tbuckley/cabot-search huggingface dataset:
Continuing Education Courses for Physicians
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
Bile Acids, but Not Neutral Sterols, Are Tumor Promoters in the Colon in Man and in Rodents
Authors: John H. Weisburger, Bandaru S. Reddy, William S. Barnes, Ernst L. Wynder
Journal: Environmental Health Perspectives (1983)

Analysis of the etiologic factors and relevant mechanisms involved in carcinogenesis leads to a classification of agents involved in the carcinogenic process as genotoxic or epigenetic. Their mode of action is distinct, especially with regard to dose-response effects and reversibility. The genotoxic carcinogens for colon cancer are unknown, but mutagenic components found in fried beef and fish are under study. Epigenetic agents as promoting factors play a major role in the development of cancer of the colon. Specific nutritional elements associated with colon cancer risk are high fat diets, high cholesterol intake, and low fiber intake. The role of micronutrients as modulators and inhibitors needs to be explored. Through metabolic studies in diverse populations and in reliable animal models, it is now clear that dietary fat and cholesterol control the total flow of bile acids in lumen and a high-fat, high-cholesterol diet increases the total of bile acids in the gut. Bile acids but not neutral sterols have promoting effects and are related to colon cancer risk although bile acids by themselves do not act as complete carcinogens. The effect of dietary fiber such as cereal bran is to increase stool bulk which dilutes the concentration of bile acids. Reducing the concentration of bile acids either by lower dietary fat and cholesterol or by increasing dietary fiber may effectively lower the risk for colon cancer.
Cultural revolution
Authors: P. Pietroni
Journal: BMJ (2003)

The UK government wants doctors to take on board patients' views in shaping practice. But how can you change the mindset of the medical profession in order to do that? Involving patients and the public in health care has been government policy for at least 30 years. This has, however, been left to develop, or not, in a haphazard manner, and exactly what "involving the patient" (let alone "the public") means has never been adequately defined. This shift in policy in the NHS has mirrored the major societal trends over the past 60 years or so (see box). Notwithstanding the many excellent attempts by individual doctors to engage with patients in a more cooperative manner, little progress has been made. The fundamental shift required in moving from an "expert doctor" centred model to one focused on patients' needs is a long way away. Patients may indeed be wanting to have a say in their care, but the ensuing conversation is often more like a shouting match than an orderly discussion where each side respects the skills, needs, and status of the other. The 4Ps Development Centre provides tailor made educational programmes to help healthcare professionals involve patients and the public. It grew out of work at the Department of Postgraduate General Practice in North West Thames region. Professor Pietroni asked a team of clinicians and managers to explore how patient and public involvement could be systematically translated from theory into practice. The group began work by asking healthcare professionals what patient and public involvement meant to them. They found that some were mystified, many were antagonistic, and others would "do it when we have time." There was also a dismissive group who felt they did it already. #### Major societal trends over past 60 years
iscellanea edica
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
Reference Committees of the House of Delegates
Journal: JAMA (1967)

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
Editor's Choice
Journal: British Journal of Dermatology (2018)

Effect of atopic skin stressors on natural moisturizing factor and skin cytokinesEngebretsen and colleagues from Denmark explain that epidermal deficiency of fi laggrin, and the derived natural moisturizing factors (NMFs), is associated with increased risk of atopic dermatitis.Furthermore, while fi laggrin gene mutations cause fi laggrin defi ciency, they explain that there is limited insight into causative environmental factors.Thus, the aim of their study was to explore the effect of selected exogenous skin stressors on levels of NMF and skin cytokines in healthy adult epidermis.They studied 40 healthy volunteers (age 18-49 years) who were exposed to hard, soft and chlorinated water, 0.5% sodium laurel sulfate, house dust mite, cat allergen, staphylococcal enterotoxin B, cooling and histamine.Participants were tape stripped and biophysiological measurements were performed.NMF levels (measured in mmol g -1 ) were determined after 24 and 48 h, while skin cytokines were measured
Highlights
Journal: JAMA Internal Medicine (2017)

Testosterone Treatment and Bone Density 471In this study, Snyder and colleagues allocated a cohort of 211 men 65 years or older with serum testosterone concentration less than 275 ng/dL who also participated in the Testosterone Trials to receive testosterone or placebo for 1 year.Volumetric bone mineral density and strength of the spine and hip were evaluated by quantitative computed tomography at baseline and after 1 year, and it was found that testosterone treatment for 1 year compared with placebo signifi cantly increased volumetric bone mineral density and strength of the spine and hip.
ACUTE OTITIS MEDIA.
Authors: B. MERRILL HOPKINSON
Journal: JAMA (1897)

After a very careful and interested study of the paper upon the above affection by Dr. Norval H. Pierce, and the discussion by some of his colleagues, members of the Chicago Academy of Medicine in theJournalof Dec. 19, 1896, I have felt impelled to report a case, in which the treatment followed was very dissimilar to that advocated by the essayist and his confrères. The case I shall herein report occurred in my own person, and is but a description of many others occurring in the practice of my very able and accomplished medical attendant, as well as in that of his students, and I am proud to number myself among the latter. I fully endorse what was said by Dr. Wm. L. Ballinger in the discussion of the paper, viz.: "Dr. Pierce is to be congratulated upon the pathologic and bacteriologic portions of his thesis;" and I
The Provincial Schools of Medicine
Journal: BMJ (1841)

By a resolutioni of the Council on the 7th of November, 1839, no Provincial Hospital will in future be recognised by this College which contains fewer than 1O0 patients, and no metro- politan hospital which contains fewer than 150 patients.f An Anatomical Session is understood to extend from Oc- tober to April inolusive,.and to comprise at least 140 Lectures Dn Anatomy and Physiology, occupying not less than onie hour each, given on separate days; and at least 100 Demonstrations 3f the like duration, given in a similar manner; exclusive of Dissections, of wbich distinct certiticatea are required.
Minerva Cardioangiologica, Turin
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 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
Amyloidosis
Authors: Alan S. Cohen
Journal: New England Journal of Medicine (1967)

Specific Organ Involvement and Clinical Manifestations Amyloidosis of the kidney. Renal involvement, the most common and potentially the most serious manifestation of amyloidosis, is the usual presenting manifestation and the major cause of death in most series. 117,127,132, 194 Despite this, renal amyloid may be present and asymptomatic for many years, and the amyloid does not inevitably progress. It is as frequent in primary and myeloma-related amyloid as it is in secondary amyloidosis,127, 194 , 195 and occurs as the major manifestation of the amyloid associated with familial Mediterranean fever.105 In addition to direct involvement of the kidney, other parts of the urogenital system . . .
Profession or technocracy.
Journal: BMJ (1970)

PointersChemotherapy for Leukaemia: Cytosine arab- inoside and daunorubicin gave an overall com- plete remission rate of 60% in a series of 23 patients with acute myelogenous leukaemia.The addition of L-asparaginase did not improve re- mission rate (p.513).Leader at p. 508.Coil and Kiil Dialysers: A study of the compara- tive efficiency, safety, and cost of maintenance dialysis showed that the two dialysers proved equally satisfactory.Running costs were approxi- mately equal (p.517).Ketonaemia in Diabetes: Biochemical findings in a small series of patients with non-ketotic diabetic coma were compared with findings in ketoacidotic subjects.Neither the levels of serum insulin nor those of free fatty acids explain the absence of hyperketonaemia in some cases (p.522).Colistin and Renal Function: Very high doses of colistin in patients with refractory klebsiella infections resulted in acute renal failure (p.525).Endocrine Disorder in Bronchial Cancer: In an unselected series of 185 patients with bronchial carcinoma 16 had endrocrine disturbance attributable to the tumour (p.528).Busulphan Lung: In an effort to achieve early detection of fibrosing alveolitis due to busulphan treatment 23 patients were investigated.Only one case was detected (p. 530).Iron and Tetracycline Interaction: Ferrous sulphate found to impair the absorption of tetracycline type antibiotics.Iron should not be taken during tetracycline treatment (p.532).Leader at p. 509.Corticosteroids and Adrenocortical Function: An investigation of the recovery of adrenocortical function during very slow withdrawal of cortico- steroids (p.534).Case Reports: High serum acid phosphatase in lymphoblastic leukaemia (p.537); Southey's tubes and vulval oedema (p.538).
Correction: Alpha blockers and converting enzyme inhibitors
Authors: Henry Elliott, Gordon Fell
Journal: BMJ (1983)

with an acute rise in the serum aluminium concentration.Dr Small and others describe abnormalities on the electroencephalogram and seizures in their haemophiliac patient, and they comment that he had received large quantities of factor VIII over 14 years and that he tended to inject the concentrate too rapidly.He may thus have gradually accumulated a substantial amount of aluminium in his body and an acute further exposure to a high concentration of aluminium may then have proved sufficient to provoke seizures.
An attitudinal assessment of faculty practice plans
Authors: G. K. MacLeod
Journal: JAMA (1987)

An awareness of potential conflict between medical schools and private practice prompted an attitudinal assessment of faculty practice plans (FPPs). A representative sample of eight medical school FPPs in seven different communities was selected for study. For each FPP, a sample of health care leaders, stratified at different levels of administrative responsibility, was selected from academic medical centers and from community settings. Topics for FPP assessment were chosen for their relevance to physician and lay administrators involved with academic and community practice. Questions were answered on a yes-no basis and were graded by intensity of response. Although only two of the questions revealed statistical disparity on a simple yes-no basis, the intensity of response differed significantly in eight of the 14 questions asked. This study gives consideration to the strategic implications of FPPs for universities, medical schools, and organized medicine. (<i>JAMA</i>1987;257:1072-1075)
Endothelial Dysfunction
Authors: Dierk H Endemann, Ernesto L Schiffrin
Journal: Journal of the American Society of Nephrology (2004)

Endothelial dysfunction is characterized by a shift of the actions of the endothelium toward reduced vasodilation, a proinflammatory state, and prothrombic properties. It is associated with most forms of cardiovascular disease, such as hypertension, coronary artery disease, chronic heart failure, peripheral artery disease, diabetes, and chronic renal failure. Mechanisms that participate in the reduced vasodilatory responses in endothelial dysfunction include reduced nitric oxide generation, oxidative excess, and reduced production of hyperpolarizing factor. Upregulation of adhesion molecules, generation of chemokines such as macrophage chemoattractant peptide-1, and production of plasminogen activator inhibitor-1 participate in the inflammatory response and contribute to a prothrombic state. Vasoactive peptides such as angiotensin II and endothelin-1; the accumulation of asymmetric dimethylarginine, an endogenous nitric oxide inhibitor; hypercholesterolemia; hyperhomocysteinemia; altered insulin signaling; and hyperglycemia can contribute to these different mechanisms. Detachment and apoptosis of endothelial cells (anoikis) are associated phenomena. Endothelial dysfunction is an important early event in the pathogenesis of atherosclerosis, contributing to plaque initiation and progression. Reductions in circulating endothelial progenitor cells that participate in regeneration of the endothelium participate in endothelial pathophysiology. The severity of endothelial dysfunction has been shown to have prognostic value for cardiovascular events. Correction of endothelial dysfunction may be associated with reduced cardiovascular risk. Circulating endothelial progenitor cells may represent a potential therapeutic approach for endothelial dysfunction.
Endarterectomy in carotid artery disease. A decision analysis
Authors: D. B. Matchar
Journal: JAMA (1987)

Carotid endarterectomy is being performed with increasing frequency, now over 100000 times annually in the United States. We used the methods of decision analysis to examine the question of when to perform carotid endarterectomy. We developed a model that simulates the possible outcomes for a cohort of patients at risk for stroke. Estimates of surgical risk, surgical efficacy, annual stroke rate, and nonstroke mortality were derived from the literature. Using sensitivity analysis, we found that surgical risk, surgical efficacy, and stroke risk are the most important factors in determining when surgery is appropriate. By examining a series of clinical scenarios, we constructed guidelines for carotid endarterectomy based on the estimated risk of future stroke. The analysis suggests that for patients with a risk of less than 3% per year, surgery is not indicated. For patients with risk between 3% and 5% per year, low-risk surgery can be expected to provide a benefit of at most three months of quality life, depending on the efficacy of surgery. For stroke risk between 5% and 10% per year, even high-risk surgery is favored if surgical efficacy is above 30% Above a stroke risk of 10% per year, even high-risk, low-efficacy surgery should be considered. The challenge to advocates of carotid endarterectomy is to develop a cost-effective strategy for identifying patients at high risk for stroke. (<i>JAMA</i>1987;258:793-798)
Orthodontics
Authors: Coenraad F. A. Moorrees
Journal: New England Journal of Medicine (1968)

ORTHODONTIC treatment is aimed in part at providing optimal tooth alignment and occlusion to remove the stigma of ugliness and to improve thereby the patient's image of himself and his psychologic adjustment. An anatomically normalized dentition also enhances functional adequacy during physiologic activities and, as a consequence, the survival of the denture during the life-span of the individual.To correct malocclusion, teeth are moved by application of forces that in turn elicit tissue changes (that is, bone resorption and bone formation) until normal tooth alignment is reached and the maxillary teeth properly interdigitate or occlude with the mandibular teeth. Not . . .
Out of Africa comes the fruit of long research: possible self-reliant control of schistosomiasis
Authors: M. F. Goldsmith
Journal: JAMA (1991)

AFTER MOVING at a snail's pace for 25 years, efforts to control schistosomiasis through the use of a made-in-Africa, plant-based molluscicide are inching nearer their goal. Ethiopian researcher Aklilu Lemma, ScD, presented the results of his long struggle for the acceptance of<i>endod</i>at a symposium entitled "Science in Africa: Achievements and Prospects" at this year's meeting of the American Association for the Advancement of Science, in Washington, DC. Endod is the Ethiopian name for the soapberry plant (<i>Phytolacca dodecandra</i>), a climber with hanging branches whose dried berries, powdered and mixed with water, have provided the traditional laundry detergent for generations of Africans. The plant is a close relative of<i>Phytolacca americana</i>, which is known in the United States as pokeweed. Lemma, who was trained in pathology with emphasis on tropical diseases at Johns Hopkins University, Baltimore, Md, has worked extensively in this country. However, it was in Ethiopia that
Laryngeal Vertigo
Authors: R. N. C. Smith
Journal: BMJ (1953)

<h3>Objective</h3> This project aims to assess the role of a standardised process of data collection to improve morbidity and mortality data across the region. <h3>Design</h3> Six hospitals within the North West (UK) were recruited and adopted the ENT Quality Improvement Program (QIP) into their daily practice. Monthly anonymous data were sent back to the reviewer for trend analysis. <h3>Outcome measures</h3> Four outcome measures were defined: (1) number of cases recorded within the region each month; (2) assessment of the severity of cases and trends; (3) assessment of action plans reviewing any changes in practice made as a result of using this tool; (4) long-term use of the tool and qualitative feedback from units. <h3>Results</h3> 162 patients over the 6 months were included with 180 case discussions. 170 of these were morbidities and 10 were mortalities. Mortality was more frequent in patients with a diagnosis of head and neck cancer. Of the 162 patients, 133 encountered postoperative complications. Post-tonsillectomy (62/133 47%) and post-thyroid surgery (19/133 14%) complications were the most frequently encountered. 66% of the complications were low grade with 18% requiring management under general anaesthetic. Actions plans included four policy reviews with the introduction of three new policies. All sites found the tool user-friendly and are continuing to use it beyond the data collection period. <h3>Conclusions</h3> The ENT QIP has been found to be a simple, user-friendly tool which has improved the quality of data over the six sites and resulted in improvements in practice. Implementation of the tool allows clinicians to critically appraise their practice and to reflect as well as to demonstrate how complications have resulted in change.