tbuckley/cabot-search huggingface dataset:
Electrocardiogram and pulmonary infarction: (acute cor pulmonale)
Authors: T. Winsor
Journal: JAMA (1968)

The electrocardiogram assists in the diagnosis of infarction when tracings are taken within 24 hours of the pulmonary arterial occlusion, when tracings are repeated at least daily, and when the infarcts are large. Electrocardiographic changes are detected in 70% to 80% of these patients, but if tracings are taken late or infrequently or if infarcts are small, changes are detected in only 10% to 20% of the patients. Electrocardiographic changes occur when at least 65% of the total cross-sectional area of the pulmonary arterial system is occluded (organically or by spasm) and hemodynamic abnormalities are present. Certain ECG changes indicate right atrial enlargement, while others indicate rotation of the right ventricle into the field of the left precordial (V<sub>4</sub>and V<sub>5</sub>) electrode position (clockwise rotation about the long axis as viewed from the apex). The enlargement is brought about by right atrial and right ventricular strain, and pulmonary
CONSULT
Authors: S. Satya Murti
Journal: JAMA (1992)

"Of all the needs a book has, the chief need is that it be readable." —Anthony Trollope In this tenth anniversary of the compact disk, the chief need for a CD is that it be easier to search and retrieve information from than its printed counterpart. <i>Scientific American Medicine</i>is a multivolume textbook of clinical medicine with quarterly updates. It occupies a sacrosanct position among other venerable American texts of clinical medicine. The entire book has been available in a CD format, called<i>CONSULT</i>, for a few years now. My review, therefore, is not as much about the book itself as it is about the CD. <i>CONSULT</i>is a single disk. Quarterly updates are issued each year. The expiring disk should be returned. In addition to text, references, and tables, the disk can display VGA figures. I used a DOS-based (version 5.0) 486-50 system, VGA monitor, and a Hitachi CD-ROM
Negative Ion Mass Spectra of Some Polychlorinated 2-Phenoxyphenols
Authors: K. L. Busch, A. Norstrom, C. -A. Nilsson, M. M. Bursey, J. R. Hass
Journal: Environmental Health Perspectives (1980)

Polychlorinated 2-phenoxyphenols were studied by negative ion mass spectrometry. Common to almost all of the methane enhanced negative ion mass spectra were (M-1)-, (M-36-)-., (M-37)-, (M-72)-., and chorinated quinoxide ions. The (M-36)-. ion does not apparently form in a mechanism analogous to the thermal or photochemical ring closure of these compounds to form the chlorinated dioxins. The chlorinated quinoxide ion reflects the number of chlorines on the ring with hydroxy substituent. Collision-induced dissociation mass-analyzed ion kinetic energy spectra (CID-MIKES) from different isomers were qualitatively different in both the normal and charge reversed mode of operation. Comparison of these spectra with those from other classes of polychlorinated aromatic hydrocarbons such as the dioxins or the furans may reveal a common negative ion gas phase chemistry.
Lumleian Lectures on the Natural History and Diagnosis of Intrathoracic Cancer
Authors: J. R. Bennett
Journal: BMJ (1870)

PASSING, now, from the consideration of examples of diffused cancerous deposits in the lungs, having more or less analogy with diffused tuber- culisation, I select some examples illustrative of limited implication of the lungs and ultimate changes of structure, in which, during life, the physical signs correspond so closely with those which are common to chronic limited tubercular disease, passing into the stage of complete pulmonary disintegration, as almost to defy the most acute powers of diagnosis.Such cases are not, however, very common; i.e., cases un- complicated with unquestionable evidence of tumour or some other in- dication, rendering it plain that we have to do with something different from common tubercular disorganisation.George Brown, aged 57, was admitted the 5th September, x863, and died on the 1gth.A tall, spare man, who, on admission, had a phthisical aspect, was ansemic, the subject of great debility, slight cough, which was once or twice attended by slight heemorrhage and the physical signs of tubercular disease of the left apex; viz., some dulness and de- ficient respiration, with crepitation and increased vocal resonance.There was, however, no febrile disturbance; and the pulse, at first, was not quickened, but extremely feeble, and the man's chiefcomplaint was ofex- treme debility; there was no dysphagia, nor indeed any local symptoms except such as were connected with the apex of the left lung.The ex- tent of dulness was not great, and was most marked beneath the sternal end of the left clavicle, and immediately above the clavicle.The augmentation of vocal resonance was considerable; but, taking into consideration its seat, in immediate proximity to the trachea, was not at all remarkable.Fine crepitation, mixed with loose mucous rdles, was very distinct, and the respiratory murmur, which was deficient, had a harsh bronchial character.The constitutional condition however was, to say the least, unusual, viewing the case as one of phthisis, and con- * Among records of Piost mortem examinations at Guy's Hospital, is one of a case of epilepsy, in which the only lesion noticed was softening of the cord.It is highly prohahie, however, that this softening was extending to the cerebral surface at the time the patient died.There was no other explanation of the epilepsy in the case.
Borrelia burgdorferi in the Central Nervous System
Authors: Daniel J. Cameron
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Luft et al<sup>1</sup>reported polymerase chain reaction (PCR) evidence in spinal fluid to suggest continued infection in a patient with relapsing arthritis. The article raises the possibility that the CNS may act as a sanctuary for<i>B burgdorferi</i>, protecting it from the action of systemic antibiotics and immunity and thereby allowing it to reseed the periphery intermittently. Active CNS infection, if demonstrated, would indicate the need for further antibiotic therapy. Luft et al<sup>1</sup>used the case to question the use of using oral antibiotics alone for chronic arthritis. The PCR cannot be used to support continued CNS infection. The presence of spirochetal DNA does not indicate that viable<i>B burgdorferi</i>are present in the CNS, as the technique measures both viable and nonviable organisms.<sup>1</sup> The PCR test appears limited to establish CNS exposure. We still need a test to determine if the CNS remains
Assessment of functional oesophageal mucosal integrity in biopsies of patients with refractory gord
Authors: P. Woodland, Y. Duraisamy, R. S. Gill, R. Farre, S. Preston, D. Sifrim
Journal: Gut (2011)

<h3>Introduction</h3> Patients with non-erosive reflux disease (NERD) exhibit oesophageal mucosal epithelial dilated intercellular spaces (DIS), which can be reversed by PPI therapy and are not seen in patients with functional heartburn. Oesophageal mucosal functional integrity can be evaluated by measuring transepithelial electrical resistance (TER) and permeability to small molecules. Such functional changes may be relevant for symptom perception but are thus far not studied in NERD. We investigated oesophageal mucosal functional integrity in patients with GORD symptoms refractory to PPI. <h3>Methods</h3> Oesophageal biopsies at 3 cm above the squamo-columnar junction were obtained from 17 patients with persistent typical reflux symptoms (heartburn, regurgitation) on PPI but with no erosions (mean age 52, range 35–76), and 10 control subjects (no upper GI symptoms; mean age 38, range 18–54). Biopsies were placed in micro-Ussing chambers and baseline TER measured after equilibration in KHBB pH 7.4 solution. The mucosal side of the biopsies was then exposed for 30 min to either: KHBB control solution at pH 7.4; weakly acidic solution pH 5 + 1 mg/ml pepsin + 1 mM sodium deoxycholic acid; or acidic solution pH 2 + 1 mg/ml pepsin + 1 mM taurodeoxycholic acid. % change in TER at the end of the exposure was recorded. Following this the mucosal chamber solution was replaced with KHBB pH 7.4 + 1 mg/ml fluorescein. Passage of fluorescein to the serosal chamber was measured after 2 h. <h3>Results</h3> There was no significant difference between controls and NERD patients on PPI with regards to TER baseline (74±6 Ω/cm<sup>2</sup> vs 99±11 Ω/cm<sup>2</sup>) or permeability after exposure to the pH 7.4 solution. There was no reduction in TER after 30 min exposure to the pH 7.4 solution. Exposure to acidic solution resulted in a significant reduction in TER (−25.0±2.9%, p&lt;0.05) for all subjects, with no significant difference between patient and control groups. Permeability to fluorescein after 2 h trended towards an increase in patients versus controls that did not reach statistical significance. Exposure to weakly acidic solution caused a smaller, significant, decrease in TER. This TER reduction was greater in patients than in controls (−6.7±1.2% vs −1.4±2.4%, p=0.02). There was no significant difference in permeability to fluorescein between groups after weakly acidic exposure. <h3>Conclusion</h3> In basal conditions or after exposure to aggressive acidic solutions, oesophageal mucosal integrity of NERD patients refractory to PPI did not differ from controls. However, mucosal exposure to weakly acidic + bile acid solutions produced a distinct response in these patients, suggesting an increased susceptibility which may explain some patients9 apparent hypersensitivity to weakly acidic refluxate and failure of PPI therapy.
Evaluation of a new antipsychotic agent. Piperacetazine (quide)
Journal: JAMA (1971)

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
PIERRE-FRANÇOIS RAYER (1793-1867) PHYSICIAN TO THE KINGS OF FRANCE
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
FROM PARIS.
Authors: None A. B.
Journal: JAMA (1884)

Paris, January 16, 1884. In opening his course of lectures as Professor of Clinical Obstetrics, to which chair he had recently succeeded the late Prof. Depual, Prof. Pajot pointed out the necessity of adjoining a chair of gynæcology to that of obstetrics, as he said that both branches were so intimately connected that he could not understand how such a desideratum was allowed to exist, and he believed that France stood alone in this respect. Under existing arrangements gynæcology is not taught at the medical schools, nor is it officially recognized as a part of the medical curriculum in this country, the consequence is, a great number of students leaving the medical schools are completely ignorant of this most important branch. It is true the students obtain a theoretical knowledge of the principles of gynæcology, but when examined clinically they display an amount of ignorance which should not be allowed
Incorrect Book Publisher and Price in: Medical Expert Testimony: Advanced Syllabus for Healthcare Professionals
Authors: Richard Piekarz, Ari Zivotofsky
Journal: JAMA (2010)

onstrated in rabbinic decisions.For example, bullfighting has been prohibited, with an admonishment that even attending such events erodes a compassionate nature and implants a sense of accepting cruelty (Yechaveh Da'at 3:66).However, this principle is not unlimited; for example, a 1978 ruling determined that medical animal experimentation is permitted even if it causes pain to the animal because of the overriding human need (Tzitz Eliezar 14:68).
Non-A, non-B posttransfusion hepatitis: Comparing C and non-C hepatitis
Authors: R Koretz
Journal: Hepatology (1993)

Using assays to detect antibodies against antigens (C-100, 5-1-1, C-22 and C-33) of the hepatitis C virus, we tested stored sera from 40 patients prospectively identified as having non-A, non-B posttransfusion hepatitis. The 28 patients who demonstrated seroconversion (“documented hepatitis C”) had more severe initial disease; all 20 cases of chronic hepatitis occurred in this subgroup. Only 2 of the 12 patients who did not demonstrate such seroconversion even had symptoms. In the group of patients with documented hepatitis C, chronic hepatitis was more commonly seen in men (89%) than in women (40%). The patients in whom antibody to the C-100 antigen developed were younger and had received more blood than had those patients who had hepatitis C diagnosed by demonstration of antibodies to the 5-1-1, C-22 or C-33 antigen (or all three). The proportion of cases of posttransfusion hepatitis that could be associated with antibody seroconversion decreased around the time that blood banks switched to an all-volunteer system. The hepatitis seen in patients who failed to demonstrate serological evidence of hepatitis C virus exposure was usually clinically unimportant; it may or may not have been due to viral infection. (HEPATOLOGY 1993;17:361–365.)
Rheumatology
Authors: W. J. Koopman
Journal: JAMA (1991)

The most prevalent form of arthritis, osteoarthritis (OA), is characterized by progressive disintegration of articular cartilage, generally accompanied by new bone formation at joint margins and beneath involved cartilage. In some cases, the disease is a clear sequel to environmental insults (eg, posttraumatic OA) or metabolic disorders (eg, ochronosis), but, more commonly, the underlying origin is not apparent (primary OA). Efforts to identify inherited structural abnormalities in cartilage as a basis for primary OA have been prompted by impressive advances in molecular characterization of the structural components of cartilage coupled with evidence of familial forms of the disease. Pursuing this approach, Knowlton and colleagues<sup>1</sup>studied a family with multiple cases of precocious primary OA associated with mild chondrodysplasia. Ten members of the family, encompassing three generations, exhibited the disease. Using a labeled DNA fragment containing the type II procollagen gene, genomic DNA from multiple family members was examined for
Encore
Authors: None Gemaennes
Journal: Annals of the Rheumatic Diseases (1990)

EncoreAnkylosing spondylitis and fractures of the spine Only minor trauma may be necessary to cause a spinal fracture in ankylosing spondylitis as is well known.A review of experience from Vancouver showed that three quarters of such fractures were accompanied by severe neurological complications.The fractures were very unstable and in about half were through the ossified disc space or the vertebral body.They were associated with the altered mechanics and increased shearing stresses seen in this disease and they usually healed without the need for surgery.The authors plead for conservative management within a spinal cord injury unit for the best results.
ARGENTINA
Journal: JAMA (1952)

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
Facing Uncertainty
Authors: Cristina Thomas, Ruth Ann Vleugels, David J. Kwiatkowski, Bruce Levy, Joseph Loscalzo
Journal: New England Journal of Medicine (2019)

A 57-year-old woman presented with a 1-year history of an itchy facial rash, which was unresponsive to a 3-month course of prednisone and hydroxychloroquine. Redness had spread from her face to her scalp and neck. She reported a productive cough and progressive dyspnea for the preceding 2 weeks.
Highlights
Journal: JAMA Pediatrics (2018)

Keim and colleagues conducted a randomized, fully masked, placebo-controlled trial of daily microencapsulated docosahexaenoic acid (DHA), 200 mg, and arachidonic acid (AA), 200 mg (DHA and AA), or microencapsulated corn oil (placebo).They found that daily supplementation with 200 mg of DHA and 200 mg of AA for 6 months resulted in no improvement in cognitive development and early measures of executive function vs placebo and may have resulted in negative effects on language development and effortful control in certain subgroups of children.Continuing Medical Education jamanetwork.com/learning High-Performing Schools and Risk of Substance Use 1135Dudovitz and colleagues conducted a natural experiment of 1270 students using admission lotteries, which mimic a random assignment, to estimate the association of school environments and adolescent health.They found that the "intervention" group reported less marijuana misuse than the control group (mean marijuana misuse score, 0.46 vs 0.71) as well as fewer peers who used substances (9.6% vs 12.7%), more time studying (mean, 2.63 vs 2.49 hours), less truancy (84.3% vs 77.3% with no truancy), greater teacher support for college (mean scores, 7.20 vs 7.02), more orderly schools (mean order score, 7.06 vs 6.83), and less school mobility (21.4% vs 28.4%) (all P < .05).
Letters to the Editor
Journal: JNCI Journal of the National Cancer Institute (1970)

Letters to the Editor Get access Martin S. Hirsch, M.D. Martin S. Hirsch, M.D. Massachusetts General Hospital, Boston, Massachusetts 02114 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 45, Issue 2, August 1970, Pages III–IV, https://doi.org/10.1093/jnci/45.2.III Published: 01 August 1970
Lead poisoning from cocktail glasses. Observations on two patients
Authors: E. A. Natelson
Journal: JAMA (1976)

When the cup of any sensual pleasure is drained to the bottom, there is always poison in the dregs. Jane Porter(1776-1850) A MAN and his wife acquired plumbism by drinking repeatedly from cocktail glasses decorated with lead-based paint. <h3>Report of Cases</h3> A 53-year-old geophysicist entered the coronary care unit for investigation of progressively severe precordial pain of three weeks' duration. He also complained of fatigue and constipation. For eight years, he had received methyldopa, 1 gm daily, as treatment for systemic arterial hypertension. On examination, his blood pressure was 140/90 mm Hg; pulse, 78 beats per minute; respiratons, 12/min; and temperature, 37 C. His cardiac and pulmonary findings were normal, and his liver and spleen were not enlarged. Chest roentgenogram and serial electrocardiograms were normal. Hemoglobin concentration, however, was 9.7 gm/100 ml and hematocrit reading, 30%. Total leukocyte count was 8,400/cu mm and platelet count, 350,000/cu mm. Reticulocyte count
Practice transformation: Early impact of OCM on hospital admissions.
Authors: Molly Mendenhall, Karyn M. Dyehouse, Andrew S Guinigundo, Teresa Meyer-Smith, Brian Bourbeau, David Michael Waterhouse
Journal: Journal of Clinical Oncology (2018)

6542 Background: The purpose of the Oncology Care Model is to improve quality and reduce cost through practice transformation. A foundational tenant is to reduce avoidable ER visits and hospitalizations. In anticipation of being an OCM participant, we instituted a multidimensional campaign designed to meet these objectives. Methods: Prior Actions: Established phone triage unit. After-hours and weekend call. Instituted weekend urgent care. Year One: Improved education provided by nurse navigators and APPs prior to start of treatment (OCM Treatment Planning visit). Implemented triage pathways: 38 symptom and 27 follow-up pathways (modified COME HOME, Barbara McAneny, M.D.). Proactive symptoms follow-up calls to help circumvent emergent admissions. Increased APP staffing to provide blocked time slots for same day patient visits w/o schedule disruptions. Initiated “Call Us Early – Call Us First” campaign. Incorporated verbal and/or written instructions at all patient touch points, emphasizing patient’s responsibility to call before going to the emergency room. Results: Based on data from the Chronic Condition Warehouse, as provided by CMS, we were successful at reducing the acute care admissions rate by 16 percent. OCM patient survey scores improved. Readmissions (4.9 vs 5.6/100 pts), ER utilization (17 vs 18.6/100 pts), and Observation Stays (2.7 vs 3.6/100 pts) remained below Risk Adjusted National averages. Conclusions: By implementing a cost efficient, reproducible, and scalable campaign targeting ER avoidance and hospitalizations, we were able to decrease hospital admissions. Reported Medicare savings amounted to nearly $798,000 in inpatient cost per quarter over 1,600 patients. Baseline Jan ’16 – Mar ‘16 Year One Jul ’16 – Jun ‘17 Year One Benchmark (Risk Cohort) Patients per Quarter 1,722 1,600 - Mean Patient Risk Score 2.999 3.000 > 2.724 Admissions per 100 Patients, per Quarter 27.0 22.6 25.9 Cost per Admission Event 11,122 11,106 - Inpatient Cost per Patient, per Quarter 3,003 2,505 -