tbuckley/cabot-search huggingface dataset:
Measuring Competence
Authors: EUGENE A. STEAD
Journal: Annals of Internal Medicine (1977)

Editorial Note1 April 1977Measuring CompetenceEUGENE A. STEAD JR., M.D.EUGENE A. STEAD JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-4-501 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe american specialty boards in medicine, surgery, and the various subspecialties were created to guarantee to the public competent performance from doctors in the area certified by the board. This objective was to be obtained by two methods: the presentation by the candidate of a program of training that was judged by the board to be of the type that would allow the candidate a reasonable chance of passing an examination given by the experts on the board; and by passing the examination.The boards early recognized that there was a difference between knowledge and competence. The development of multiple...Reference1. SENIOR J: Toward the Measurement of Competence in Medicine. The Development and Validation of a Computer-Based System for Testing and Teaching Clinical Competence in Medicine: A Report and Discussion. Philadelphia, [published by the author], 1976. [Inquiries on copies for distribution should be addressed to John R. Senior, M.D.; Graduate Hospital, 19th and Lombard Sts.; Philadelphia, PA 19146] Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine Duke University Medical Center Durham, North Carolina PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byContinuing professional competence: Voluntary or legislated? A panel discussion 1 April 1977Volume 86, Issue 4Page: 501-501KeywordsSub-specialty careSurgery ePublished: 1 December 2008 Issue Published: 1 April 1977 PDF downloadLoading ...
Reflectance confocal microscopy terminology glossary for nonmelanocytic skin lesions: A systematic review
Authors: Cristian Navarrete-Dechent, Antonio P. DeRosa, Caterina Longo, Konstantinos Liopyris, Margaret Oliviero, Harold Rabinovitz, Ashfaq A. Marghoob, Allan C. Halpern, Giovanni Pellacani, Alon Scope, Manu Jain
Journal: Journal of the American Academy of Dermatology (2018)
Injuries From Propane Gas Grills
Journal: JAMA (1996)

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
Thresholds, dose-response relationships and dose metrics in allergic contact dermatitis: reply
Authors: P.S. Friedmann
Journal: British Journal of Dermatology (2008)

Conflicts of interest: none declared. Sir, Ian Kimber and David Basketter raise an interesting and important point about whether or not agents regarded as ‘weak’ or low‐potency sensitizers can induce very strong sensitization. They contend that the clinical expression of allergic reactivity is the product of both the sensitizing potency of the agent, the exposure dose and the individual susceptibility – a view with which I agree completely. However, their contention that weak sensitizers might be able to induce strong reactivity has given me cause to reconsider the issue carefully and I confess I must agree with them. I am therefore grateful for the opportunity to lay out some further thoughts on the matter. This question can be considered from two standpoints. The first is the presumption that everyone can become allergic to everything; the second is that contact hypersensitivity, like drug hypersensitivity, is an individual‐specific ‘idiosyncratic’ response. From the first standpoint, consideration of the basic dose–response relationships of single applications of potent sensitizers such as dinitrochlorobenzene shows that everyone can be made allergic and, as the sensitizing dose is progressively reduced, so fewer people become sensitized (clinically allergic) and they give progressively weaker responses to challenge – requiring higher challenge doses to elicit reactivity. A second aspect of the dose–response relationships is the much less well‐defined one of the effects of repeated applications of sensitizers. The famous Al Kligman investigated some aspects of this question.1 He showed that repeated applications of many agents not regarded as potent sensitizers, including penicillin and para‐phenylenediamine, would indeed sensitize increasing numbers of human volunteers – which supported the premise that everyone can become allergic to everything if given sufficient exposure. Unfortunately, he did not quantify responses so we do not know whether or not these individuals were highly reactive to low elicitation concentrations. To the best of my knowledge there has been no systematic work in humans examining the dose–response relationships with so‐called ‘weak’ sensitizers so there is no direct evidence about whether or not they can induce strong sensitization. Hence, from the first standpoint it could be argued (as I did2) that weak sensitizers are indeed weak and cannot induce strong degrees of reactivity, mainly because the exposure doses required to generate strong sensitization are not normally reached. This appears to be the thrust of the argument by Kimber and Basketter.
Radionuclide scanning of the placenta in abdominal pregnancy
Authors: G. C. Curry
Journal: JAMA (1968)

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
Postponing or preventing deaths? Trends in infant survival
Authors: S. Sepkowitz
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Buehler et al<sup>1</sup>in their article on infant survival in Georgia state that "recent declines in neonatal mortality in the United States have been largely attributed to lower mortality among low-birth-weight infants." Such is not the case in Georgia, based on the information supplied by the authors. Although neonatal mortality declined from 12 per 1,000 live births in 1974-1975 to 8.1 per 1,000 live births in 1980-1981, the percentage of low-birth-weight deaths remained the same (77.3% vs 77.5%). These similar proportions suggest diverse sources of causation for the decline or a generalized one operating in both weight groups; it argues against the greater utilization of neonatal intensive care units (NICUs) as a single cause of the decline in neonatal mortality. The interpretation of weight-specific neonatal mortality declines is a specious one. Demonstrating an increased utilization of NICU care over time hardly justifies the statement that improved
Correlation between acute tissue plasminogen activator release from the human coronary and peripheral circulations David E. Newby, Fraser N. Witherow, Andrew L. McLeod, Neal G. Uren, Bernard Prendergast, Laura L. Flint, David J. Webb, Keith A. A. Fox, Nicholas A. Boon. Royal Infirmary, Edinburgh, United Kingdom, Western General Hospital, Edinburgh, United Kingdom
Journal: Journal of the American College of Cardiology (2001)
Allergy and Immunology
Authors: Samuel C. Bukantz
Journal: JAMA (1990)

The exploration of immunologic mechanisms has entered a new phase, that of molecular biology,<sup>1</sup>resulting in an improved understanding of diseases that arise from immunologic injury. From among the many basic and clinical contributions,<i>Science</i>has selected a "Molecule of the Year," the DNA polymerase, which drives the polymerase chain reaction.<sup>2</sup> The polymerase chain reaction has been used to detect proviral DNA in the peripheral blood mononuclear cells of persons infected with human immunodeficiency virus 1 who are seropositive and virus culture negative. An assay has also been developed to detect human immunodeficiency virus 1 RNA in patients with acquired immunodeficiency syndrome and acquired immunodeficiency syndrome—related complex, which raises the possibility of early detection of human immunodeficiency virus in plasma and serum through gene amplification,<sup>3</sup>of obvious benefit in blood bank screening. The long-term safety and efficacy of zidovudine therapy have been examined in 229 subjects with
As data on antiprogesterone compounds grow, societal and scientific aspects are scrutinized
Authors: M. F. Goldsmith
Journal: JAMA (1991)

ALTHOUGH some people wish it would just go away, a symposium at the American Association for the Advancement of Science meeting in Washington, DC, has presented new evidence for the argument that RU-486 (mifepristone) is here to stay. Ever since the first reports were published in the early 1980s of this drug's use in France as a safe and effective abortifacient, researchers have also emphasized the many other potential indications inherent in the entire class of antiprogestational compounds (<i>JAMA</i>. 1989;262:1808-1814 and 1990;264:1026-1027). Now, the results of clinical trials of RU-486 for at least two gynecologic uses—ripening of the cervix at term and expulsion of the fetus after spontaneous intrauterine death during the second or third trimester-are so encouraging that its approval for these purposes appears to be "imminent." That is the opinion of the symposium chair, Sheldon J. Segal, PhD. He says the French researchers have enough data now to
THE NATURAL AND MENTAL HAZARDS OF RADIOLOGY
Journal: JAMA (1927)

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
Pernicious Anemia
Authors: Ban-Hock Toh, Ian R. van Driel, Paul A. Gleeson
Journal: New England Journal of Medicine (1997)

Pernicious anemia is the most common cause of vitamin B12 deficiency. Vitamin B12 deficiency has many causes; the term "pernicious anemia" applies only to the condition associated with chronic atrophic gastritis. A recent population survey revealed that 1.9 percent of persons more than 60 years old have undiagnosed pernicious anemia.1 Earlier studies suggested that pernicious anemia is restricted to Northern Europeans.2 However, subsequent studies have reported the disease in black and Latin-American subjects, with an earlier age of onset in black women.1,3 Although the disease is silent until the end stage, the underlying gastric lesion can be . . .
The archives of Family medicine. Emphasizing primary care in the 1990s
Authors: G. D. Lundberg
Journal: JAMA (1992)

The American Medical Association (AMA) announces its first new scientific journal since 1926. The<i>Archives of Family Medicine</i>will be sent monthly on a complimentary basis to approximately 83000 family physicians and general practitioners in the United States in addition to being available on a paid subscription basis to anyone, anywhere. Under the leadership of Marjorie A. Bowman, MD, professor and chair of family and community medicine at the Bowman Gray School of Medicine, an outstanding editorial board, and Associate Publisher Michael Springer, thisArCHIVESwill deliver peer-reviewed, primary source, scientific and clinical articles, reviews, and articles on practice management, prevention, health promotion, and technology assessment, as well as timely commentaries on ethical, social, economic, and political issues. The editors will serve the information needs of frontline family physicians and will use reader-friendly language and design to deliver the messages in the most palatable manner possible. Credit for this initiative
Vemurafenib Active in Iodine-Refractory Thyroid Cancer
Journal: Cancer Discovery (2016)

A new study shows that the BRAF inhibitor vemurafenib may induce partial responses and stable disease in patients with papillary thyroid cancer that has become refractory to radioactive iodine. However, the drug led to a variety of serious adverse events in roughly 65% of patients, including the development of some squamous cell carcinomas.
Phase II trial of irinotecan plus cisplatin in patients with recurrent or metastatic squamous carcinoma of the head and neck (RMHNC)
Authors: C. V. Ikpeazu, B. A. Murphy, B. Kish, A. Cmelak, Y. Shyr, J. Netterville, B. Burkey, C. Chung, W. Yarbrough
Journal: Journal of Clinical Oncology (2004)

5580 Background: Based on previous work demonstrating an overall response rate of 20% with single agent CPT-11 (Murphy, Oncology, vol. 15,), we undertook a phase II trial conducted through the Vanderbilt Ingram Cancer Center Network to evaluate the combination of CPT-11 plus Cisplatin as first line therapy for RMHNC. Methods: squamous cell histology, ECOG PS of 0 or 1, good organ system function, no prior chemotherapy for metastatic or recurrent disease, able to give informed consent, bi-dimensionally measurable disease. Patients received CPT-11 65mg/m2 IV over 60 minutes plus Cisplatin 30mg/m2 IV weekly x 4 weeks followed by a 2-week rest for a maximum of 6 cycles. Results: 13 patients were accrued and 11 are evaluable for response and toxicity. Median age was 60 years. Six patients had prior chemotherapy as part of primary treatment. Toxicity was significant with grades 3 and 4 leukopenia/neutropenia in 12 patients (92%), grade 3 diarrhea in 5 patients (38%), grades 3 and 4 dysphagia in 3 patients (23%), grade 3 nausea and vomiting in 4 patients (30%). Response: 5 partial responses, 5 PD, 1 withdrawl due to toxicity and 1 too early for evaluation. Conclusions: The combination of CPT-11 and cisplatin at the doses used in this study resulted in a high response rate; however, toxicity was significant. Study accrual was suspended pending modification of the treatment regimen. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Pharmacia
Quality Improvement Strategies for Type 2 Diabetes—Reply
Authors: Kaveh G. Shojania, Sumant R. Ranji, Kathryn M. McDonald, Jeremy M. Grimshaw, Robert J. Rushakoff, Douglas K. Owens
Journal: JAMA (2006)

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
Reply:
Authors: Pablo Bellot, Jose Such, Jaime Bosch
Journal: Hepatology (2011)

We thank Vlachogiannakos et al. for their interest in our recent article.1 One of the main questions raised in their letter is whether bacterial DNA detection is a more accurate marker of bacterial translocation than endotoxin. Considering that the detection of endotoxin, which is almost exclusively present in gram-negative microorganisms, or its soluble receptor lipopolysaccharide binding protein may severely underestimate the translocation of gram-positive microorganisms, we have proposed bacterial DNA detection as a broad-range marker of bacterial translocation in the setting of cirrhosis. In our experience, bacterial DNA is present in approximately 35% of patients with cirrhosis and ascites, and similar findings have recently been reported by Angeli et al.2 with the same methodology. Our results show that baseline portal pressures are similar for patients with ascites independently of the presence of bacterial DNA. This finding is in line with previous clinical studies showing that elevated serum levels of lipopolysaccharide binding protein, which is a more sensitive marker of endotoxemia than endotoxin itself because of its longer biological half-life, are not associated with a greater degree of portal hypertension.3 In our study,1 which included a large series of uninfected patients with cirrhosis, we did not find any correlation between the bacterial DNA concentration and systemic hemodynamic parameters (mean arterial pressure and systemic vascular resistance). This does not entirely rule out a role for bacterial translocation because other bacterial products besides bacterial DNA can hypothetically play a role in the inflammatory response. Indeed, monocytes from patients with cirrhosis seem to have an enhanced response to bacterial products. Therefore, small or even undetectable amounts of bacterial products may cause an enhanced release of cytokines by monocytes and thus further impair systemic hemodynamics. We cannot offer a clear explanation for the discrepancies between our results and Vlachogiannakos et al.'s results with respect to the detection of bacterial DNA. Methodological variations are likely responsible for the differences because we would expect to find bacterial DNA in 30% to 35% of the baseline samples from Vlachogiannakos et al.'s patients (they all had ascites, and some had measurable levels of endotoxin). The inability to detect bacterial DNA after a 28-day course of rifaximin does not seem unexpected, although we do not have our own data for this. Molecular techniques are in continuous development. The detection of small amounts of bacterial DNA in blood samples from patients is always challenging, and we must take advantage of more powerful methodologies such as pyrosequencing for studying different issues that still remain controversial with respect to bacterial translocation in patients with cirrhosis. Pablo Bellot M.D.*, Jose Such M.D. , Jaime Bosch M.D.*, * Hepatic Hemodynamics Laboratory, Hospital Clinic, Barcelona, Spain, Liver Unit, University General Hospital, Alicante, Spain.
SURGERY IN ASYLUMS.
Journal: JAMA (1903)

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
THE RETICULAR FORMATION
Journal: JAMA (1963)

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