitation showed a limited effect in preventing decreased FS in 166 matched pairs by McNemar’s test (p=0.327). <h3>Conclusions</h3> Aspiration and PSI played important roles in reducing FS. The effect of rehabilitation remains unclear in CAP. <h3>Trial registration number</h3> UMIN000046362.
Bcl-6 mutation status provides clinically valuable information in early-stage B-cell chronic lymphocytic leukemia
Authors: E Sarsotti, I Marugan, I Benet, M J Terol, D Sanchez-Izquierdo, M Tormo, F Rubio-Moscardo, J A Martinez-Climent, J García-Conde
Journal: Leukemia (2004)
Physician Payment: Fee for Time-Reply
Authors: Toni J. Wachtel
Journal: JAMA (1994)

In Reply.  —We are pleased that our article proposing to pay physicians on the basis of time spent with patients provoked some thoughts. To address Dr Brodell's ideologic concerns, let it be known that we both own shares in the stock market. That makes us capitalists! In our free country, Brodell has the option to buy marked-up milk and improve his grocer's family situation. He can also buy cheaper milk elsewhere. If interested, he could find out what it costs to produce a bottle of milk and what the profit margins are in the distribution chain. It is not as easy for patients to find the best value in town for a diagnosis and treatment, let alone figure out why the price is what it is. And why should they? Usually a third party pays the bill. Therefore, free market theory does not apply well to health care, unlike most
WHO says more HIV patients should be screened for tuberculosis
Authors: B. Roehr
Journal: BMJ (2008)

The World Health Organization has issued guidelines to try to reduce the burden of tuberculosis among people infected with HIV in an effort to tackle the 230 000 deaths a year in people infected with both conditions.

The guidelines say that it is essential to increase the use of isoniazid as a preventive measure for tuberculosis and the use of antiretroviral drugs for HIV.

They also emphasise the need for collaboration and coordination of activities at all levels of operations, including planning, surveillance, delivery of services, and programme evaluation. The guidelines were …
Degrees Kelvin: A Tale of Genius, Invention, and Tragedy
Authors: S. Satya-Murti
Journal: JAMA (2004)

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