tbuckley/cabot-search huggingface dataset:
Advances in the Development of Vaccines against<i>Neisseria meningitidis</i>
Authors: Lionel K.K. Tan, George M. Carlone, Ray Borrow
Journal: New England Journal of Medicine (2010)

A lthough two centuries have passed since Vieusseux described epidemic meningococcal disease, 1 Neisseria meningitidis remains a leading cause of meningitis and sepsis.Overwhelming meningococcal disease can develop rapidly and is associated with mortality rates exceeding 20%. 2 Thus, efforts to control the disease have focused on vaccination.In the past, vaccines against meningococcal disease have failed to provide immunogenicity and long-term protection in infants, who are at greatest risk.Although recent vaccines have improved coverage for this age group, there is still no broadly effective vaccine against N. meningitidis group B (NMB), now the predominant disease-causing isolate in industrialized countries.Developments during the past decade have renewed hopes for solving this seemingly intractable problem.Knowledge of the meningococcal genome has led to the identification of novel antigens that have been incorporated into the NMB vaccines now being studied in clinical trials.However, it remains unclear whether these vaccines will provide sufficient immunogenicity in infants as well as wide-ranging coverage.This review highlights the evolution of meningococcal vaccines in general and discusses strategies being used to overcome the barriers to developing vaccines against NMB. Epidemiology of N. meningitidis InfectionMeningococcal disease is a global health problem.The World Health Organization estimates that there are 1.2 million cases of invasive meningococcal disease and 135,000 related deaths annually. 3Although the disease occurs sporadically in industrialized countries, with an incidence of 0.35 cases per 100,000 population in the United States and of 1.01 per 100,000 in Europe (ranging from 0.25 to 4.4 per 100,000 in Italy and Malta, respectively), 4 the major disease burden is in the nonindustrialized countries.A recent epidemic in Nigeria resulted in 4164 cases and 171 deaths in 1 week alone. 5 The meningococcus is pathogenic only in humans.It colonizes the nasopharynx asymptomatically in up to 40% of the adult population but occasionally causes invasive disease.When the infection is classified according to the polysaccharide capsule surrounding the bacterium, only six capsular groups (A, B, C, W-135, X, and Y) are associated with invasive disease. 6 The epidemiology of disease caused by these groups varies: group A is responsible for large epidemics in Africa, in which the incidence approaches 1000 cases per 100,000 population (and may involve environmental factors), whereas groups B and C cause disease predominantly in industrialized and newly industrialized countries. 2,6 Recently, groups W-135 and X (predominantly in Africa) and group Y (in the United States and other countries) have emerged as important disease-causing isolates.
Acute gastroenteritis in children
Authors: Elizabeth Jane Elliott
Journal: BMJ (2007)

Rotavirus is the most common cause of acute gastro enteritis worldwide and vaccination will have a major impact on disease rates, morbidity, and mortality Most children are not dehydrated and can be managed at home Dehydration, metabolic acidosis, and electrolyte disturbance can be prevented and treated by fluid therapy Most children with mildmoderate dehydration can be treated with oral or enteral rehydration using low osmolality oral rehydration solutions Severely dehydrated or shocked children usually need intravenous fluids and hospital admission Drugs are usually unnecessary and may do harm General practitioners have an important role in prevention, through encouraging breastfeeding, recommending and advocating free access to rotavirus vaccination, and educating carers about personal and food hygiene
Rheumatoid Arthritis of the Crico-arytenoid Joints
Authors: W. S. C. Copeman
Journal: BMJ (1957)

FOETAL SEX DETERMINATION in ten instances representing 1.3% of all pregnancies referred to the radiological department during 1956.The cleft is usually confined to the lumbar region.One further specimen was found in a series of 73 viable stillbirths.In every instance the child was a male.The normal proportion of ventral and dorsal ossification centres in foetuses before the 28th week of gestation is 33%, with no obvious male bias.It is suggested that the presence of the condition, which has no pathological importance, may be used as an aid in determining the sex of the foetus.
Estrogen, progesterone receptors in ovarian cancer
Authors: Elizabeth Rasche González
Journal: JAMA (1981)

Preliminary research hints at the possibility that the presence of steroid hormone receptors in ovarian malignant neoplasms may have some prognostic value. In the first study to examine clinical and histopathological correlates of estrogen and progesterone receptors with respect to cancer of the ovary, Robert A. Sasso, William Creasman, MD, and Kenneth McCarty, Jr, MD, PhD, of Duke University School of Medicine, Durham, NC, assessed tumor characteristics and clinical course for 18 patients with the disease. The women ranged in age from 27 to 79 years. Thirteen had adenocarcinoma; the rest had adenosquamous carcinoma, adenoacanthoma, endometroid tumors, or malignant granulosa cell tumors. After surgical debulking, all tumor specimens were evaluated for the presence of cytosolic estrogen and progesterone binding proteins. In addition, they were examined by two independent pathologists, who assessed the nuclear grade (in general, the degree of anaplasia and of nuclear abnormalities) of each tumor. The investigators confirmed
Mortality control charts for comparing performance of surgical units: validation study using hospital mortality data
Authors: P. P Tekkis
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objective:</b> To design and validate a statistical method for evaluating the performance of surgical units that adjusts for case volume and case mix. <b>Design:</b> Validation study using routinely collected data on in-hospital mortality. <b>Data sources:</b> Two UK databases, the ASCOT prospective database and the risk scoring collaborative (RISC) database, covering 1042 patients undergoing surgery in 29 hospitals for gastro-oesophageal cancer between 1995 and 2000. <b>Statistical analysis:</b> A two level hierarchical logistic regression model was used to adjust each unit9s operative mortality for case mix. Crude or adjusted operative mortality was plotted on mortality control charts (a graphical representation of surgical performance) as a function of number of operations. Control limits defined as 90%, 95%, and 99% confidence intervals identified units whose performance diverged significantly from the mean. <b>Results:</b> The mean in-hospital mortality was 12% (range 0% to 50%). The case volume of the units ranged from one to 55 cases a year. When crude figures were plotted on the mortality control chart, four units lay outside the 90% control limit, including two outside the 95% limit. When operative mortality was adjusted for risk, three units lay outside the 90% limit and one outside the 95% limit. The model fitted the data well and had adequate discrimination (area under the receiver operating characteristics curve 0.78). <b>Conclusions:</b> The mortality control chart is an accurate, risk adjusted means of identifying units whose surgical performance, in terms of operative mortality, diverges significantly from the population mean. It gives an early warning of divergent performance. It could be adapted to monitor performance across various specialties. <h3>What is already known on this topic</h3> League tables are an established technique for ranking the performance of organisations such as healthcare providers Mortality control charts are another way to compare the performance of healthcare providers, particularly for outcomes of surgery <h3>What this study adds</h3> Mortality control charts can be adjusted for case mix and case volume and are better than league tables for monitoring surgical performance Mortality control charts have a “buffer zone” for indicating divergence from the mean mortality and are particularly useful for specialties with a low volume of surgery
Early Repolarization Revisited
Authors: Hein J. Wellens
Journal: New England Journal of Medicine (2008)

For more than 60 years, physicians have been fascinated by a peculiar electrocardiographic pattern called "early repolarization."1 When Google is queried, more than 1 million hits turn up on this subject. Although Boineau recently described the electrocardiographic features of early repolarization as being quite diverse,2 such features have one factor in common: slurring or notching that produces a positive hump, called a J wave, is found at the junction at the end of the QRS complex and the beginning of the ST segment. However, the location of the electrocardiographic leads showing the J wave may vary among patients, and dynamic . . .
Editorial: Exceptions in search of a rule
Authors: S. Vaisrub
Journal: JAMA (1974)

An "exception proves a rule" only in the realm of the humanities. A scientific rule brooks no exceptions. If these occur, they must be subsumed under a new rule or a modification of the old one. Exceptions now crowd the rule that angina and myocardial infarction are caused by coronary artery disease. Angina, even myocardial infarction (in a communication in this issue p 804), have been reported in young people whose coronary arteries show no abnormalities on the angiogram or at postmortem examination. Can we find a new rule for these exceptions? On reviewing a six-year experience with 200 patients who had angina despite normal coronary arteriograms, Kemp et al<sup>1</sup>analyzed some current hypotheses. Apparently none passed muster. The psychosomatic hypothesis fails to explain away the myocardial damage. The coronary artery spasm theory has not been confirmed by evidence that spasms occur spontaneously. Occlusions of small vessels undetectable by
Ethanol up-regulates fatty acid uptake and plasma membrane expression and export of mitochondrial aspartate aminotransferase in HepG2 cells
Authors: Sheng-Li Zhou, Ronald E. Gordon, Michael Bradbury, Decherd Stump, Chih-Li Kiang, Paul D. Berk
Journal: Hepatology (1998)

To explain the increased plasma mitochondrial aspartate aminotransferase (mAspAT) observed in alcoholics, we cultured HepG2 hepatoma cells in ethanol. Acute (24 hour) exposure to 0, 20, 40, or 80 mmol/L ethanol produced a dose-dependent ( r = .98) increase in mAspAT messenger RNA (mRNA) of ≤ thirteen-fold, with no significant change in the cellular content of mAspAT or of several other enzymes. The recovery of mAspAT in the medium over 24 hours of ethanol exposure correlated with both ethanol concentration and with mAspAT mRNA ( r = .90), reaching 808% of cellular enzyme content/24 hours at 80 mmol/L. Recovery of all other enzymes studied was ≤ 20% of cellular content and unaffected by ethanol. Plasma membrane mAspAT content also correlated with mAspAT mRNA ( r = .96) and mitochondrial levels were unchanged. No mitochondrial morphologic abnormalities were observed at any ethanol concentration studied. In cells cultured chronically at 0 to 80 mmol/L ethanol, fatty acid uptake V max increased in parallel with plasma membrane expression of mAspAT ( r = .98). Cellular triglyceride content was highly correlated with V max . Thus, the data suggest that: 1) the increased plasma mAspAT observed in alcoholics may reflect pharmacologic upregulation of mAspAT mRNA and of mAspAT synthesis by ethanol; and 2) increased mAspAT-mediated fatty acid uptake may contribute to alcoholic fatty liver.
A potential serum panel for breast cancer diagnosis: ongoing clinical validation for its clinical implication.
Authors: J Lee, B Kim, W Han, E Ko, E Kim, K Hwang, S Kim, P Park, C Kim, D Noh
Journal: Cancer Research (2009)

Abstract Abstract #5006 Although every effort has been made to discover single potent biomarkers in oncology, the promising single biomarker often loses its clinical potency in the course of clinical validations. We aimed to construct and verify a biomarker panel with multiple proteins for breast cancer diagnosis. Using Surface-Enhanced Laser Desorption/ Ionization Time-of-Flight mass spectrometry (SELDI-TOF-MS) and microbead array system, epidermal growth factor (EGF), vascular cell adhesion molecule-1 (VCAM-1), CD40L, vitronectin, plasminogen activation inhibitor-1 (PAI-1), vitamin-D binding protein (VDBP), C-reactive protein (CRP), kininogen, apolipoprotein A1 and proapolipoprotein A1 were identified and validated as useful biomarkers for detection of breast cancer. The multiplexing panel (MP) which was constructed by combining algorithm (random forest, support vector machine) with above biomarkers showed that the diagnostic accuracy approached 91% in 216 test samples. A following double blind test verified that the diagnostic accuracy of the MP was 68% with an additional validation set including sera from 49 patients with breast cancer and 51 healthy women (sensitivity=74%; 95% confidence interval (CI)=58.9–85.0%, specificity=62.7%; 95% CI=48.1–75.9%, positive predictive value=65.5%; 95% CI=55.7-75.3%, negative predictive value=71.7%; 95% CI=61.7-80.35%). We suggest that these results support the potential use of the MP as an early detector of breast cancer. In order to validate the role and potency of the MP in routine clinical practice, a large scale clinical validation in a cohort consisting of 500 patients with breast cancer and the same number of healthy women are underway and the results will be released in the near future. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5006.
Kernohan-Woltman Notch Phenomenon in Acute Subdural Hematoma
Authors: Patrick J. Codd, Pankaj K. Agarwalla, John Berry-Candelario, Brian V. Nahed
Journal: JAMA Neurology (2013)

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 Neurology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Neurology journal
The Time of the First Abnormal Electrocardiogram in Patients with Acute Myocardial Infarction.
Authors: William J. Grace
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970The Time of the First Abnormal Electrocardiogram in Patients with Acute Myocardial Infarction.William J. Grace, M.D., F.A.C.P., Richard J. Kennedy, M.D., F.A.C.P., John A. Chadbourn, M.D.William J. Grace, M.D., F.A.C.P.Search for more papers by this author, Richard J. Kennedy, M.D., F.A.C.P.Search for more papers by this author, John A. Chadbourn, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-780_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is commonly believed that patients with acute myocardial infarction or impending myocardial infarction may have a perfectly normal ECG when first examined so that patients with a normal ECG are frequently hospitalized on the basis of a history of chest pain alone. To study this concept the hospital records of 200 consecutive patients with proved acute myocardial infarction were studied. Diagnosis was established by the typical ECG appearance of diagnostic Q waves, sequential T wave changes and elevated (2X) enzymes. Autopsy was performed in 44% of persons who died. Seventy-five percent of the patients had an ECG within 6... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: William J. Grace, M.D., F.A.C.P.; Richard J. Kennedy, M.D., F.A.C.P.; John A. Chadbourn, M.D.Affiliations: New York, N.Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 780-780KeywordsAcute myocardial infarctionAutopsyElectrocardiographyEnzymesIschemiaMyocardial infarction ePublished: 1 December 2008 Issue Published: 1 May 1970 PDF downloadLoading ...
Surgical Excision After Neoadjuvant Therapy With Vismodegib for a Locally Advanced Basal Cell Carcinoma and Resistant Basal Carcinomas in Gorlin Syndrome
Authors: Anne Lynn S. Chang, Scott X. Atwood, Danielle M. Tartar, Anthony E. Oro
Journal: JAMA Dermatology (2013)

Vismodegib is useful to treat locally advanced or metastatic basal cell carcinomas (BCCs), 1 but to our knowledge, its use as a neoadjuvant to shrink BCCs before surgery has not been reported.This case illustrates the role of vismodegib as a neoadjuvant agent.In addition, this case highlights the fact that a patient with Gorlin syndrome can develop resistant BCCs while taking vismodegib, a phenomenon not widely recognized although recently reported.
227 CHANGES IN TUMOR BLOOD VOLUME AND PERFUSION ASSESSED PERFUSION COMPUTED TOMOGRAPHY PREDICT THE TIMING OF TUMOR PROGRESSION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA TREATED WITH SORAFENIB
Authors: M. Reig, J. Rimola, A. Forner, C. Rodriguez de Lope, S. Tremosini, C. Ayuso, J.M. Llovet, J. Bruix
Journal: Journal of Hepatology (2010)
Combined Papillary Muscle and Left Ventricular Wall Dysfunction as a Cause of Mitral Regurgitation
Authors: ARUN K. MITTAL, MANLY LANGSTON, KEITH E. COHN, ARTHUR SELZER, WILLIAM J. KERTH
Journal: Circulation (1971)

Papillary muscle infarction was produced in 16 mongrel dogs by placing sutures around the base of one of the papillary muscles. In addition, patchy infarction of the adjacent left ventricular wall was produced by placing an Ameroid constrictor around the appropriate coronary artery. Mitral insufficiency developed in 14 of these animals; it was severe in four and mild to moderate in ten. Mitral insufficiency was not produced by isolated infarction of a papillary muscle or by isolated infarction of the left ventricular wall. It is concluded that papillary muscle infarction alone does not lead to mitral regurgitation, but that papillary; muscle dysfunction acts in concert with left ventricular wall dyskinesia or dilatation to produce mitral valve incompetency.
Transforming growth factor-beta 1 stimulates angiotensinogen gene expression in kidney proximal tubular cells
Authors: M.-L. Brezniceanu, C.-C. Wei, S.-L. Zhang, T.-J. Hsieh, D.-F. Guo, M.-J. Hébert, J.R. Ingelfinger, J.G. Filep, J.S.D. Chan
Journal: Kidney International (2006)
Human-Baboon Cross-Circulation for Treatment of Hepatic Coma
Authors: Daniel Hollander
Journal: JAMA (1971)

A patient in fulminant hepatorenal failure due to alcoholic hepatitis was cross-circulated with a baboon for 5 1/2 hours. His mentation began to improve during the procedure, concomitantly with improvement in his biochemical abnormalities. Added normalization of results from liver function tests followed a subsequent exchange transfusion. Reevaluation of the patient three months later disclosed no signs of hepatic encephalopathy, no marked biochemical abnormalities, and no immunological sequelae. Heterologous cross-circulation merits further evaluation as a therapeutic modality for fulminant hepatic failure.
Association of Noninvasive Ventilation With Nosocomial Infections and Survival in Critically Ill Patients
Authors: Emmanuelle Girou
Journal: JAMA (2000)

Invasive life-support techniques are a major risk factor for nosocomial infection. Noninvasive ventilation (NIV) can be used to avoid endotracheal intubation and may reduce morbidity among patients in intensive care units (ICUs).To determine whether the use of NIV is associated with decreased risk of nosocomial infections and improved survival in everyday clinical practice among patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) or hypercapnic cardiogenic pulmonary edema (CPE).Matched case-control study conducted in the medical ICU of a French university hospital from January 1996 through March 1998.Fifty patients with acute exacerbation of COPD or severe CPE who were treated with NIV for at least 2 hours and 50 patients treated with mechanical ventilation between 1993 and 1998 (controls), matched on diagnosis, Simplified Acute Physiology Score II, Logistic Organ Dysfunction score, age, and no contraindication to NIV.Rates of nosocomial infections, antibiotic use, lengths of ventilatory support and of ICU stay, ICU mortality, compared between cases and controls.Rates of nosocomial infections and of nosocomial pneumonia were significantly lower in patients who received NIV than those treated with mechanical ventilation (18% vs 60% and 8% vs 22%; P<.001 and P =.04, respectively). Similarly, the daily risk of acquiring an infection (19 vs 39 episodes per 1000 patient-days; P =.05), proportion of patients receiving antibiotics for nosocomial infection (8% vs 26%; P =.01), mean (SD) duration of ventilation (6 [6] vs 10 [12] days; P =.01), mean (SD) length of ICU stay (9 [7] vs 15 [14] days; P =.02), and crude mortality (4% vs 26%; P =.002) were all lower among patients who received NIV than those treated with mechanical ventilation.Use of NIV instead of mechanical ventilation is associated with a lower risk of nosocomial infections, less antibiotic use, shorter length of ICU stay, and lower mortality. JAMA. 2000;284:2361-2367.
The Measurement of Total "Sodium Space" and Total Body Sodium in Normal Individuals and in Patients with Cardiac Edema
Authors: GEORGE F. WARNER, ERNEST L. DOBSON, CAROLINE E. RODGERS, MURIEL E. JOHNSTON, NELLO PACE
Journal: Circulation (1952)

Total sodium space and total body sodium contents were determined in four groups of individuals with the aid of radiosodium 24 . There appears to be an increase in these values with age, but the presence of well compensated cardiovascular disease in the older age group does not significantly alter the magnitude of these measurements. When congestive failure with edema occurs, there is a marked increase in total sodium space and total body sodium. The increase in total sodium space shows a good correlation with the clinical degree of edema.
Exotic Viral Infections (Kass Handbook of Infectious Diseases)
Authors: D. Mabey
Journal: BMJ (1996)

Ed James S Porterfield Chapman and Hall, pounds sterling85, pp 389 ISBN 0 412 63030 3

Question: Which arthropod borne flavivirus is endemic in Britain? Answer: Louping (or leaping) ill—so named because of the characteristic signs of encephalomyelitis that it causes in sheep—which has long been endemic in Scotland but which is now known to be present in many other parts of the British Isles. In addition to sheep, small mammals and the red grouse comprise its animal reservoir, and it is transmitted by Ixodid ticks, occasionally infecting humans who expose their flesh in sheep pastures.

This and …
Heterogeneity of ventricular repolarization is increased in first degree relatives of patients with arrhythmogenic right ventricular cardiomyopathy
Authors: Velislav N. Batchvarov, Mohammad S. Hamid, Katerina Hnatkova, Rajesh Thaman, Juan R. Gimeno, Peter Smetana, Sami Firoozi, Asifa Quaraishi, Perry M. Elliott, William J. McKenna, Marek Malik
Journal: Journal of the American College of Cardiology (2003)