tbuckley/cabot-search huggingface dataset:
The impact of a regulation restricting medical house staff working hours on the quality of patient care
Authors: C. Laine
Journal: JAMA (1993)

<h3>Objective.</h3> —To examine the impact on patient care of a New York State regulation that restricted house staff working hours. <h3>Design.</h3> —Retrospective cohort study. <h3>Setting.</h3> —General medical service of an urban teaching hospital. <h3>Patients.</h3> —A total of 263 (94%) of 281 patients discharged from the study service during October 1988 and 263 (93%) of 283 patients discharged from the same service during October 1989. <h3>Interventions.</h3> —On July 1, 1989, New York State enacted a new regulation, Code 405, which limited residents' working hours and specified levels of supervision and ancillary support. <h3>Main Outcome Measures.</h3> —In-hospital mortality, transfers to intensive care units, cardiopulmonary resuscitation attempts, discharge disposition, length of stay, medical complications, and house staff delays in ordering tests and procedures. <h3>Results.</h3> —Although the cohorts were comparable in severity of illness measures, more patients in 1989 suffered at least one medical complication (91 [35%] vs 59 [22%];<i>P</i>=.002) and experienced at least one diagnostic test delay because of house staff (44 [17%] vs 4 [2%];<i>P</i>&lt;.001). These significant differences persisted after controlling for potential confounders in multivariate analyses. However, we found no significant differences in more serious outcomes: in-hospital mortality, transfer to intensive care unit, discharge disposition, or length of stay. <h3>Conclusions.</h3> —These results suggest that restricted house staff working hours were associated with delayed test ordering by house staff and increased in-hospital complications. While these potentially deleterious effects on the quality of care did not result in statistically significant differences in more serious outcomes, further study at other hospitals is warranted to determine staffing strategies that optimize quality of care for patients, as well as medical education and quality of life for house officers (<i>JAMA</i>. 1993;269:374-378)
Novel Corticosteroid-Binding Globulin Variant That Lacks Steroid Binding Activity
Authors: I. Perogamvros, C. Underhill, D. E. Henley, K. D. Hadfield, W. G. Newman, D. W. Ray, S. L. Lightman, G. L. Hammond, P. J. Trainer
Journal: Endocrine Reviews (2010)

Abstract Background: Corticosteroid-binding globulin (CBG) is the principal carrier for glucocorticoids in the circulation and a regulator of their bioavailability. Inherited CBG deficiencies are rarely reported, and only three causative mutations in four families have been described. Patients, Methods, and Results: In a 26-yr-old female with hypotension, fatigue, and undetectable serum cortisol at presentation, we have identified a novel homozygous c.776g&amp;gt;t transversion in exon 3 of the CBG (SERPINA6) gene. This results in a p.Gly237Val substitution that is predicted to influence the positioning of two β-sheets that constitute part of the CBG steroid-binding site. Two siblings were also homozygous for the variant, whereas her mother and an unaffected sibling were heterozygous. No other symptomatic family members were identified apart from the proband. Individuals homozygous for the variant had serum CBG levels below the reference range when measured by RIA, but CBG was unmeasurable in cortisol-binding capacity assays. In the same individuals, we observed very low baseline and stimulated serum cortisol levels but normal free serum and salivary cortisol and plasma ACTH. In a study of ultradian cortisol pulsatility, increased pulse frequency was only observed in the proband. Conclusion: We describe a novel CBG variant that lacks steroid binding. All mutant homozygotes have very low serum cortisol, but normal free cortisol levels. The only biochemical feature to distinguish the symptomatic subject was increased cortisol pulsatility, and we suggest that this may influence glucocorticoid signaling and contribute to symptoms previously associated with CBG deficiency.
The Effect of Omalizumab on Basophil and Mast Cell Responses using an Intranasal Cat Allergen Challenge
Authors: J.A. Eckman, P.M. Sterba, D. Kelly, V. Alexander, B.S. Bochner, D.W. MacGlashan Jr., S.S. Saini
Journal: Journal of Allergy and Clinical Immunology (2009)
Infections, Escherichia coli, and sickle cell anemia
Authors: M. G. Robinson
Journal: JAMA (1974)

In a prospective study, 457 black children admitted consecutively for serious infections were classified as to hemoglobin genotype, type of infection, and etiologic agent. Of these 457 patients, eight had sickle cell anemia (hemoglobin [Hb] SS). This was eight times the expected frequency. The Hb SS patients had a 25% mortality as compared to 1.5% for Hb AA and AS patients. In analyzing the type of infections and etiologic agents, a significantly increased frequency of pyelonephritis, diarrhea, sepsis, and meningitis was found among the sickle cell disease patients. These infections were due to two organisms, the pneumococcus and<i>Escherichia coli</i>. An increased frequency of infections or specific etiologic agent was not found in the Hb AS group. (<i>JAMA</i>230:1145-1148, 1974)
LIABILITY FOR DISMISSAL OF PATIENT.
Journal: JAMA (1894)

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
INTERNATIONAL RECIPROCITY IN MEDICINE.
Journal: JAMA (1902)

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 pattern of oesophageal acid exposure and oesophageal pressure morphology in patients with hiatus hernia
Authors: R. Vardar, R. Sweis, A. Anggiansah, T. Wong
Journal: Gut (2011)

<h3>Introduction</h3> Gastro-oesophageal reflux disease (GORD) generally presents as pathological Upright, Supine or Bi-positional reflux. Hiatus hernia (HH) and dysmotility are common in chronic GORD. However, in the presence of HH, it is unclear how age, severity of oesophageal acid exposure and dysmotility are related to the different postural types of GORD. <h3>Methods</h3> From March 2006 to July 2010, 1242 patients with GORD symptoms had high resolution manometry (HRM; Manoscan 360, Sierra) and 24-h catheter-based pH-monitoring (Slimline™, Medtronic) performed. 124 consecutive patients with both pathologic reflux and HH were collected. Patients were classified as Upright (n = 24), Supine (n = 38) or Bi-positional (n = 62) predominant reflux. Total (TR &gt; 4.2%), upright (UR &gt; 8.15%) and supine (SR &gt; 3.45%) reflux parameters were used to classify GORD into position subtypes. HH was defined as Type II (lower oesophageal sphincter (LOS)-crural diaphragm (CD), 1–2 cm) and Type III (LOS-CD &gt; 2 cm) in accordance with the Chicago Classification. Student9s t test, χ<sup>2</sup> tests and Mann–Whitney-U test were used for statistical analysis. <h3>Results</h3> Mean ±SD age was 54 ± 14 years (range 16–85 years; 64 males). Patients with Bi-positional reflux (57 years) were older than those with Supine (49 years) (p = 0.013) or Upright reflux (53 years) (p = 0.04). Furthermore the severity of oesophageal acid exposure (TR, UR and SR) was greater in the Bi-positional (18.1%, 17.6%, 19.7%) than Supine (8.6%, 4.8%, 14.8%) (p &lt; 0.001) or Upright (8.5%, 12.8%, 1.1%) (p &lt; 0.001) reflux group. Total supine reflux episodes in the Supine group were fewer in number (54) compared to the total upright reflux episodes in the Upright group (127) (p &lt; 0.001), although the total reflux time was similar in both positions (124 min supine vs 127 min upright; p = NS). Although there was no significant difference in the mean peristaltic wave contractility and velocity between the three groups, the % of successful peristalsis was higher in the Upright (65%) than Supine (54%) or Bi-positional (52%) GORD group (p = 0.008 and p = 0.001, respectively). Patients with Type III HH were older (mean age 57 years; n = 71) than Type II HH (mean age 50 years; n = 53) (p = 0.013). There was no difference in HH length between the GORD position subtypes (range 2.0–8.4 cm). Although there was no difference in TR, UR and SR, the LOS basal pressure was lower in Type III (8.9 mmHg) than Type II (12.0 mmHg) HH patients (p = 0.05). <h3>Conclusion</h3> In patients with manometry-proven HH who present with symptoms suggestive of GORD, Bi-positional and Supine reflux predominance are associated with more severe disease and are more likely to be associated with failed peristalsis. Furthermore Bi-positional reflux disease is more common with increasing age as is Type III HH.
RAT-BITE OF THE FACE AND EYE
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
Screening for Thyroid Disease
Authors: Mark Helfand
Journal: Annals of Internal Medicine (1999)

Letters19 January 1999Screening for Thyroid DiseaseMark Helfand, MD and Craig C. Redfern, DOMark Helfand, MDPortland Veterans Affairs Medical Center; Portland, OR 97201 (Helfand)PACE Center; Portland, OR 97213 (Redfern)Search for more papers by this author and Craig C. Redfern, DOPortland Veterans Affairs Medical Center; Portland, OR 97201 (Helfand)PACE Center; Portland, OR 97213 (Redfern)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-2-199901190-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Hortin that some hyperthyroid patients have detectable TSH levels, but we disagree with his conclusion that a decision limit of 0.1 mU/L should be used to screen for thyroid dysfunction in primary care practice. Dr. Hortin's statement that when third-generation TSH assays are used, 4% to 17% of patients with overt thyrotoxicosis have a detectable TSH level applies to samples of patients with known thyroid disease seen at tertiary teaching hospitals; it does not apply to the general population as he suggests. Moreover, the functional sensitivity of most “ultrasensitive” assays in current use is ...References1. Marquesee E, Haden ST, Utiger RD. Subclinical thyrotoxicosis. Endocrinol Metab Clin North Am. 1998;27:37-49. CrossrefMedlineGoogle Scholar2. Vanderpump MP, Neary RH, Manning K, Clayton RN. Does an increase in the sensitivity of serum thyrotropin assays reduce diagnostic costs for thyroid disease in the community? J R Soc Med. 1997;90:547-50. CrossrefMedlineGoogle Scholar3. Sawin CT, Geller A, Wolf PA, Belanger AJ, Baker E, Bacharach P, et al . Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249-52. CrossrefMedlineGoogle Scholar4. Danese MD, Powe NR, Sawin CT, Ladenson PW. Screening for mild thyroid failure at the periodic health examination: a decision and cost-effectiveness analysis. JAMA. 1996;276:285-92. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Portland Veterans Affairs Medical Center; Portland, OR 97201 (Helfand)PACE Center; Portland, OR 97213 (Redfern) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Thyroid DiseaseScreening for Thyroid Disease Glen L. Hortin Screening for Thyroid Disease Flavio Zelmanovitz Screening for Thyroid Disease Mark N. Friedman Screening for Thyroid Disease Robert S. Dieter Metrics Cited ByAutoimmunthyreoiditisAutoimmunthyroiditis – wann abwarten, wann substituieren? 19 January 1999Volume 130, Issue 2Page: 162KeywordsAtrial fibrillationForecastingHypercholesterolemiaHyperthyroidismHypothyroidismRelative riskThyroidThyroid diseasesThyroid hormonesThyroid-stimulating hormone Issue Published: 19 January 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Actual Causes of Death in the United States
Authors: Stanton A. Glantz
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Drs McGinnis and Foege<sup>1</sup>recently published an article pointing out that the most prominent cause of death is tobacco (419 000 deaths) compared with other behaviors, such as illicit use of drugs (20 000 deaths), which command much greater public attention. Their article only tells half the story, however. As the Figure demonstrates, the federal government devotes resources to these problems in inverse proportion to the real public health impacts, despite the fact that there are proven public health interventions that can control many of these diseases, particularly tobacco. For example, in California voters increased the tobacco tax by 25 cents per pack of cigarettes and devoted 5 cents to an aggressive media and community-based tobacco control campaign. Despite the fact that the legislature and governor have never fully funded these programs,<sup>2</sup>the rate of decline in tobacco consumption in California tripled.<sup>3</sup>At a
Stem cells hold vision for the future
Authors: R. Voelker
Journal: JAMA (1997)

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
Radiology, Detroit
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
Renal Tubular Dysfunction and Abnormalities of Calcium Metabolism in Cadmium Workers
Authors: George Kazantzis
Journal: Environmental Health Perspectives (1979)

Tubular proteinuria is generally accepted as the critical effect following long-term, low-level exposure to cadmium as seen in an industrial environment. This effect may not be of immediate importance to the health of the individual, but the significance, in terms of long-term morbidity and mortality, of the renal tubular defect of which it is an indicator is not fully understood, and certain sequelae may have remained unrecognized due to inadequate follow-up. Follow-up studies have been performed in nine of 12 workers who were initially investigated in 1962. In six of the men exposures ranged from 28 to 45 years to cadmium sulfide dust and for shorter periods in the earlier years to cadmium oxide fume and dust. These six men had tubular proteinuria when first seen, and this has persisted in the five survivors. All six men had hypercalciuria, and two of them became recurrent stone formers. One man whose urinary calcium excretion later fell to a low level more recently developed vitamin D resistant osteomalacia. In addition, each of the six men had exhibited some, but not all, of a variety of biochemical abnormalities related to other proximal renal tubular defects, and the worker who developed osteomalacia had additional evidence of a distal tubular defect. The five survivors also have evidence of slowly progressive deterioration in glomerular function. Follow-up of this small group has shown that renal tubular dysfunction in cadmium workers may continue symptom-free for long intervals, but in a proportion of cases serious clinical effects may develop after a number of years.
How It Happened.
Journal: JAMA (1931)

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
Acta Neurologica Scandinavica, Copenhagen
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
Diseases of the Kidney
Authors: George Dunea
Journal: JAMA (1993)

Did you know that there are six types of Alport's syndrome? That any of 35 possible nonrenal anomalies may be associated with it? That a similar x-linked nephritis occurs in Samoyed dogs, most of whom die of renal failure by nine months of age? All this tends to confirm the old precept that reading through a new textbook every few years will keep you better informed than subscribing to 100 journals. So settle down, gentle reader, and learn all about Alport's syndrome and the Fechtner, Alstrom, and Muckle-Wells variants—for this indeed is the Cadillac of kidney books. Written by authorities in the field, it has been extensively revised and brought up to date. Most of the 113 chapters are excellent, covering their subjects in a comprehensive and readable way. The format remains largely unchanged from the previous edition. There are some 300 pages on basic sciences covering structure, function, biochemistry,