tbuckley/cabot-search huggingface dataset:
Abstract 18314: Fragmented QRS on a 12-lead ECG: A Predictor of Major Arrhythmic Events and Sudden Cardiac Death in Patients with Hypertrophic Cardiomyopathy; Long-term Follow-up Study
Authors: KI-Woon Kang, Hye Jin Hwang
Journal: Circulation (2012)

INTRODUCTION Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) is associated with major arrhythmic events (MAEs) included sudden cardiac death (SCD). However, Limited data was still shown in patients with hypertrophic cardiomyopathy (HCM). METHODS fQRS included various RSRpatterns (QRS duration &lt; 120ms), such as ≥1 R prime or notching of the R wave or S wave present on at least two contiguous leads of those representing anterior (V1-V5), lateral (I, aVL, V6), or inferior (II, III, aVF) myocardial segments on a 12-lead electrocardiogram (ECG). In the 454 (71% male, age 62±11 years, mean follow-up duration 10±1 years) patients with diagnosed HCM using echocardiography. We divided into two groups; fQRS and non-fQRS group at the time of diagnosis. MAEs (sustained VT or non-sustained VT on ambulatory 24-hr holter monitoring) including SCD were retrospectively reviewed. RESULTS fQRS was found (87/203, 42.8%) and predominantly located in inferior lead, the patients were divided into two groups: Heart rate, PR interval, QRS duration and QTc interval were similar in both groups. MAEs including SCD [14 (31.1%) vs. 2 (2.2%)] were higher in the fQRS group compared with the non-fQRS group (mean follow-up duration, 7.1±2.2 years). Multivariate Cox regression analysis revealed that fQRS was an independent significant predictor for MAE including SCD [hazard ratio 11.09 (confidence interval 2.40-51.09), p=0.002]. A Kaplan-Meier survival analysis revealed that fQRS group was significantly associated with lower MAE-free survival rate compared to non-fQRS group (P=0.004). CONCLUSION The fQRS complex is an independent predictor of MAEs including SCD in patients with HCM on long-term follow-up.
Stop using old weapons to fight the war against TB
Authors: Susmita Barman
Journal: BMJ (2004)

This year, World TB Day saw posters in health clinics, on billboards, and in newspapers trumpeting the success of the supervised drug regimen Directly Observed Therapy, Short Course (DOTS) launched 10 years ago. They advertised encouraging statistics, such as that DOTS has a cure rate of 83%.1 But how long will this strategy-which deploys outdated drugs and diagnostic tests-work against the new multi-drug resistant superstrains or those who have both tuberculosis and HIV/AIDS?

The same week saw two contradictory press releases. The first, issued by the World Health Organization (WHO), claimed it was “gaining ground” against tuberculosis, and the second, released by the aid agency Medecins …
Living with Parkinsons disease - a childs perspective
Authors: Lesley Rees, Great Ormond
Journal: BMJ (2002)

I was 10 years old when my mother came back from a large London teaching hospital, having been given the diagnosis of young onset Parkinsons disease. She was 46 years of age. She had made the diagnosis herself before this appointment. She was first told it by medical students when, during a consultant-led teaching session, she had been asked to walk across the front of a lecture theatre to show the characteristic gait. She was humiliated, and I was angry. That was when I decided to become a doctor myself.

Fortunately, young onset Parkinsons disease is …
Hand hygiene and healthcare associated infections
Authors: Andrew McArdle, Jason Ali, Nicholas Brown
Journal: BMJ (2007)

Andrew McArdle and colleagues assess the importance of hand hygiene in controlling infections during delivery of health care In 1847, Ignaz Semmelweis was house officer for a Viennese maternity ward that had a shocking mortality rate for maternal puerperal fever.1 His breakthrough was to realise that medical students and doctors were carrying the infection from autopsy specimens to patients. He instituted a policy of handwashing with chlorinated lime between autopsy and clinical work, and successfully reduced the mortality rate by a factor of five to a level comparable with that of the nearby midwives' maternity ward. Today, healthcare associated infections are still a hugely important problem (see box 1 for types of infection). A 1995 study by the Department of Health showed that almost 8% of inpatients became infected in hospital.2 These patients had a 10% chance of dying (sevenfold higher than other patients) and stayed on average 14 more days in hospital, with added costs estimated at £3000 (€4400; $5900). The overall burden on the country has been estimated to be £1bn a year, and patients with healthcare associated infections within the NHS are estimated to consume the equivalent of 27400 hospital beds.2 Continuing the Semmelweis tradition ### Box 1: What is healthcare associated infection? This can be defined as an infection occurring with no evidence of its presence or incubation at the time of a patient's admission, unless related to a previous admission. Because of the typical incubation period of most bacterial infections, nosocomial infection usually becomes evident 48 hours or more after admission. Common healthcare associated infections include those of the urinary tract, the lower respiratory tract, the gastrointestinal tract, skin and wound infections, and bacteraemias. The relative incidence of the main types is illustrated in the figure. Types of hospital acquired infection in acute trusts in England Although healthcare associated infections … RETURN TO TEXT
Life and loathings of a new doctor: All change
Authors: Stephen Goldie
Journal: BMJ (2005)

Six months as a surgical house officer went by so fast. I am sure I only graduated last week, but today was my first day as a medical junior doctor. I am working in a hospital I haven't visited for four and a half years, since I was a very junior student and not really paying much attention. It's so disorientating that I bumbled about for the first few hours generally getting in everyone's way. I …
Herbal medicine industry threatens future of thousands of wild plants
Authors: Clare Hughes
Journal: BMJ (2004)

The rapidly growing herbal medicine industry is threatening thousands of plant species around the world, according to a report by Plantlife International. About 35 000 plants are used medicinally worldwide, and there are fears that between 4000 and 10 000 species may now be endangered.

Alan Hamilton of the World Wildlife Fund said, “We have concerns about biological and cultural loss, and about loss of local knowledge--we can learn a lot about …
Altered relaxation times in MRI indicate bronchopulmonary dysplasia
Authors: Kai Förster, Birgit Ertl-Wagner, Harald Ehrhardt, Hannah Busen, Steffen Sass, Andreas Pomschar, Lutz Naehrlich, Andreas Schulze, Andreas W Flemmer, Christoph Hübener, Oliver Eickelberg, Fabian Theis, Olaf Dietrich, Anne Hilgendorff
Journal: Thorax (2019)

We developed a MRI protocol using transverse (T2) and longitudinal (T1) mapping sequences to characterise lung structural changes in preterm infants with bronchopulmonary dysplasia (BPD). We prospectively enrolled 61 infants to perform 3-Tesla MRI of the lung in quiet sleep. Statistical analysis was performed using logistic Group Lasso regression and logistic regression. Increased lung T2 relaxation time and decreased lung T1 relaxation time indicated BPD yielding an area under the curve (AUC) of 0.80. Results were confirmed in an independent study cohort (AUC 0.75) and mirrored by lung function testing, indicating the high potential for MRI in future BPD diagnostics. Trial registration DRKS00004600.
Diving and hyperbaric medicine
Authors: Christopher John Williams, Philip A Hendy
Journal: BMJ (2006)

You'd be hard pressed to find a better site than the NHS Scottish Diving Medicine website (www.sdm.scot.nhs.uk). This excellent easy to navigate site contains comprehensive reviews of most aspects of diving medicine from the gas laws to treatment of decompression illness. The information is well referenced and pitched at a level appropriate for the lay diver or the non-diving physician. Contact information and comprehensive emergency procedures are also detailed for Scottish recompression facilities.



If you're interested in “fitness to dive,” look no further than the UK Sport Diving Medical Committee (UKSDMC) website (www.uksdmc.co.uk). This group advises …
Dieting and body shaming: political correctness has trumped common sense
Authors: Anthony N Williams
Journal: BMJ (2019)

I’m not sure what point Kar is trying to make about body shaming.1 He expects us to provide information to patients with obesity—that requires a conversation about their weight. This must start with a judgment that it would be better for them if they lost weight. Some patients will choose to regard this as “shaming.” But he then implies …
BMA calls on UK government to review ethics teaching
Authors: Clare Hughes
Journal: BMJ (2004)

The BMA has called on the UK government for an “urgent review of medical ethics teaching at medical school.” Raanan Gillon, deputy chairman of the BMA's medical ethics committee, said, “The core curriculum makes sure that medical ethics are taught in medical schools, but there's quite a bit of anecdotal evidence that it's pretty patchy.

“Quite a lot of doctors are still keen to get on with the hard stuff-teaching people how to do medicine, but are less …
Examine the patient as if she’s your mother
Authors: Jonny Martell
Journal: BMJ (2009)

“No,” I lied to the consultant, “I have no questions.” In fact I wanted him and the assembled students, bar myself, out of the room. The teaching session was over and the questions I had could wait. The 60 year old woman before us had had a stroke a little more than a day before. A left hander, she had left sided hemiplegia and considerable global dysphasia. The series of neurological examinations she had just undergone had brought home to her how much of her former self she had lost. She was tired and no doubt a little …
A political doctor
Authors: Rebekka T Stiasny
Journal: BMJ (2007)

<b>Jerry Cowley</b> is a general practitioner, a lawyer, and an elected independent representative in the lower chamber of the Irish parliament. He has campaigned for improvements in health care for older people. His involvement in Irish politics started in 1997, when he campaigned nationally for an orthopaedic unit at Mayo General Hospital. He also campaigned for a national helicopter emergency medical service. <b>Rebekka T Stiasny</b> caught up with him
Poly(amine-co-ester) nanoparticles for effective Nogo-B knockdown in the liver
Authors: Jiajia Cui, Alexandra S. Piotrowski-Daspit, Junwei Zhang, Mingjie Shao, Laura G. Bracaglia, Teruo Utsumi, Young-Eun Seo, Jenna DiRito, Eric Song, Christine Wu, Asuka Inada, Gregory T. Tietjen, Jordan S. Pober, Yasuko Iwakiri, W. Mark Saltzman
Journal: Journal of Controlled Release (2019)
Complicated and Uncomplicated Acute Appendicitis Are Different Diseases—Do Not Compare Apples With Oranges
Authors: Paulina Salminen, Juha Grönroos, Tero Rautio
Journal: JAMA Surgery (2019)

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 Surgery HomeNew OnlineCurrent IssueFor Authors Podcast 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 Surgery journal
The Bedford Murder: an Evidence-Based Clinical Mystery
Authors: Mirza Muminovic
Journal: BMJ (2003)

Leslie Sharpe is a young family doctor in the town of Bedford, who sees a lot of interesting clinical cases in her everyday practice. When Nick Sampson suddenly disappears in mysterious circumstances and the body of a dead woman-who has connections to Nick, to Sharpe, and to you-turns up, you are drawn into the web of this thrilling and interactive mystery.

First …
Minerva: June 2002
Authors: Nandita K Parmar, Parth Paskaran, R A Daoud
Journal: BMJ (2002)

A 28 year old patient with a history of personality disorder and deliberate self harm presented to casualty having swallowed a radio aerial. Three weeks before this, he had swallowed more objects including stationery.

The patient was asymptomatic and an abdominal x ray showed air throughout the bowel, the aerial in four sections, and pens in the region of the stomach. No foreign bodies were seen in either the small or large bowel. The patient had to undergo a laparotomy as endoscopy was unsuccessful. Foreign bodies retrieved included two pens, six sections of a radio aerial, a pen refill, and a pencil.

Ingestion of foreign bodies is uncommon when done with the intent to cause self damage; liquids such as caustic agents, detergents, poisons, etc, are more common.



Corneal tattoos provide an interesting solution for disfiguring corneal scars. Varying shades of drawing ink can be put into the anterior corneal stroma by using punctures made by a conventional spatula needle. For a week after the operation patients notice a moderate sensation of a foreign body and have conjunctival redness, but they seem happy with the results ( British Journal of Ophthalmology 2002;86:397-9).

Oxidative stress increases significantly in people undergoing dialysis and is a risk factor for accelerated …
Home kit to test for sexually transmitted diseases
Authors: Karen Hebert
Journal: BMJ (2004)

Researchers at Johns Hopkins University in Baltimore, United States, have developed a home testing kit for sexually transmitted diseases that will be piloted in the Maryland area over the next six months. Five hundred kits will be available in the study, which is funded by the US Centers for Disease Control and Prevention in Atlanta.

The aim is to replicate the successful, widely used home pregnancy tests and lower the rates of sexually transmitted diseases (STDs) among young women, who are most at …
Patterns of substrate affinity, competition, and degradation kinetics underlie biological activity of thalidomide analogs
Authors: Adam S. Sperling, Michael Burgess, Hasmik Keshishian, Jessica A. Gasser, Shruti Bhatt, Max Jan, Mikołaj Słabicki, Rob S. Sellar, Emma C. Fink, Peter G. Miller, Brian J. Liddicoat, Quinlan L. Sievers, Rohan Sharma, Dylan N. Adams, Elyse A. Olesinski, Mariateresa Fulciniti, Namrata D. Udeshi, Eric Kuhn, Anthony Letai, Nikhil C. Munshi, Steven A. Carr, Benjamin L. Ebert
Journal: Blood (2019)
Archeogenetics of F11 p.Cys38Arg: a 5400-year-old mutation identified in different southwestern European countries
Authors: María Eugenia de la Morena-Barrio, Salam Salloum-Asfar, Julio Esteban, Belén de la Morena-Barrio, Carmen Altisent, Laura Martin-Fernández, Paul Gueguen, Jose Padilla, Antonia Miñano, Rafael Parra, Vicente Vicente, Francisco Vidal, Frederic Bauduer, Pablo Carbonell, Javier Corral
Journal: Blood (2019)
French toast adventures
Authors: Marcela Castillo-Rama
Journal: BMJ (2001)

One of these days we will all be proper doctors. But let's face it, who during their years at medical school has not had the occasional ‘most embarrassing moment’ that they will remember for life? Let me share mine with you.

My best friend and I were sent away from Sheffield to a district general hospital to do our paediatrics attachment. We had heard that we would get great teaching and wonderful accommodation at this hospital. New, big, ensuite rooms with phone and …
BCL6 corepressor contributes to Th17 cell formation by inhibiting Th17 fate suppressors
Authors: Jessica A. Kotov, Dmitri I. Kotov, Jonathan L. Linehan, Vivian J. Bardwell, Micah D. Gearhart, Marc K. Jenkins
Journal: The Journal of Experimental Medicine (2019)

CD4+ T helper 17 (Th17) cells protect vertebrate hosts from extracellular pathogens at mucosal surfaces. Th17 cells form from naive precursors when signals from the T cell antigen receptor (TCR) and certain cytokine receptors induce the expression of the RORγt transcription factor, which activates a set of Th17-specific genes. Using T cell–specific loss-of-function experiments, we find that two components of the Polycomb repressive complex 1.1 (PRC1.1), BCL6 corepressor (BCOR) and KDM2B, which helps target the complex to unmethylated CpG DNA islands, are required for optimal Th17 cell formation in mice after Streptococcus pyogenes infection. Genome-wide expression and BCOR chromatin immunoprecipitation studies revealed that BCOR directly represses Lef1, Runx2, and Dusp4, whose products inhibit Th17 differentiation. Together, the results suggest that the PRC1.1 components BCOR and KDM2B work together to enhance Th17 cell formation by repressing Th17 fate suppressors.
Pregnane X receptor activation potentiates ritonavir hepatotoxicity
Authors: Amina I. Shehu, Jie Lu, Pengcheng Wang, Junjie Zhu, Yue Wang, Da Yang, Deborah McMahon, Wen Xie, Frank J. Gonzalez, Xiaochao Ma
Journal: Journal of Clinical Investigation (2019)

Ritonavir (RTV) is on the World Health Organization's list of essential medicines for antiretroviral therapy, but can cause hepatotoxicity by unknown mechanisms. Multiple clinical studies found that hepatotoxicity occurred in 100% of participants who were pretreated with rifampicin or efavirenz followed by RTV-containing regimens. Both rifampicin and efavirenz are activators of the pregnane X receptor (PXR), a transcription factor with marked interspecies differences in ligand-dependent activation. Using PXR-humanized mouse models, we recapitulated the RTV hepatotoxicity observed in the clinic. PXR was found to modulate RTV hepatotoxicity through CYP3A4-dependent pathways involved in RTV bioactivation, oxidative stress, and endoplasmic reticulum stress. In summary, the current work demonstrated the essential roles of human PXR and CYP3A4 in RTV hepatotoxicity, which can be applied to guide the safe use of RTV-containing regimens in the clinic.
Skin colour versus skills
Authors: Abhishek Sharma, Taaran Cariappa, Shamsher Singh Mann
Journal: BMJ (2008)

We are medical students of Indian origin who study with students from countries such as Turkey, Nigeria, Syria, Greece, Macedonia, and the United States in a small but rapidly growing town in Bulgaria. It never crossed our minds that racism could creep into the heart of a noble profession, where your origin, ethnicity, skin colour, and religion are secondary to your skills.

Finally, in our third year, we have the invigorating taste of being clinical doctors instead of lab rats and …
Science of Sport
Authors: Aula Abbara, Ali Abbara
Journal: BMJ (2004)

Science of Sport is a striking exhibition now on at the Science Museum, London, which promises children and parents a fun and energetic day out investigating the relevance of science and technology to sport. The exhibition is timely-2004 is a big year for sport and an ideal time to draw children into the joys of different sports.

When there is growing concern in the United Kingdom about childhood obesity and its impact on the future health of our nation, this exhibition highlights one way of tackling the bulging waistlines of the younger generation. It uses simulators and interactive displays to draw children into the games and get them excited about sport.

The most popular display is the 20 metre sprint station, where two visitors compete from the start line to see who sprints fastest, and this comes complete with action replay to check the …
Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?
Authors: Rui‐Mei Feng, Yi‐Nan Zong, Su‐Mei Cao, Rui‐Hua Xu
Journal: Cancer Communications (2019)

Abstract Cancer is the leading cause of death in China and depicting the cancer pattern of China would provide basic knowhows on how to tackle it more effectively. In this study we have reviewed several reports of cancer burden, including the Global cancer statistics 2018 and Cancer statistics in China, 2015, along with the GLOBCAN 2018 online database, to investigate the differences of cancer patterns between China, the United States (USA) and the United Kingdom (UK). An estimated 4.3 million new cancer cases and 2.9 million new cancer deaths occurred in China in 2018. Compared to the USA and UK, China has lower cancer incidence but a 30% and 40% higher cancer mortality than the UK and USA, among which 36.4% of the cancer‐related deaths were from the digestive tract cancers (stomach, liver, and esophagus cancer) and have relatively poorer prognoses. In comparison, the digestive cancer deaths only took up ≤ 5% of the total cancer deaths in either USA or UK. Other reasons for the higher mortality in China may be the low rate of early‐stage cancers at diagnosis and non‐uniformed clinical cancer treatment strategies performed by different regions. China is undergoing the cancer transition stage where the cancer spectrum is changing from developing country to developed country, with a rapidly increase cancer burden of colorectal, prostate, female breast cancers in addition to a high occurrence of infection‐related and digestive cancers. The incidence of westernized lifestyle‐related cancers in China (i.e. colorectal cancer, prostate, bladder cancer) has risen but the incidence of the digestive cancers has decreased from 2000 to 2011. An estimated 40% of the risk factors can be attributed to environmental and lifestyle factors either in China or other developed countries. Tobacco smoking is the single most important carcinogenic risk factor in China, contributing to ~ 24.5% of cancers in males. Chronic infection is another important preventable cancer contributor which is responsible for ~ 17% of cancers. Comprehensive prevention and control strategies in China should include effective tobacco‐control policy, recommendations for healthier lifestyles, along with enlarging the coverage of effective screening, educating, and vaccination programs to better sensitize greater awareness control to the general public.