tbuckley/cabot-search huggingface dataset:
Retrieval of migrated pancreatic stent: “stent-in-stent” technique
Authors: Yalaka Reddy, Harpal Dhaliwal, Pankaj Gupta, Saroj Sinha, Rakesh Kochhar
Journal: Endoscopy (2015)

A 13-year-old boy, in whom a 10-Fr, 10-cm pancreatic stent had been placed 3 months earlier to manage chronic pancreatitis and pain syndrome, was admitted for stent exchange. On endoscopic retrograde cholangiopancreatography, the pancreatic stent was not visible at the papilla. The pancreatic duct was cannulated with a 0.025-inch guidewire (VisiGlide; Olympus America, Center Valley, Pennsylvania, USA). Fluoroscopy showed that the stent had migrated deeply into the pancreatic duct and that the guidewire had passed through the stent ([Fig. 1 a, b]).
Ethical Issues
Authors: E. Charlotte Theis
Journal: New England Journal of Medicine (1986)

Any discussion of ethical issues from a nursing perspective must take into consideration the particular context of nursing. Ordinarily, nurses do not function as self-employed practitioners with a high degree of autonomy and freedom. Rather, most are employees of health care institutions and are thus accountable not only to their patients but also to their employers. As employees, nurses are obliged to abide by institutional policies, rules, and expectations. In addition, the care they render to their patients is carried out within a medical framework. Thus, nurses are also accountable to physicians and are expected to follow their orders as . . .
&lt;emph type="ital"&gt;Winter Landscape&lt;/emph&gt;
Authors: Thomas B. Cole
Journal: JAMA (2011)

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
Clinical Trials Series
Authors: Janet Woodcock, James H. Ware, Pamela W. Miller, John J.V. McMurray, David P. Harrington, Jeffrey M. Drazen
Journal: New England Journal of Medicine (2016)

Clinical trials are our best vehicle for turning medical information that we may think is true into evidence that we know, within reasonable limits, to be true. Since the introduction of random assignments to treatment in the 1930s,1 the clinical trial has been in continuous evolution. Among the major milestones have been the development of methods to perform randomization; the convening of data and safety monitoring committees; the formulation of stopping guidelines for safety, efficacy, and futility; and many others. Indeed, the clinical trial landscape is far different today from what it was over 80 years ago, when investigators first . . .
CNS chemoradiotherapy of childhood leukemia: the plot thickens but the ending bodes well.
Authors: A Bleyer
Journal: Journal of Clinical Oncology (1995)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1995.13.10.2480 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 7595696 CNS chemoradiotherapy of childhood leukemia: the plot thickens but the ending bodes well. A BleyerxA BleyerSearch for articles by this author https://doi.org/10.1200/JCO.1995.13.10.2480 First Page PDF © 1995 by American Society of Clinical Oncology
Protecting Action of Citrate on the Agent of Chicken Tumor I (Rous Sarcoma Virus) During Roentgen Radiation &lt;italic&gt;in Vitro&lt;/italic&gt;
Authors: W R BRYAN, E LORENZ, D CALNAN
Journal: JNCI Journal of the National Cancer Institute (1953)

Journal Article Protecting Action of Citrate on the Agent of Chicken Tumor I (Rous Sarcoma Virus) During Roentgen Radiation in Vitro Get access W. Ray Bryan, W. Ray Bryan Search for other works by this author on: Oxford Academic PubMed Google Scholar Egon Lorenz, Egon Lorenz Search for other works by this author on: Oxford Academic PubMed Google Scholar Dorothy Calnan Dorothy Calnan National Cancer Institute3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 13, Issue 6, June 1953, Pages 1447–1461, https://doi.org/10.1093/jnci/13.6.1447 Published: 01 June 1953 Article history Received: 21 January 1953 Published: 01 June 1953
PTH-210 Using quality improvement methodology can easily achieve savings in parenteral nutrition wastage
Authors: P Allan, A Ramu, M Taylor, C Guest, C Harris, B Blackett, L Harper, K Farrer, A Abraham, A Teubner, S Lal
Journal: Gut (2015)

<h3>Introduction</h3> Parenteral nutrition (PN) cost ∼£80 per day to provide. Wastage of PN is high due to sudden changes in the clinical condition of the patient, loss of venous access or for organisational reasons. In healthcare settings improvement in patient quality of care at low cost yet that also achieves savings in provision of patient care is imperative to increase the quality of care available to other patients. We undertook a quality improvement project to reduce PN wastage by 10% in 9 months. <h3>Method</h3> Quality Improvement (QI) project was carried out at a national Intestinal Failure Unit (IFU) to reduce waste in provision of in-patient PN. Using QI methodology we developed a SMART objective of reducing PN wastage by 10% in 9months. We drew up an appropriate driver diagram of primary and secondary drivers for PN wastage. We recorded reason for wastage and using a pareto chart determined the most likely cause of waste to target change. Using Plan, Do, Study, Act (PDSA) cycles we activated a number of different strategies to reduce wastage. We mapped changes in the main 7 categories for waste using i-charts and g-charts. Balancing charts were also used to ensure that any intervention did not have a negative impact on quality provision of care on the IFU. We compared waste between IFU to Nutrition Support Teams in Salford and in Oxford. <h3>Results</h3> Baseline wastage over 12 weeks suggested 1000 bags per annum (p.a.) wastage. Using the following PDSA cycles we achieved a 39% reduction in PN wastage in 9 months, exceeding the proposed 10% and saving the unit ∼£35000. PDSA cycles used: Team awareness, regular highlighting of the problem, introducing it as a handover question, relabelling bags if not used whilst still within expiry date, stock rotation of stock bags, following a bag from fridge to patient, better coordination of discharge planning to prevent patients being at home when feed bags still available for them, splitting the fridge storage into days of the week so bags could be placed in correct day for each patient and if bags relabelled moved to the next available day, changing to standard bags during weaning process, taking patients off pre-ordering and changed to daily ordering to allow for altered discharge dates. <h3>Conclusion</h3> PN wastage is common and costly – in a high use unit ∼£90000 p.a. Using appropriate driver diagram, concurrent PDSA cycles and a motivated team high levels of cost savings are possible with resulting quality improvement in patient care. <h3>Disclosure of interest</h3> None Declared.
New Methods for the Early Detection and Diagnosis of Breast Cancer
Authors: Donald E. Henson
Journal: JNCI Journal of the National Cancer Institute (1984)

Journal Article New Methods for the Early Detection and Diagnosis of Breast Cancer Get access Donald E. Henson Donald E. Henson Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 73, Issue 2, August 1984, Pages 549–552, https://doi.org/10.1093/jnci/73.2.549 Published: 01 August 1984
Differences between forensic and general psychiatry
Authors: J R Rappeport
Journal: American Journal of Psychiatry (1982)

There are important differences between general and forensic psychiatry. In forensic psychiatry the psychiatrist serves a third party rather than the patient; both the patient and the psychiatrist must understand this to avoid misrepresenting the doctor's role to the patient and to enable the doctor to adequately serve the law. Psychiatric opinions that are useful for treatment may not be useful in determining whether a person can be considered responsible or competent. In forensic work the psychiatrist's role is not that of a therapist; it is that of an evaluator and an opinion giver but not a decision maker.
10 Minute consultation: Hyperhidrosis
Authors: Jo Piercy
Journal: BMJ (2005)

A 26 year old woman presents with excessive sweating, which she says embarrasses her socially and at work. Sometimes her hands literally drip with sweat, making work involving writing difficult. Concerned to conceal her excessive axillary sweating, she is self conscious and particular about her clothing. She asks what help you can give her.
THU0346 Utilization and Outcomes After Total Ankle Arthroplasty: Time Trends Study Using U.S. Nationwide Sample
Authors: J.A. Singh, R. Ramachandran
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Studies examining national trends in total ankle arthroplasty (TAA) in the U.S. are lacking. <h3>Objectives</h3> To assess the time-trends in utilization, clinical characteristics and outcomes of patients undergoing total ankle arthroplasty (TAA) in the U.S. <h3>Methods</h3> We used the Nationwide Inpatient Sample (NIS) data from 1998 to 2010 to examine time-trends in the utilization rates of TAA. We used the Cochran Armitage test for trend to assess time-trends across the years and the analysis of variance (ANOVA), Wilcoxon test or chi-squared test (as appropriate) to compare the first (1998-2000) and the last time periods (2009-10). <h3>Results</h3> TAA utilization rate increased significant from 1998 to 2010: 0.13 to 0.84 per 100,000 overall, 0.14 to 0.88 per 100,000 in females and from 0.11 to 0.81 per 100,000 in males (p&lt;0.0001 for each comparison for time-trends). Compared to the 1998-2000, those undergoing TAA in 2009-10: were older (41% fewer patients &lt;50 years, p&lt;0.0001); less likely to have RA as the underlying diagnosis (55% fewer patients, p=0.0001); more likely to have Deyo-Charlson index of two or more (197% more, p=0.0010); and had a shorter length of stay at 2.5 days (17% reduction, p&lt;0.0001). Mortality was rare, ranging 0 to 0.6% and discharge to inpatient facility ranged 12.6-14.1%; we noted no significant time-trends in either (p&gt;0.05). <h3>Conclusions</h3> The utilization rate of TAA increased rapidly in the U.S. from 1998 to 2010, but post-arthroplasty mortality rate was stable. Underlying diagnosis and medical comorbidity changed over time and both can impact outcomes after TAA. Further studies should examine how the outcomes and complications of TAA have evolved over time. <h3>Disclosure of Interest</h3> J. Singh Grant/research support from: takeda, savient, Consultant for: Takeda, Savient, Allergan, Regeneron, R. Ramachandran: None declared
Massachusetts Medical Society
Authors: John Figgis Jewett, Donald M. Muirhead
Journal: New England Journal of Medicine (1975)

COMMITTEE ON MATERNAL WELFAREPlacental Insufficiency Causing Fetal DeathAfter an uncomplicated prenatal course, a 27-year-old gravida 2, para 1, was admitted to the hospital at 41 weeks with bleeding and in labor, one hour after spontaneous rupture of the membranes. At first in doubt because conception occurred after two years of oral contraception without an intervening spontaneous menstrual flow, the date of confinement had been confirmed when the fetal heartbeat first became audible. The patient was not obese, and weight gain was normal.On arrival, maternal vital signs included a temperature of 36.9°C, pulse of 84 and respiration of . . .
OP0232 Outcomes Following Renal Transplantation (RTX) in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis (AAV): An Analysis of 46 Patients
Authors: E. Lefèvre, M.-N. Péraldi, L. Galmiche-Rolland, L. Doucet, G. Desbuissons, V. Audard, M. Delahousse, A. Durrbach, A. Karras, E. Rondeau, R. Snanoudj, R. Salomon, A. Mahr
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Single case series suggested that RTx in AAV complicated by end-stage renal disease (ESRD) is safe and effective for graft and AAV outcome. Limited data are available with respect to predictors of increased risk of AAV relapse following RTx. <h3>Objectives</h3> To investigate the outcomes of AAV patients who underwent RTx and the factors predictive of subsequent AAV relapse. <h3>Methods</h3> Patients with AAV who had undergone RTx for AAV-related ESRD between 1994 and 2013 were identified from 7 RTx centers in the greater Paris area of France. Medical charts were retrospectively reviewed for demographic and AAV characteristics, pre- and post-RTx immunosuppressive therapy, AAV relapse and overall and graft survival. Episodes of acute rejection and renal AAV relapses were defined from renal graft biopsy findings. Survival and cumulative incidence rates were calculated by Kaplan-Meier analysis. Log rank analyses were used to study the risk of renal AAV relapses associated with factors assessed at the time of RTx (age, AAV and ANCA phenotype, pre-RTx cyclophosphamide [CYC] therapy). <h3>Results</h3> We analyzed 46 patients (24 males [52%]) with AAV, including 9 (20%) with granulomatosis with polyangiitis (GPA), 13 (28%) microscopic polyangiitis (MPA) and 24 (52%) renal-limited vasculitis (RLV); ANCA specificities were PR3-ANCA in 12 (26%), MPO-ANCA in 29 (63%) and unknown in 5 (11%). Mean (SD) age at RTx was 40.7 (19.7) years; 10 (22%) underwent RTx during childhood (age&lt;18 yr). Forty-two patients (91%) received CYC before RTx. The 10-year cumulative incidence of acute rejection episodes was 38%; 9 (20%) patients returned to dialysis and 3 (7%) underwent a second RTx. After a mean (SD) follow-up of 7.5 (5.2) years, renal AAV relapses were identified in 6 (13%) patients (10-year cumulative renal relapse incidence: 16%). No extra-renal AAV relapse was recorded and 1 (2%) patient died (10-year overall survival rate: 97%). The risk of renal AAV relapses was increased for patients who underwent RTx during childhood (hazard ratio [HR]: 5.7, <i>P</i>=0.01), with detectable ANCA at RTx (HR: 4.4, <i>P</i>=0.008) and in CYC-naive patients (HR: 11.6, <i>P</i>=0.0002) but was not linked with the GPA/MPA vs RLV phenotype (HR: 1.7, <i>P</i>=0.36) and MPO- vs PR3-ANCA specificity (HR: 2.2, <i>P</i>=0.46). <h3>Conclusions</h3> The current outcomes of AAV patients undergoing RTx are favorable. Lack of pre-RTx CYC therapy and detectable ANCA at RTx may predict increased risk of renal AAV relapses. The increased AAV relapses in RTx during childhood may reflect lower adherence to anti-rejection therapy. <h3>Disclosure of Interest</h3> None declared
Bicarbonate therapy revisited. A study in therapeutic revisionism.
Authors: Eidelman Ai, Hobbs Jf
Journal: JAMA Pediatrics (1978)

In summary, infusion of bicarbonate in the treatment of neonatal acidosis has limited value. Although it may be useful adjunct in the resuscitation of severely depressed and acidotic infants, its efficacy in the management of postasphyxia acidosis or RDS is not supported by any data. The clear risks and disadvantages of such infusions should warn against its current indiscriminate use.
MEDICAL REHABILITATION
Authors: H Rinne
Journal: JAMA (1964)

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
ACID-BASE BALANCE IN THE CEREBROSPINAL FLUID
Authors: L Kepa
Journal: JAMA (1965)

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
SP0009 Primary Central Nervous System Vasculitis
Authors: C. Salvarani
Journal: Annals of the Rheumatic Diseases (2015)

Primary CNS vasculitis is an uncommon disorder of unknown cause that is restricted to brain and spinal cord. The median age of onset is 50 years. The neurological manifestations are diverse, but generally consist of headache, altered cognition, focal weakness, or stroke. Serological markers of inflammation are usually normal. Cerebrospinal fluid is abnormal in about 80-90% of patients. Diagnosis is unlikely in the presence of a normal MRI of the brain. Biopsy of CNS tissue showing vasculitis is the only definitive test; however, angiography has often been used for diagnosis even though it has only moderate sensitivity and specificity. The size of the affected vessels varies and determines outcome and response to treatment. Early recognition is important because treatment with corticosteroids with or without cytotoxic drugs can often prevent serious outcomes. The differential diagnosis includes reversible cerebral vasoconstriction syndromes and secondary cerebral vasculitis. <h3>Disclosure of Interest</h3> None declared
Depressive behavior and hyperactive adrenocortical function
Authors: J H Kocsis, J M Davis, M M Katz, S H Koslow, P E Stokes, R Casper, D E Redmond
Journal: American Journal of Psychiatry (1985)

This study examined relationships between depressive subtypes, clinical-behavioral characteristics, and hypothalamic-pituitary-adrenocortical (HPA) function in 132 hospitalized depressed patients. There were significant positive correlations between several pre- and postdexamethasone plasma cortisol measures and anxiety, psychomotor disturbance, distressed expression, and sleep disturbance. Few significant relationships were seen between illness severity and HPA function. Virtually no endocrine differences were seen between endogenous and nonendogenous subtypes or between psychotic and nonpsychotic subtypes. These results and the previous literature suggest a profile of depressed patients with HPA overactivation; they are likely to be anxious, to have sleep and psychomotor disturbances, to have lost weight in the current episode, and to be older.
Treatment engagement of individuals experiencing mental illness: review and update
Authors: Lisa B. Dixon, Yael Holoshitz, Ilana Nossel
Journal: World Psychiatry (2016)

Individuals living with serious mental illness are often difficult to engage in ongoing treatment, with high dropout rates. Poor engagement may lead to worse clinical outcomes, with symptom relapse and rehospitalization. Numerous variables may affect level of treatment engagement, including therapeutic alliance, accessibility of care, and a client's trust that the treatment will address his/her own unique goals. As such, we have found that the concept of recovery‐oriented care, which prioritizes autonomy, empowerment and respect for the person receiving services, is a helpful framework in which to view tools and techniques to enhance treatment engagement. Specifically, person‐centered care, including shared decision making, is a treatment approach that focuses on an individual's unique goals and life circumstances. Use of person‐centered care in mental health treatment models has promising outcomes for engagement. Particular populations of people have historically been difficult to engage, such as young adults experiencing a first episode of psychosis, individuals with coexisting psychotic and substance use disorders, and those who are homeless. We review these populations and outline how various evidence‐based, recovery‐oriented treatment techniques have been shown to enhance engagement. Our review then turns to emerging treatment strategies that may improve engagement. We focus on use of electronics and Internet, involvement of peer providers in mental health treatment, and incorporation of the Cultural Formulation Interview to provide culturally competent, person‐centered care. Treatment engagement is complex and multifaceted, but optimizing recovery‐oriented skills and attitudes is essential in delivery of services to those with serious mental illness.