tbuckley/cabot-search huggingface dataset:
"Genetics and Ironing," or the Two Cultures and the Physician
Authors: J. R. E.
Journal: Annals of Internal Medicine (1962)

Editorials1 March 1962"Genetics and Ironing," or the Two Cultures and the PhysicianJ. R. E.J. R. E.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-3-523 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring a recent vacation from college my daughter announced that she had to spend the evening "doing genetics and ironing." Now here is a phrase that epitomizes the situation of all of us—modern men caught up in the accelerating whirl of the scientific revolution, modern physicians faced with the challenge of understanding molecular disease. My daughter studies genetics in order to comprehend the new world in which she lives; she does her ironing to prepare for practical social living. Modern man is buffeted by a veritable hurricane of new scientific knowledge of the macrocosm and microcosm and struggles to trim...References1. SNOW CP: The Two Cultures and the Scientific Revolution, Cambridge University Press, New York, 1959. Google Scholar2. RUTSTEIN DD: Physicians for Americans. Two medical curricula: a new proposal. Lancet 1: 498, 1961. CrossrefMedlineGoogle Scholar3. TALBOTT JH: The art of medicine. J. A. M. A. 175: 162, 1961. Google Scholar4. PELLEGRINO ED: The split mind of medicine. Clin. Research 9: 313. 1961. Google Scholar5. ROMANO J: Comparative observations of medical education. J. A. M. A. 178: 741, 1961. CrossrefMedlineGoogle Scholar6. HORSFALL FL: On the unity of the sciences. Science 133: 1059, 1961. CrossrefMedlineGoogle Scholar7. MACKAY RS: Radio telemetering from within the body. Science 134: 1196, 1961. CrossrefMedlineGoogle Scholar8. STORERDODDSNYDEREDDLEMON EHDTPACO: A telemetering capsule for gastrointestinal pH measurement. J. A. M. A. 178: 830, 1961. CrossrefMedlineGoogle Scholar9. LIPKINENGLEDAVISZWORYKINEBALDSENDROWBERKLEY MRLBJVKABBSC: Digital computer as aid to differential diagnosis. Arch. Intern. Med. 108: 56, 1961. CrossrefMedlineGoogle Scholar10. WATSON CJ: Presidential address. The physician and the two cultures. Trans. Ass. Amer. Physicians 74: 1, 1961. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. R. E. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe researchers, practitioners and teachers of rheumatology 1 March 1962Volume 56, Issue 3 Page: 523-524 Keywords Genetics ePublished: 1 December 2008 Issue Published: 1 March 1962 PDF downloadLoading ...
Revascularization of the Heart
Authors: E LEITER
Journal: JAMA (1966)

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
PTU-168 Risk factors for transperineal gracilis flap interposition failure: another reason to avoid mesh
Authors: CA Wang, R Akiba, T Elarini, Y Yao, G Dasilva, Q Li, D Maron, SD Wexner
Journal: Gut (2015)

<h3>Introduction</h3> Transperineal gracilis muscle flap interposition (TGMFI) has been used to treat complex or recurrent perineal fistulas including rectovaginal fistula (RVF), pouch vaginal fistula (PVF), rectourethral fistula (RUF), and complex perianal fistula, refractory to heal or having failed other procedures (CPF), with an overall success rate of 50–90%. Our study was designed to evaluate risk factors for TGMFI failure in the treatment of complex perineal fistula. <h3>Method</h3> After IRB approval, a retrospective review of all patients who underwent TGMFI interposition for complex perineal fistula between 1994–2014 was undertaken. Data collected included patient demographics including BMI, fistula characteristics, prior attempts at fistula repair, procedure details including suture material, use of mesh, and surgical outcomes. The results were compared between patients whose fistula healed and those whose fistula failed to heal. Risks factors for TGMFI failure were assessed using Student’s t-test and Fisher’s exact test. <h3>Results</h3> 84 patients [34 females; mean age 57.5 (22–85) yeas] with a mean follow up of 18 (1–120) months were included. The most common cause of fistula was radiation. All patients had a diverting stoma. 36 (42.8%) patients (RVF: 9, RUF: 23, PVF: 2, CPF: 2) healed after initial TGMFI; 24 (28.6%) healed following further procedures including 10 redo TGMFI, for a final success rate of 71.4%. 24 (28.6%) patients (RVF: 11, PVF: 2, RUF: 10 RUF, CPF: 1) failed. The only significant risk factors for TGMFI failure were female gender (44.1% vs. 20% p = 0.04), 2 or more surgical attempts at prior fistula repair TGMFI (42.8% vs 20.4%; p = 0.04), urethral closure using mesh vs no mesh (80% vs. 25%; p = 0.01), and perineal skin closure with nylon versus polyglactin suture material (56.2% vs. 27.8%; p = 0.03). <h3>Conclusion</h3> Risks factors for TGMFI failure in patients with complex fistula include female gender, 2 or more prior surgical closure attempts, use of nylon suture material for perineal closure, and mesh interposition for urethral closure. <h3>Disclosure of interest</h3> None Declared.
FRI0304 Bone Turnover and Fracture Incidence Evaluation in Osteoporosis Patients Cohort with Intravenous Zoledronate Treatment
Authors: P.V. Castillo Dayer, J.L. Valero Sanz, E. Grau García, D. Hervás Marín, I. Chalmeta Verdejo, J. Ivorra Cortés, I. Martínez Cordellat, C. Núñez-Cornejo Piquer, C.M. Feced Olmos, F.M. Ortiz Sanjuán, L. González Puig, R. Negueroles Albuixech, E. Labrador Sánchez, K. Arévalo Ruales, C. Alcañiz Escandell, J.A. Román Ivorra
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Osteoporosis (OP) is a systemic chronic disease caused by low bone mineral density mass and bone microarchitecture alteration, and is characterized by an increased skeletal fragility and fracture risk. In the osteoporosis therapeutic arsenal bisphosphonate therapy is included, being the zoledronate treatment one with intravenous administration. Is a potent treatment and is indicated in post-menopausal OP and corticosteroid-induced OP. <h3>Objectives</h3> To analyze the bone turnover and fracture incidence in post-menopausal and corticosteroid-induced OP patients with intravenous zoledronate therapy. <h3>Methods</h3> Retrospective observational study in which data from OP patients treated with intravenous zoledronate therapy were collected, and that are included in a protocol of bone turnover biomarkers and fracture monitoring in the Rheumatology Department of HUP La Fe. Analytical data of bone turnover, fracture incidence, other previous or concomitant antiosteoporotic treatment and possible adverse events from 2011 to 2014 were collected. A Chi-square test and Logrank survival analysis were used for statistical analysis. <h3>Results</h3> We included 178 OP patients from H.U.P La Fe classified as 103 post-menopausal OP and 75 secondary OP (18 with liver transplantation, 12 rheumatoid arthritis and 18 with other diagnosis). All, patients had vitamin D supplementation, and in 136 cases received calcium supplementation due to intolerances. 53 patients were treated previously with other bisphosphonate therapy, 19 with teriparatide, 14 with strontium ranelate, 2 with denosumab and 2 with hormone replacement therapy. In all of them zoledronate therapy was indicated due to previous therapies intolerance and/or fragility or minimal trauma fractures. In 53 cases zoledronate therapy was suspended, due to fractures in 8 of them. Since the beginning of zoledronate treatment a decrease in P1NP values of 72.6% (from 84ng/mL to 23ng/mL) and in bCTX values of 62.5% (from 0,4ng/mL to 0,15ng/mL) were observed. 18 fractures in all patients were identified (7 in post-menopausal OP and 11 in secondary OP), with a mean treatment interval of 24 months. The most frequent locations were femur (5) and radius (4). Statistical analysis predict whether fractures are likely to occur in patients with secondary OP (P=0.005). <h3>Conclusions</h3> Zoledronate therapy improved bone turnover biomarkers scores, both in post-menopausal OP and in secondary OP patients. During zoledronate treatment fractures were identified in 10% of patients, and they are more likely to be present in secondary OP patients. <h3>Disclosure of Interest</h3> None declared
Dihydropyrimidine dehydrogenase activity and fluorouracil chemotherapy.
Authors: R B Diasio, Z Lu
Journal: Journal of Clinical Oncology (1994)

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.1994.12.11.2239 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 7964937 Dihydropyrimidine dehydrogenase activity and fluorouracil chemotherapy. R B DiasioxR B DiasioSearch for articles by this author , Z LuxZ LuSearch for articles by this author https://doi.org/10.1200/JCO.1994.12.11.2239 First Page PDF © 1994 by American Society of Clinical Oncology
THU0357 Prevalence of Rheumatoid Arthritis in French West Indies, an African Ancestry Population. The Eppra Study
Authors: M. Debandt, R. Banydeen, L. Brunier, M. Blettery, C. Derancourt, K. Polomat, V. Dehlinger, S. Arfi, C. Deligny, S. Merle, G. Jean-Baptiste
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Rheumatoid arthritis (RA) is a disabling chronic disease, regarded as the most frequent inflammatory rheumatism in adults, with a prevalence estimated between 0.3 and 1%, and a feminine ascendancy. In metropolitan France this prevalence is estimated from 0.3% to 0.5% of the general population. No precise data is available for French West Indies, and the prevalence of RA in this population of African ancestry is poorly evaluated. <h3>Objectives</h3> The objective of the study is to estimate RA prevalence in the FWI by a census forward-looking epidemiological survey in the hospital and liberal sectors for one year duration. <h3>Methods</h3> It is a unique tour with clinical examination, self-administered questionnaires and declaration. Secondary objectives are description of clinical and socio economical aspects of RA and cardiovascular comorbidities. We present the results for Martinique. Our survey was widely distributed (radio, press, patients9 associations…) to ensure a good completeness. Data were analysed using SAS 9.3 software (SAS Institute Inc., Cary, NC, USA). Throrough descriptive analysis of collected variables was conducted. Crude prevalence rates were adjusted to a standard population of Martinique (nationwide census in 2010). The 95% CIs were calculated using the Poisson distribution. <h3>Results</h3> Our completeness is good. 538 RA were collected, giving a prevalence in Martinique of 0.184% of the adult population (290 000), respectively 0.049 for men and 0.292 for women. 44% of these patients are treated in private practice and 56% in hospital. This cohort is composed of 88% women and 12% men; 92% were born in Caribbean and 7.7% elsewhere. Patients self declared of Afro Caribbean origin in 92.7%, Caribbean White in 1.7%, caucasian in 3% and other in 2.1%. Their mean disease duration was 9.7±10 years. RF and ACPA were positive in 82.2% (FR+ 392, ACPA+349, 35% low level, 65% high level): CCP+FR+ in 306, FR+CCP- in 77, FR-CCP+ in 41, FR-CCP- in 96. 17% had extra articular manifestations. ACR1987 and ACR2010 criteria were pos in 94.4% and 78%. HAQ was &lt;1 in 74%, &gt;1and &lt;2 in 20% and &gt;2 in 3%. DAS28 were respectively &lt;2.6 in 59%, &lt;3.2 in 15.4%, &lt;5.1 in 23% and &gt;5.1 in 3%. Less than 5% are ever smoker. Parodontopathy is infrequent. Cardiovascular risk factors were noticed in 89,4% with a mean of 2 CVRF beside RA. <h3>Conclusions</h3> This work clarifies the low prevalence of RA in this population of African origin. Some characteristics as: reduced prevalence, strong female representation, strong seropositivity, high levels of anti-CCP, no tobacco, differentiate our patients from other populations and evoke another etiology than tobacco. <h3>Disclosure of Interest</h3> None declared
A Chromatographic Study of the Deoxyribonucleic Acids From Normal and Leukemic Human Tissues&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Giampiero di Mayorca, Herbert S. Rosenkranz, Elio E. Polli, Grace C. Korngold, Aaron Bendich
Journal: JNCI Journal of the National Cancer Institute (1960)

Deoxyribonucleic acid (DNA) was prepared from normal human spleen and from the leukocytes of normal human donors as well as from patients with chronic lymphatic and granulocytic leukemia. The samples were found to be essentially indistinguishable in base, nitrogen, phosphorus, sodium, and water contents and in molecular extinction coefficient with respect to phosphorus (ɛP). However, the samples differed significantly from each other when examined by anion-exchange chromatography. It is concluded that the DNA of leukemic leukocytes differs chromatographically from that of normal white cells. Evidence is presented for a direct action in vivo of the alkylating agent methanesulfonic acid, tetramethylene ester (Myleran), on the DNA of the leukocytes from 2 patients with chronic granulocytic leukemia who had been treated with the agent.
Commentary: A spirited attempt
Authors: K. MacRae
Journal: BMJ (1994)

Scotch malt whisky has been the subject of another study from Canada earlier this year. Lapointe and Legendre from the University of Montreal used cluster analysis to group the 109 distilleries in Scotland that produce single malt whiskies.1 Ambitious as that study was, it did not do full justice to the topic as many of these distilleries bottle at several ages and strengths. Jackson estimates that over 400 different bottlings of Scotch malt whisky exist at any time.2 Cognac is also available from many producers and in different grades —for example, three star, ive star, VSOP, XO, Napoleon, and vintage. So this paper, by Campbell et al, in considering just two malt whiskies and two cognacs, hardly constitutes even a pilot study of this subject.

The malt whiskies chosen for the study were Gleniddich and Springbank. Gleniddich, from Dufftown, is the world's best …
THU0348 The Influence of Drug Exposures and Comorbidity on Survival in Patients with Rheumatoid Arthritis
Authors: J. Widdifield, M. Abrahamowicz, M. Paterson, C. Bombardier, G. Tomlinson, A. Huang, B. Kuriya, S. Bernatsky
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) have an increased mortality compared with the general population.<sup>1</sup> Established risk factors for premature mortality include active inflammation/disease activity, comorbidity and extra-articular disease manifestations. Thus, early and greater exposure to disease-modifying anti-rheumatic drugs (DMARDs) may mitigate these risk factors and improve survival in RA. <h3>Objectives</h3> Our aim was to evaluate the associations between RA drug exposures and survival in seniors with incident RA. <h3>Methods</h3> This retrospective cohort study investigated all incident cases of RA diagnosed from 2000 to 2013. We studied a subset of patients within the Ontario RA Database (ORAD) - a validated population-based cohort of all Ontarians with RA - who were aged 66 years and older who have comprehensive public drug insurance. We used Cox proportional hazards regression to investigate mortality, defined as death from any cause, exploring time-dependent cumulative drug exposures during the entire duration of follow-up, while adjusting for baseline age, sex, urban vs. rural residence, socioeconomic status, pre-existing comorbidities (e.g. hypertension, COPD, diabetes, coronary artery disease, cancer), past drug exposures, time-dependent number of physician visits, and extra-articular manifestations of RA (as proxies for RA severity). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. <h3>Results</h3> Among 25,416 senior RA patients, 67.8% were female, the mean (SD) age was 75.2 (6.5) years, and 85.4% lived in urban areas. During median and maximum follow-up times of 4.4 and 13.2 years, respectively, 7,956 patients died (31.3%) for a mortality rate of 6.2 per 100 person-years. In multivariable analyses, we observed no association between greater cumulative exposure to methotrexate, other DMARDs, or anti-TNF agents and survival. Greater exposure to corticosteroids was associated with greater risk of mortality [HR 1.15 (95% CI 1.14-1.17)], as were greater baseline comorbidity [Charlson HR 1.36 (95% CI 1.34-1.38)] and extra articular disease [HR 1.53 (95% CI 1.47, 1.61)]. Females and residents living in urban areas had lower mortality risk [HR 0.78 (95% CI 0.75-0.82) and HR 0.92 (95% CI 0.86-0.98), respectively]. <h3>Conclusions</h3> Though we could not demonstrate an association between exposure to DMARDs and over-all survival in seniors with RA, cause-specific mortality warrants further investigation. Greater exposure to corticosteroids, comorbidity and extra articular RA was associated with pre-mature mortality in our sample. <h3>References</h3> Widdifield et al, Trends in Excess Mortality among Patients with Rheumatoid Arthritis in Ontario, Canada. Arthritis Care &amp; Research 2015 [in press]. <h3>Disclosure of Interest</h3> None declared
Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial
Authors: Cecile A. Lengacher, Richard R. Reich, Carly L. Paterson, Sophia Ramesar, Jong Y. Park, Carissa Alinat, Versie Johnson-Mallard, Manolete Moscoso, Pinky Budhrani-Shani, Branko Miladinovic, Paul B. Jacobsen, Charles E. Cox, Matthew Goodman, Kevin E. Kip
Journal: Journal of Clinical Oncology (2016)

The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe.
Corn sugar as an allergen.
Authors: T G Randolph, L B Yeager
Journal: Allergy (1948)

A number of recent papers on gout refer to it as a forgotten disease, implying thereby that it is frequently overlooked. In a series of 100 patients reported by Hench 1 approximately fifteen years had elapsed from the first attack before a correct diagnosis was made. The average age of onset.of gout is usually about 40. Although the majority of patients are men, women are not infrequently affected, and the disease has also been described in children.2 It is generally recognized that the essential features of this condition consist of arthritis with or without podagra, hyperuricemia, deposits of sodium urate crystals in the articular, periarticular and subcutaneous tissues and, in a certain number of cases, of manifestations of cardiovascular or renal involvement. The complete reversibility of the arthritic attacks in the early stages and their irreversibility in the later phases, terminating in crippling chronic gouty arthritis with tophaceous deposits, are features which have been familiar to the physician and the laity for many generations. Heredity plays an important role in this condition, and one of the most striking phenomena is the trans¬ mission in gouty families of hyperuricemia without the disabling symptoms of the disease. Talbott,3 for exam¬ ple, reported high amounts of uric acid in the blood in 25 per cent of the relatives of gouty persons. Hyper¬ uricemia is likewise frequently observed in a number of clinical conditions in the absence of gout or a family history. Thus patients with glomerulonephritis may have elevated blood uric acid without any gouty arthri¬ tis. Persons having leukemia and polycythemia as well as pernicious anemia may also present similar findings. Nevertheless, the frequency of the association of hyperuricemia with gout serves to differentiate it from other forms of arthritis, although its exact role is not clear. There often is no relationship between the amount of uric acid in the blood and urine and the degree of arthritic involvement. Paroxysms of gout may occur on one occasion with normal and on another with elevated blood uric acid. The latter may be present between attacks when the patient is completely free of symptoms. Acutely affected joints have been found to be apparently free of urates, whereas certain symptomless joints have revealed extensive deposits of urates. Furthermore, there is no constant relationship between the formation or resorption of tophi and acute attacks. Nor does the increase in bound uric acid reported by, Adlersberg, Grishman and Sobotka4 in 10 cases of gout in conjunction with hyperuricemia help to explain the causation of the gouty paroxysms. This is especially so since they also found abnormal uric acid partitions in about half of their patients with hepatitis, cirrhosis of the liver, prolonged obstructive jaundice and in 1 patient with suppurative cholangitis as well