tbuckley/cabot-search huggingface dataset:
How to deal with poor medical care
Authors: W. E. Mitchell
Journal: JAMA (1976)

THE COURSE of a medical audit prompted by poor medical care may depend on the specific problem, but the approach discussed here has proved useful in almost all instances, the only exception being the rare situation in which a problem of ethics or falsification is involved. <h3>RECOGNITION OF POSSIBLE PROBLEM</h3> Presented with allegations that a staff member is rendering poor care, the hospital governing body should first consider whether facts rather than hearsay support the allegation. The sources should have personal knowledge or professional experience to raise questions of professional performance, and problems should involve substantial potential for harm to patients and be amenable to correction. <h3>UNNECESSARY SURGERY</h3> Informed that a staff physician, "Dr A," is performing too many unnecessary appendectomies, how should the governing body instruct the surgical audit committee to proceed? A frontal assault on the problem, ie, auditing all the appendectomies performed by the physician, may be
Toxicology Testing and Results for Suicide Victims—13 States, 2004
Journal: JAMA (2007)

In 2003, an estimated 31,484 suicides (10.7 per 100,000 population) occurred in the United States. Suicide was the fourth leading cause of death among persons aged 10-64 years and the second and third leading causes of death among persons aged 25-34 and 10-24 years, respectively. Few studies have attempted to determine the contribution of substance use to suicide. To assess toxicology testing practices and to determine the prevalence of positive results for alcohol or other drugs, CDC analyzed test results of suicide victims in the 13 states that collected data for the National Violent Death Reporting System (NVDRS) in 2004. This report summarizes the results of that analysis, which determined that 1) the percentage of suicide victims tested varied among states, ranging from 25.9% to 97.7%; 2) of those victims tested, 33.3% were positive for alcohol, and 16.4% were positive for opiates; and 3) similar percentages of poisoning suicide (i.e., suspected intentional overdose) and nonpoisoning suicide victims tested positive for alcohol or other drugs, with the exception of opiates. These results underscore the need to continue monitoring toxicology test results of suicide victims, which might identify patterns of substance use that can help guide development of effective suicide interventions. Such data can be enhanced by uniform, comprehensive, toxicology testing practices on a state and national basis.
THE MASSACHUSETTS STATE HOSPITAL FOR CONSUMPTIVES AT RUTLAND.
Journal: JAMA (1900)

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
The common anemias
Authors: E. Beutler
Journal: JAMA (1988)

LIKE fever, anemia is a sign of disease. It has many causes, most of them quite rare. In this article, advances in our understanding of only three of the most common forms of anemia will be discussed. These are thalassemia, iron deficiency, and, for want of a better name, "the anemia of chronic disease." I do not wish to slight either the importance or the interesting nature of advances in the understanding of other anemias. However, such disorders as sickle cell anemia; the hemolytic anemias caused by membrane defects of red blood cells, enzyme deficiencies, or antibodies; the megaloblastic anemias; the myelodysplastic anemias; and paroxysmal nocturnal hemoglobinuria will not be discussed here. The collective frequency with which these disorders occur does not approach that of thalassemia, iron deficiency, and the anemia of chronic disease (Fig 1). <h3>THE THALASSEMIAS</h3> The inclusion of thalassemia among the most common of the anemias may
Effects of Coal Combustion Products and Metal Compounds on Sister Chromatid Exchange (SCE) in a Macrophagelike Cell Line
Authors: Ole Andersen
Journal: Environmental Health Perspectives (1983)

Investigations of genotoxic effects of particles have almost exclusively been performed by organic extraction, while direct investigations in cells capable of engulfing particles have only been performed in few cases. Thus, in most studies, the eventual effects of particle-associated metal compounds have remained undiscovered. The present study attempted direct measurement of genotoxic effects of particulate coal combustion products by using the P388D1 macrophage cell line. The capability of these cells for phagocytosis was demonstrated with insoluble particles. The sister chromatid exchange (SCE) test was used for measuring genotoxic effects of test compounds. Dimethylnitrosamine and benzo(a)pyrene did not increase SCE, indicating that the P388D1 cell line has lost the capacity for metabolism of latent organic carcinogens, reducing the value of these cells for evaluating genotoxic effects of complex particles. Indirect evidence has been obtained that the cell line may be infected with a virus. Thus, interactions between virus and test compound may lead to erroneous results. This should be kept in mind during evaluation of the results. The effects of metals with reported carcinogenic or mutagenic effects on SCE were compared in P388D1 cells and human lymphocytes: NaAsO2, CdCl2, K2Cr2O7, CoCl2, CH3HgCl and MnSO4 increased SCE in both cell systems. Pb(CH3COO)2, BeSO4 and NiSO4 had a weak effect on SCE in P388D1. Pb(CH3COO)2 and NiSO4, but not BeSO4, increased SCE in human lymphocytes. Cr(CH3COO)3 increased SCE in human lymphocytes at high concentration, but was a strong inducer of increased SCE in P388D1 cells, which take up Cr(III) by phagocytosis. This suggests that the Cr(III) ion is an ultimate carcinogenic form of chromium. Generally P388D1 cells and human lymphocytes respond to in vitro exposure to metals in agreement with reported mutagenic/carcinogenic effects of the metals. Of four precipitated coal fly ash samples tested, only one sample (from an electrostatic precipitator downstream of a cyclone at an electricity generating plant burning pulverized coal) had a clear increasing effect on SCE in P388D1. Extraction of this sample with medium with 10% serum yielded an extract capable of increasing SCE. The extracted particles still increased SCE, but less than unextracted particles. Emission samples taken with impactor sampler after a dilution probe using controlled cooling of the flue gas were obtained from an oil-fired (one sample) and a coal-fired (one sample < 3 μm and one sample < 3 μm) steam boiler. The only sample increasing SCE was the sample < 3 μm from the coal-fired boiler. Extract from this sample also increased SCE. The results demonstrated that the use of phagocytizing cells for assessment of genotoxic effects of particles offers a useful system, since the particles can be investigated directly. Furthermore, particles, extracted particles and extract can be investigated in the same system.
AMA-RPS Educational Program on Family Violence
Journal: JAMA (1992)

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
Etude sur L'Epilepsie Traumatique. Travail du Service de la Clinique des maladies du système nerveux à la Salpêtrière.
Journal: JAMA (1920)

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
Correction
Journal: Thorax (2015)

Chest clinicin clinical trials in high burden countries.However, the challenges for the next decade are clear.The refinement of the preclinical animal models, together with the identification of immune correlates of protection, would greatly facilitate vaccine development.Given the uncertainties in this field, a collaborative approach between vaccine researchers and developers is essential if progress is to be expedited.It is essential that we maintain the momentum gained over the last decade if we are to have a new licensed vaccine in the next decade.
Chronic Intestinal Stasis (Arbuthnot Lane's Disease). A Radiological Study.
Journal: JAMA (1924)

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
ABC of sleep disorders. Non-Psychotropic drugs and sleep.
Authors: C Idzikowski, C M Shapiro
Journal: BMJ (1993)

Psychotropic drugs-drugs that affect the mental state-can also have peripheral effects.Similarly, drugs that are usually thought to have only peripheral actions may also influence the mental state, usually by affecting ........ ~~~~sleep patterns.The mechanisms are varied.Some drugs penetrate the blood/brain barrier and directly affect the central nervous system (for example, antihistamines with sedative effects).Some drugs cause or aggravate conditions that disturb sleep-for example, sleep apnoea and restless legs.The effect may be extreme, as when sleep is broken by periods of wakefulness, or it may be subtle, as when only the electroencephalographic stages of sleep are disturbed.Assessment of sleep patterns. General effectsThe pharmacokinetic profile of any drug is important.Those with short halflives that are taken in the morning are unlikely to affect sleep the following night.It is also unlikely that they will accumulate (unless they have metabolites with long half lives) and affect sleep in that way.Those with long half lives that are given over long periods, however, will accumulate and produce high concentrations of the drug in the body.To understand the effects of non-psychotropic drugs on sleep we must know: * Whether the drug is likely to enter the central nervous system: its lipophilicity will indicate whether it will enter the brain, and so whether it will affect sleep.* The receptor binding profile, which may predict the pharmacological action, particularly if it affects one of the main neurotransmitter systems (aminergic, cholinergic, or y aminobutyric acid).Drugs that stimulate the
Carcinogenicity studies of Estonian oil shale soots
Authors: A I Võsamäe
Journal: Environmental Health Perspectives (1979)

Several series of chronic experiments in white mice and white rats were carried out in order to determine the carcinogenicity of Estonian oil shale soot as well as the soot from oil shale fuel oil.All the investigated samples of soot showed a relatively low (from 14 to 1200 ppm) benzo(a)pyrene content.The benzene extract of oil shale soot, painted on the skin of white mice, proved to be strongly car- cinogenic: in most of the animals skin tumors developed.The benzene extract of shale fuel oil exerted a considerably weaker carcinogenic action than the extract of soot of solid oil shale.The effect of oil shale soots as well as of tars extracted from oil shale soot on the bronchial mucosa and lung respiratory tissue was studied in white rats.Lung tumors were induced in a considerable number of cases in a series of experiments, where the tarry material from solid fuel soot, containing 1070 ppm benzo(a)pyrene, as a suspension in an aqueous solution of Tween 40, was administered by repeated intratracheal instillation.Lung tumor incidence among various control and experimental groups of rats is presented.The peculiarities of oil shale combustion are described.
IN THIS ISSUE
Journal: JNCI Journal of the National Cancer Institute (2011)

Treatment for DCISLumpectomy is a common and effective surgery to treat ductal carcinoma in situ (DCIS), but a common failure event is ipsilateral breast tumor recurrence (IBTR).The National Surgical Adjuvant Breast and Bowel Project (NSABP) conducted two prospective randomized trials in patients with localized DCIS to compare the risk of IBTR after lumpectomy only (LO) with lumpectomy followed by radiation therapy (LRT) in the B-17 trial, and addition of tamoxifen to LRT in the B-24 trial.The most risk reduction was noted in the LRT plus tamoxifen group (published results).In an update, Wapnir et al. (p.478) investigated the risk of invasive IBTR (I-IBTR) and survival in these patients after a median follow-up of more than 17 years.The 15-year cumulative incidence of I-IBTR was highly reduced in the LRT and LRT plus tamoxifen groups compared with the LO group.Survival was similar for the three groups.However, the risk of death was higher after I-IBTR.The authors conclude that adjuvant therapies remain the most effective treatment for DCIS after lumpectomy.
Oxidation of the zinc-thiolate complex and uncoupling of endothelial nitric oxide synthase by peroxynitrite
Authors: Ming-Hui Zou, Chaomei Shi, Richard A. Cohen
Journal: Journal of Clinical Investigation (2002)

Nitric oxide (NO) is produced by NO synthase (NOS) in many cells and plays important roles in the neuronal, muscular, cardiovascular, and immune systems. In various disease conditions, all three types of NOS (neuronal, inducible, and endothelial) are reported to generate oxidants through unknown mechanisms. We present here the first evidence that peroxynitrite (ONOO–) releases zinc from the zinc-thiolate cluster of endothelial NOS (eNOS) and presumably forms disulfide bonds between the monomers. As a result, disruption of the otherwise SDS-resistant eNOS dimers occurs under reducing conditions. eNOS catalytic activity is exquisitely sensitive to ONOO–, which decreases NO synthesis and increases superoxide anion (O2.–) production by the enzyme. The reducing cofactor tetrahydrobiopterin is not oxidized, nor does it prevent oxidation of eNOS by the same low concentrations of OONO–. Furthermore, eNOS derived from endothelial cells exposed to elevated glucose produces more O2.–, and, like eNOS purified from diabetic LDL receptor–deficient mice, contains less zinc and fewer SDS-resistant dimers. Hence, eNOS exposure to oxidants including ONOO– causes increased enzymatic uncoupling and generation of O2.– in diabetes, contributing further to endothelial cell oxidant stress. Regulation of the zinc-thiolate center of NOS by ONOO– provides a novel mechanism for modulation of the enzyme function in disease.
Adverse effect of hydralazine in patients with primary pulmonary hypertension
Authors: I. Kronzon
Journal: JAMA (1982)

Hydralazine hydrochloride has been recommended as a treatment for primary pulmonary hypertension. Two patients who were so treated experienced further elevation of the pulmonary artery pressure and clinical deterioration. The mechanism of this adverse effect was a decrease of systemic vascular resistance attended by an increase in cardiac output without a fall in the pulmonary vascular resistance. Hemodynamic monitoring is advised in patients undergoing vasodilator therapy for primary pulmonary hypertension. (<i>JAMA</i>1982;247:3112-3114)
Evaluation of the Population Distribution of Dietary Contaminant Exposure in an Arctic Population Using Monte Carlo Statistics
Authors: Hing Man Chan, Peter R. Berti, Olivier Receveur, Harriet V. Kuhnlein
Journal: Environmental Health Perspectives (1997)

Organochlorines and heavy metals have bioaccumulated in Arctic wildlife, which is an important food source for the Inuit. In this study, we have developed a statistical model to describe the population distribution of contaminant exposure and the usual intake of the high-end contaminant consumers. Monte Carlo methods are used to account for variations due to seasonal dietary pattern and contaminant concentrations. Distribution of the dietary intake of the contaminants of most concern-mercury, polychlorinated biphenyls (PCBs), chlordane, and toxaphenes-are described. Over 50% of the residents had dietary exposure levels exceeding the tolerable daily intake or provisional tolerable daily intake for Hg, toxaphene, and chlordane (83, 91, and 71% for men and 73, 85, and 56% for women, respectively). The high-end consumers (i.e. the 95th centile) have intake levels 6 times higher than the provisional tolerable weekly intake of Hg, and over 20 times the tolerable daily intake of chlordane and toxaphene. Assessment of health risks of the relative high contaminant exposure in this community must also consider the nutritional, economical, cultural, and social importance of these traditional foods. A comprehensive risk management scheme has yet to be developed.
Contents
Authors: Jern Chen, Mark Jones, Sathish Srinivasan, Timothy Neal, W Frcpath, Stephen Armitage, Mats Lundström, Pik-Pin Goh, Ype Henry, Mohamad Salowi, Peter Barry, Sonia Manning, Paul Rosen, Ulf Stenevi, Dhivya Kumar, Amar Agarwal, Athiya Agarwal, Radika Chandrasekar, Vijetha Priyanka, Esen Akpek, Priya Mathews, Sarah Hahn, Michelle Hessen, Jean Kim, Thomas Grader-Beck, Julius Birnbaum, Alan Baer, Julia Haller, Peter Stalmans, Matthew Benz, Arnd Gandorfer, Stephen Pakola, Aniz Girach, Anselm Kampik, Glenn Jaffe, Cynthia Toth, Kazuaki Kadonosono, Akira Arakawa, Shin Yamane, Maiko Inoue, Tadashi Yamakawa, Eiichi Uchio, Yasuo Yanagi, Sang Park, Hyun Lee, Joon Woo, Woong Kang, Kyu Park, Kattayoon Hashemi, Ivo Guber, Ciara Bergin, François Majo
Journal: Ophthalmology (2014)
Correction
Journal: Thorax (2013)

We have since realised that there were two transcription errors included in the manuscript that should ideally be corrected.Since these were transcription errors, neither had any influence on the statistical analyses presented.▸ The study flow (figure 1) states that 28 in the CPAP groups and 24 in the sham group completed the 12 week treatment period.Actually, 29 completed CPAP and 23 completed sham CPAP.Furthermore, 2 men in the CPAP group and 3 men in the sham CPAP group withdrew prior to receiving the open-label CPAP treatment after week 12.The completion numbers of 26 in the CPAP group and 20 in the sham group at week 24 are correct.▸ In table 1 and 2 for the results of insulin sensitivity (ISx) a negative sign (ie, '-') was inadvertently left out (all the result should be 10 -4 not 10 4 ).Again this was a transcription error that had no influence on the statistical analyses presented.
A spleen stiffness measurement-based model for recognition of high risk varices: Baveno VI criteria and beyond
Authors: F. Ravaioli, A. Colecchia, G. Marasco, A. Colli, E. Dajti, A. DI Biase, M.L.B. Reggiani, A. Berzigotti, M. Pinzani, D. Festi
Journal: Journal of Hepatology (2018)
Panel calls E coli screening inadequate
Authors: R. Voelker
Journal: JAMA (1994)

HOPING TO REDUCE unnecessary medical treatment and strengthen the detection of disease outbreaks, an expert panel has recommended widespread culturing of laboratory specimens for<i>Escherichia coli</i>O157:H7. The panel, sponsored by the American Gastroenterological Association Foundation, met last month in Washington, DC. After hearing testimony from experts in medicine, public health, the food industry, and federal regulatory agencies, the panel produced a report with recommendations to stem "a major national problem." <h3>Who's Getting Sick, and Why?</h3> From 1982, when the virulent O157:H7 strain was identified as a human pathogen, through 1992, only two to three outbreaks were investigated each year in the United States. The figure jumped to 16 in 1993; 11 outbreaks during the first half of this year are being studied. Some of the increase is attributed to growing awareness, but the panel said the actual number of infections appears to be rising. It is estimated that<i>E</i>