tbuckley/cabot-search huggingface dataset:
Health care in transition. Consequences for young physicians. Council on Long-Range Planning and Development
Journal: JAMA (1986)

Individuals planning for a career in medicine must weigh a number of factors into their decisions. Increasingly, they must understand the nature of the socioeconomic environment of health care, including the extent of competition with other physicians and other health professionals; the degree of autonomy from health care institutions, government, and third-party payers; the impact of demographic or technological changes; and the economics of medical practice. This report analyzes the environment of medicine, emphasizing those elements that will be most important to medical students and resident physicians. It focuses on three stages of a physician's career: obtaining a medical education, beginning to practice medicine, and maintaining a viable practice.
BOOK REVIEWS
Journal: Circulation Research (1954)

RESEARCH IN PROGRESSism) revealed only moderate increase in pulmonary artery pressure with right pulmonary artery occlusion despite a left lung flow of approximately eight times normal (fig.2)."With exercise and further increase of cardiac output, there is only a slight increase in pressure.In the presence of a competent left ventricle, the left lung in humans accommodates S to 10 times normal flow without marked incre-ments in pressure or evidence of right ventricular failure.Contrary to popular belief, complete sudden occlusion of a main pulmonary artery in the unanesthetized patient is well tolerated and does not produce shock nor characteristic electrocardiogram changes.Clinically, this also appears the ideal method for determining "resection tolerance" for pulmonary surgery.
AMA-RPS Resolutions to Be Acted on by the AMA House of Delegates
Journal: JAMA (1994)

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
Another side effect of NSAIDs
Authors: G. R. Gay
Journal: JAMA (1990)

The nonsteroidal anti-inflammatory drugs (NSAIDs) have enjoyed a generally laudatory press, their acronym implying neither steroid nor narcotic mechanism of action. They encompass a heterogeneous group of compounds, mostly organic acids, that appear to owe their therapeutic efficacy to an inhibition of the biosynthesis of prostaglandins. They exhibit very real analgesic and antipyretic actions as well as being anti-inflammatory (acetaminophen and phenacetin are<i>not</i>NSAIDs, lacking anti-inflammatory action), are surely our major pharmacologic tools in the treatment of rheumatic and arthritic disorders, and as such enjoy an expanding global utilization and popularity. The NSAIDs do, however, share certain therapeutic side effects as well as benefits.<sup>1</sup>Aspirin, the prototype NSAID (available since 1898), indomethacin (for over 35 years), phenylbutazone, and other older NSAIDs have a long track record of clinical efficacy and "relative" safety. Hepatotoxicity, however, is an increasingly recognized laboratory abnormality and a rare clinical side effect of the
Implications of the United States Preventive Services Task Force (USPSTF) recommendations on prostate cancer (PCa) stage migration.
Authors: Iris Yeong- Fung Sheng, Yu-Wei Chen, Moshe Chaim Ornstein, Timothy D. Gilligan, Brian I. Rini, Jorge A. Garcia
Journal: Journal of Clinical Oncology (2019)

5071 Background: Prostate specific antigen (PSA) screening has been controversial, given unrefined screening guidelines leading to overdiagnosis and overtreatment of “indolent” PCa. In 2008, the USPSTF recommended against PSA screening for men aged ≥75 and in 2012 broadened this recommendation to include all men. The impact of these changes is unstudied. We hypothesize that these screening changes could delay the diagnosis of advanced PCa. Methods: The Surveillance, Epidemiology and End Results Program (SEER) was used to identify men (age 55-69) diagnosed with PCa between 2004-2015. PCa stage was categorized as nodal (N1M0) and metastatic (NxM1). Trend analysis was stratified based on year 2004-2008 (group 1), 2009-2012 (group 2), and 2012-2015 (group 3). Using group 2 as a reference, multivariable logistic regression was used to identify predictors for N1M0 and NxM1 in each group. Results: From 2004-2015, there were 603,323 eligible men diagnosed with PCa (group 1: 262,240 men, group 2: 210,045 men, group 3: 131,038 men). In group 1, 1.4% had N1M0 and 2.8% had NxM1. In group 2, 1.6% had N1M0 and 3.7% had NxM1. In group 3, 1.4% had N1M0, and 6.1% had NxM1. The adjusted odds ratio (AOR) of N1M0 was 0.78 (95%CI 0.74-0.82; p&lt;0.0001) in group 1 and 1.71 (95%CI 1.63-1.80; p&lt;0.0001) in group 3. Similar AOR trends were seen in NxM1 (group 1, 0.71; 95%CI 0.68-0.73, p&lt; 0.0001 vs. group 3, 1.70; 95% CI 1.63-1.75, p&lt;0.0001). (Table) Subset analysis of non-eligible patients (age &gt;70 and &lt;55) showed a similar stage migration. Conclusions: With each USPSTF recommendation, there have been significantly more diagnoses of advanced PCa; suggesting stage migration. The sequelae of having advanced PCa include more aggressive treatments, increased financial burden, and reduced quality of life. Future population studies are warranted to investigate whether the updated 2018 USPSTF recommendation now encapsulates the best target population.[Table: see text]
Reply to Sarah Willis, Alec Miners, and Jan van der Meulen's Letter to the Editor re: Maarten de Rooij, Simone Crienen, J. Alfred Witjes, Jelle O. Barentsz, Maroeska M. Rovers, Janneke P.C. Grutters. Cost-effectiveness of Magnetic Resonance (MR) Imaging and MR-guided Targeted Biopsy Versus Systematic Transrectal Ultrasound–guided Biopsy in Diagnosing Prostate Cancer: A Modelling Study from a Health Care Perspective. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2013.12.012
Authors: Maarten de Rooij, Simone Crienen, J. Alfred Witjes, Jelle O. Barentsz, Maroeska M. Rovers, Janneke P. Grutters
Journal: European Urology (2014)
Brazil enters the Bolsonaro zone
Authors: None The Lancet Global Health
Journal: The Lancet Global Health (2019)

The first day of 2019 saw Brazil inaugurate its new President, Jair Bolsonaro. Having campaigned predominantly on issues of crime, corruption, and fiscal mismanagement, and with a right-leaning track record of expositions on homosexuality, gender, socialism, and the environment, Bolsonaro did little in his inauguration speech to encourage those of us concerned with health and equity. Indeed, his speech was the first since the end of the military dictatorship in 1985 not to mention the need to address poverty and inequality.
THE MANAGEMENT OF THE URINARY TRACT OF PARAPLEGIC PATIENTS
Journal: JAMA (1921)

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
JAMA 75 YEARS AGO
Journal: JAMA (1980)

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 Subsyndromal Phenomenology of Borderline Personality Disorder: A 10-Year Follow-Up Study
Authors: Mary Zanarini
Journal: American Journal of Psychiatry (2007)

Objective: The purpose of this study was to characterize the course of 24 symptoms of borderline personality disorder in terms of time to remission. Method: The borderline psychopathology of 362 patients with personality disorders, all recruited during inpatient stays, was assessed using two semistructured interviews of proven reliability. Of these, 290 patients met DSM-III-R criteria as well as Revised Diagnostic Interview for Borderlines criteria for borderline personality disorder, and 72 met DSM-III-R criteria for another axis II disorder. Over 85% of the patients were reinterviewed at five distinct 2-year follow-up waves by interviewers blind to all previously collected information. Results: Among borderline patients, 12 of the 24 symptoms studied showed patterns of sharp decline over time and were reported at 10-year follow-up by less than 15% of the patients who reported them at baseline. The other 12 symptoms showed patterns of substantial but less dramatic decline over the follow-up period. Symptoms reflecting core areas of impulsivity (e.g., self-mutilation and suicide efforts) and active attempts to manage interpersonal difficulties (e.g., problems with demandingness/entitlement and serious treatment regressions) seemed to resolve the most quickly. In contrast, affective symptoms reflecting areas of chronic dysphoria (e.g., anger and loneliness/emptiness) and interpersonal symptoms reflecting abandonment and dependency issues (e.g., intolerance of aloneness and counterdependency problems) seemed to be the most stable. Conclusions: The results suggest that borderline personality disorder may consist of both symptoms that are manifestations of acute illness and symptoms that represent more enduring aspects of the disorder.
Treatment of Hodgkin's disease in private practice
Authors: V. T. DeVita
Journal: JAMA (1972)

The chemotherapy of the leukemias and lymphomas has evolved rapidly in the past decade. More patients are achieving remission of their disease, these remissions are lasting significantly longer, and survival of afflicted patients is improving. The most gratifying aspect of this improvement is that a significant proportion of patients are remaining continuously free of their disease for longer periods after treatment is stopped. These results have been achieved through the use of more intensive treatment programs which employ several drugs in combination, or extensive x-irradiation, or sometimes a combination of both. These forms of treatment are often complicated and costly, both economically and in terms of toxic effect on the patient. Although few would argue about the worth of such therapy if the end result were a disease-free, functional patient, the question of who should use them is a favorite one for discussion among physicians. This point is highlighted in
Hereditary Spherocytosis and Infectious Mononucleosis with Acquired Hemolytic Anemia
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
Cerebral Death
Authors: Raymond D. Adams
Journal: JAMA (1986)

Once irreversible coma (<i>coma depassé</i>) and its concomitant, the massive central necrosis of the brain, had been recognized as a clinicopathologic entity by Fischgold et al and Mollaret et al in Paris in 1959, the question of the significance of life without a brain had to be answered. But the first issue then to be considered was whether the clinical diagnosis could be made with complete certainty. This matter was addressed by the Harvard Ad Hoc Committee, who set forth what it conceived as the criteria for reliable diagnosis in 1968. Almost immediately, critical essays followed in the United States, France, West Germany, and Switzerland on the medical, ethical, and religious implications of redefining death in terms of pannecrosis of the brain rather than the traditional view of cardiac arrest. Professor Walker, who served on the President's Committee to evaluate guidelines for the determination of death, presents in this small
Susceptibility of women athletes to injury. Myths vs reality
Authors: C. E. Haycock
Journal: JAMA (1976)

To separate fact from fiction regarding the susceptibility of women athletes to injury, three surveys were conducted. The initial data were collected from the athletic departments of collegiate institutions, and the final material was assembled from certified athletic trainers at these institutions, plus an extensive computer search of applicable publications. The collected statistical data were tabulated, and a written commentary was evaluated by the authors. It was established that injuries sustained by female athletes, aside from those related to different biological structures, were essentially no different than those of men, nor are well-trained women athletes more prone to injury. Ankle and knee injuries are most frequent, and women sustain many contusions, sprains, and shin splints. It is anticipated that the overall number of injuries will decrease as better coaches and trainers become available to women athletes. (<i>JAMA</i>236:163-165, 1976)
Admission to medical school
Authors: H. K. Silver
Journal: JAMA (1982)

DEANS and associate deans for admissions of state-supported schools of medicine are frequently contacted by individuals who indicate, but do not declare outright, that certain applicants to medical school should receive "thorough consideration" (do they mean "special consideration" or "preference?") when these applicants come up for review for admission to medical school. The deans and associate deans often have great sympathy for the arguments given for an applicant to receive "thorough consideration," but they usually cannot, and feel they should not, do anything to influence the admissions process, since the faculty and others involved in the process are (and necessarily should be) precluded from giving special consideration to anyone except under guidelines established by state and federal regulations or under overall university or medical school policy. I wonder whether those who contact deans or admissions committee personnel would, overall, be any more satisfied if special consideration actually were given to
A study of the combination of oxaliplatin, capecitabine, and trastuzumab and chemo-radiotherapy in the adjuvant setting in operated patients with HER2+ gastric or gastroesophageal junction cancer (TOXAG study).
Authors: Huseyin Abali, Suayib Yalcin, Cem Onal, Faysal Dane, Berna Oksuzoglu, Nuriye Ozdemir, Huseyin Mertsoylu, Mehmet Artac, Celaletdin Camci, Bulent Karabulut, Fatma Bugdaycı Basal, Burcin Budakoglu, Mehmet Ali Nahit Sendur, Burce Goktas, Fatih Ozdener, Arzu Baygul
Journal: Journal of Clinical Oncology (2018)

26 Background: We evaluated the safety and tolerability of trastuzumab (T) in combination with oxaliplatin (O), capecitabine (C) and chemo-radiotherapy in the adjuvant setting in operated, HER-2 positive gastric or gastroesophageal junction adenocarcinoma patients. Methods: We have screened 212 and enrolled 34 patients who were curatively resected (R0, R1 with partial or total gastrectomy, with D2 lymph node dissection) and were HER2-positive (IHC 2+/FISH+ or IHC 3+). The primary objectives were safety and tolerability of the treatment combination and secondary objectives were disease-free and overall survival rates. Patients received T 8 mg/kg intravenously (iv) on Day 1 of cycle 1 and 6 mg/kg iv on day 1 of every following 3-weekly cycle for 1 year as 17 cycles, O 100 mg/m2 iv on Day 1 of cycles 1-3 and C 850 mg/m2 orally twice daily on days 1-14 of cycles 1-3 and 5 days per week during chemo-radiotherapy. Radiotherapy was given at a total dose of 45 Gy divided into 25 doses 5 treatment days per week for 5 weeks starting from the 1st day of cycle 4. Results: The median age was 57 years and 73.5% were male, 97.0% had an ECOG PS score ≤ 1,33, 97.0% had D2 lymph node resection. Staging was 3A or higher at the time of diagnosis in 76.4% of patients. Patients had high rate of tolerability to the combination regimen (90.3%) and successfully completed 3 cycles of O+C+T plus chemoradiotherapy followed by continuation with T, achieving the primary goal of the study by showing a better tolerability rate as compared to tolerability reported for INT0116 study (p = 0.0068). After 25 months of follow-up confirmed through a telephone visit, 59.8% patients were still alive and median overall survival was not yet reached. Twelve patients died secondary to disease progression. There were no deaths due to toxicity and 6 dose reductions overall (1 for T, 2 for O and 3 for C). T was stopped in one patient; C was temporarily interrupted 11 times (mostly during radiotherapy) and stopped in 1 patient. Conclusions: T in combination with C, O and radiotherapy in the adjuvant setting for gastric or gastroesophageal junction adenocarcinoma seems safe and tolerable. Clinical trial information: NCT01748773.
The Chinese Medical Journal Vol 1, No. 1, January 1973
Authors: Tsung O. Cheng
Journal: JAMA (1973)

One of the most noteworthy events in the modern medical history is the recent reappearance of the<i>Chinese Medical Journal</i>, the official publication of the Chinese Medical Association in Peking.<i>The Chinese Medical Journal</i>resumed its publication as vol 1, No. 1 in January 1973 after its temporary suspension for the past few years following the Cultural Revolution. I was aware of the imminent reappearance of the<i>Chinese Medical Journal</i>as far back as last May when I visited the People's Republic of China.<sup>1</sup>At that time my Chinese colleagues told me that careful notes were being kept of all clinical studies, clinical investigations, and basic research during those years when all the journals ceased publication. The reappearance of this journal is indeed a welcome event, at a time when American interest in Chinese medicine increases by leaps and bounds following recent resumption of friendly relations between the People's
Solitary Congenital Pelvic Kidney An Extremely Rare Developmental Aberration
Authors: MILENA RAJIĆ, MOMČILO BOGIĆEVIĆ, SLOBODAN ILIĆ, MARINA VLAJKOVIĆ, GORAN LILIĆ, MILOŠ STEVIĆ
Journal: Clinical Nuclear Medicine (2003)

An ectopic pelvic kidney contralateral to an agenetic one is an extremely rare congenital malformation that is usually discovered incidentally on abdominal ultrasound or computed tomography. The authors describe a 40-yearold woman with right renal agenesis and a contralateral pelvic kidney who had a history of symptomatic recurrent urinary tract infections. She underwent Tc-99m DTPA dynamic scintigraphy and clearance measurement to assess renal function and the patency of the urinary tract. She had bacteruria and proteinuria at the time of the study but normal blood urea (4.6 mmol/l) and serum creatinine (91 μmol/l) levels. An ultrasound scan did not show renal pelvis dilatation. Dynamic scintigraphy and the clearance value of Tc-99m DTPA showed a compensatory elevated glomerular filtration rate and normal urine outflow despite the presence of a urinary tract infection and short ureter, which is commonly associated with an ectopic kidney.
Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections
Authors: D. H. Martin
Journal: JAMA (1982)

In a prospective study of morbidity associated with<i>Chlamydia trachomatis</i>infections during pregnancy, we isolated<i>C trachomatis</i>from the endocervix of 18 (6.7%) of 268 women examined before 19 weeks' gestation. Infected women were significantly younger than noninfected women, and significantly more often unmarried, supported by public assistance, and pregnant for the first time. Among women followed up from 19 weeks' gestation until delivery, the mean duration of gestation was significantly shorter for those with antepartum chlamydial infection. Stillbirth or neonatal death occurred in six (33%) of the 18 pregnancies of infected women compared with eight (3.4%) of the 238 pregnancies of noninfected women followed up from the 19th week of gestation through delivery. Stillbirth or neonatal death occurred ten times more often among<i>Chlamydia</i>infected women than among uninfected controls matched for age, marital status, socioeconomic status, pregnancy order, and race. (<i>JAMA</i>1982;247:1585-1588)