tbuckley/cabot-search huggingface dataset:
Effects of acute steroid administration on ventilatory and peripheral muscles in rats.
Authors: S Nava, G Gayan-Ramirez, H Rollier, A Bisschop, R Dom, V de Bock, M Decramer
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Occasional case reports have shown that acute myopathy may occur in patients treated with massive doses of corticosteroids. The mechanism of this myopathy is poorly understood. Therefore, 60 male rats were randomly assigned to receive daily injection of saline (C), methylprednisolone (M), or triamcinolone (T) 80 mg/kg/d for 5 d. Nutritional intake, measured daily in 15 animals, showed a significant reduction of food intake in the steroid-treated groups (-50 and -79% in M and T, respectively). This was associated with a similar loss in body weight. In the 45 remaining animals, diaphragm contractility and histopathologic features of several muscles were studied. Weights of respiratory and peripheral muscles were similarly decreased after steroid treatment. Maximal twitches of the diaphragm were lower in the C group (653 +/- 174 g/cm(2)) than in the M group (837 +/- 171 g/cm(2); p < 0.05) and the T group (765 +/- 145 g/cm(2), NS). Half-relaxation time was prolonged in both steroid groups, and time to peak tension was longer with M, whereas tetanic tensions were similar. Steroid treatment also induced a leftward shift of the force-frequency curve at 25 and 50 Hz when compared with saline treatment (p < 0.05). ATPase staining of the diaphragm, scalenus medius, and gastrocnemius showed type IIb fiber atrophy in the steroid groups and also diaphragmatic type IIa atrophy with T, whereas histologic examinations revealed a normal muscular pattern with absence of necrosis. Finally, a pair-fed (PF) study, performed in 18 rats (C, T, and PF), showed that muscle atrophy was considerably less pronounced in PF animals than in T-treated animals. We conclude that (1) short-term treatment with massive doses of steroids induced severe respiratory and limb muscle wasting; (2) both types of steroids induced predominantly type IIb atrophy, resulting in the expected alterations in diaphragm contractile properties; (3) neither steroid caused muscle necrosis; (4) type IIb atrophy was not caused by acute nutritional deprivation alone.
A comparison of a series of newer anticholinergic agents with atropine as regards their effect on saliva flow and gastric secretion in man
Authors: D. W. Piper, M. C. Stiel
Journal: Gut (1962)

The effect of anticholinergic agents—atropine, propantheline, oxyphencyclimine, and propionyl atropine methyl nitrate—on silva flow and on hypoglycaemic stimulated gastric secretion has been studied. The acid secretion of the nervous phase of gastric secretion was inhibited by anticholinergic drugs. They influenced gastric secretion to a greater extent than saliva flow. Both propantheline and oxyphencyclimine have a selective action on the stomach superior to atropine. Propionyl atropine methyl nitrate appears to have only weak anticholinergic activity in the dose recommended and is not superior to atropine.
Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation
Authors: Arshad Jahangir, Victor Lee, Paul A. Friedman, Jane M. Trusty, David O. Hodge, Stephen L. Kopecky, Douglas L. Packer, Stephen C. Hammill, Win-Kuang Shen, Bernard J. Gersh
Journal: Circulation (2007)

Background— The long-term natural history of lone atrial fibrillation is unknown. Our objective was to determine the rate and predictors of progression from paroxysmal to permanent atrial fibrillation over 30 years and the long-term risk of heart failure, thromboembolism, and death compared with a control population. Methods and Results— A previously characterized Olmsted County, Minnesota, population with first episode of documented atrial fibrillation between 1950 and 1980 and no concomitant heart disease or hypertension was followed up long term. Of this unique cohort, 76 patients with paroxysmal (n=34), persistent (n=37), or permanent (n=5) lone atrial fibrillation at initial diagnosis met inclusion criteria (mean age at diagnosis, 44.2±11.7 years; male, 78%). Mean duration of follow-up was 25.2±9.5 years. Of 71 patients with paroxysmal or persistent atrial fibrillation, 22 had progression to permanent atrial fibrillation. Overall survival of the 76 patients with lone atrial fibrillation was 92% and 68% at 15 and 30 years, respectively, similar to 86% and 57% survival for the age- and sex-matched Minnesota population. Observed survival free of heart failure was slightly worse than expected ( P =0.051). Risk for stroke or transient ischemic attack was similar to the expected population risk during the initial 25 years of follow-up but increased thereafter ( P =0.004), although CIs were wide. All patients who had a cerebrovascular event had developed ≥1 risk factor for thromboembolism. Conclusions— Comorbidities significantly modulate progression and complications of atrial fibrillation. Age or development of hypertension increases thromboembolic risk.
HUMAN UMBILICAL CORD BLOOD STEM CELLS SECRETE GROWTH FACTORS AND ANTI-INFLAMMATORY CYTOKINES THAT PROTECT VASCULAR ENDOTHELIAL CELLS AND CARDIAC MYOCYTES FROM ISCHEMIA AND INJURY
Authors: Robert J. Henning, Darrell Sawmiller, David Fleming, Lorynn Hunter, Jeffrey Aufman, Michael B. Morgan
Journal: Journal of the American College of Cardiology (2010)
Principles and Practice of Critical Care
Authors: D W Ryan
Journal: BMJ (1998)

Ed C G Garrard, P Foex, S Westaby Blackwell Science, £149.50, pp 880 ISBN 0632 032 839

Textbooks on intensive care used to be pretty sparse, but they are now widely available. So why do we need another one? This book represents an attempt to provide a truly multidisciplinary approach to intensive care. It doubles as a reference book for the more experienced readers and a “look up and learn” guide for the uninitiated.



The latest developments in repair of …
Lenvatinib versus Placebo in Radioiodine-Refractory Thyroid Cancer
Authors: Martin Schlumberger, Makoto Tahara, Lori J. Wirth, Bruce Robinson, Marcia S. Brose, Rossella Elisei, Mouhammed Amir Habra, Kate Newbold, Manisha H. Shah, Ana O. Hoff, Andrew G. Gianoukakis, Naomi Kiyota, Matthew H. Taylor, Sung-Bae Kim, Monika K. Krzyzanowska, Corina E. Dutcus, Begoña de las Heras, Junming Zhu, Steven I. Sherman
Journal: New England Journal of Medicine (2015)

Lenvatinib, an oral inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, fibroblast growth factor receptors 1 through 4, platelet-derived growth factor receptor α, RET, and KIT, showed clinical activity in a phase 2 study involving patients with differentiated thyroid cancer that was refractory to radioiodine (iodine-131).In our phase 3, randomized, double-blind, multicenter study involving patients with progressive thyroid cancer that was refractory to iodine-131, we randomly assigned 261 patients to receive lenvatinib (at a daily dose of 24 mg per day in 28-day cycles) and 131 patients to receive placebo. At the time of disease progression, patients in the placebo group could receive open-label lenvatinib. The primary end point was progression-free survival. Secondary end points included the response rate, overall survival, and safety.The median progression-free survival was 18.3 months in the lenvatinib group and 3.6 months in the placebo group (hazard ratio for progression or death, 0.21; 99% confidence interval, 0.14 to 0.31; P<0.001). A progression-free survival benefit associated with lenvatinib was observed in all prespecified subgroups. The response rate was 64.8% in the lenvatinib group (4 complete responses and 165 partial responses) and 1.5% in the placebo group (P<0.001). The median overall survival was not reached in either group. Treatment-related adverse effects of any grade, which occurred in more than 40% of patients in the lenvatinib group, were hypertension (in 67.8% of the patients), diarrhea (in 59.4%), fatigue or asthenia (in 59.0%), decreased appetite (in 50.2%), decreased weight (in 46.4%), and nausea (in 41.0%). Discontinuations of the study drug because of adverse effects occurred in 37 patients who received lenvatinib (14.2%) and 3 patients who received placebo (2.3%). In the lenvatinib group, 6 of 20 deaths that occurred during the treatment period were considered to be drug-related.Lenvatinib, as compared with placebo, was associated with significant improvements in progression-free survival and the response rate among patients with iodine-131-refractory thyroid cancer. Patients who received lenvatinib had more adverse effects. (Funded by Eisai; SELECT ClinicalTrials.gov number, NCT01321554.).
Implementing Qualifications Criteria and Technical Assistance for Accountable Care Organizations
Authors: Stephen M. Shortell
Journal: JAMA (2010)

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
Public health doctors angry over McDonald's tutoring programme for students
Authors: M. Sweet
Journal: BMJ (2009)

<h3>Objective:</h3> NA <h3>Background:</h3> A 39-year-old lady complained of epigastric pain for last seven months. Due to persistent pain, she underwent a contrast enhanced computed tomography of the abdomen which revealed a tumor in the head of the pancreas. Four months later, she started having insomnia along with continuous twitching in bilateral calves, angle of the mouth, chin and nostrils. In addition, she had severe bilateral leg pain which was associated with episodes of hyperhidrosis. Subsequently three months afterwards her tumor was resected. A diagnosis of solid pseudopapillary tumor of the pancreas was made on histopathology. However, her neurological symptoms persisted. On examination, the patient was distressed due to continuous leg pain. General physical examination was normal. Neurological examination revealed continuous rippling in the face, bilateral calves and tongue (Video 1). Rest of the neurological examination was normal. Her routine biochemistry, hematology and CSF examination were normal. HRCT chest did not reveal any thymoma. She underwent contrast enhanced MRI of the Brain with whole spine which was normal. Nerve conduction studies in all the four limbs were normal. Electromyography (EMG) revealed continuous spontaneous activity in the form of doublets, triplets, multiplets and fasciculation potentials in bilateral gastrocnemii and the genioglossus suggestive of peripheral nerve hyperexcitability (video 2). In view of the history, examination and EMG findings, a diagnosis of Morvan’s syndrome was suspected. Anti-CASPR2 antibodies were done and were positive. Treatment with intravenous methylprednisolone along with antiepileptics was instituted. However, her symptoms persisted, following which she received intravenous rituximab and her symptoms improved. Morvan’s syndrome has been associated with tumors of the thymus, lung, colon and prostate. To the best of our knowledge, this is the first case of Morvan syndrome associated with a pseudopapillary pancreatic tumor to be reported. High clinical suspicion and awareness of this rare potentially treatable is required. <h3>Design/Methods:</h3> NA <h3>Results:</h3> NA <h3>Conclusions:</h3> NA <b>Disclosure:</b> Prof. Dhamija has nothing to disclose. Dr. Saluja has nothing to disclose.
The Cigarette Papers
Authors: Tom Houston
Journal: JAMA (1996)

<h3>Aphasia</h3> When I sat in your class, you paced, tapped chalk and slate, but gave only eyebrow clues that you were seeding your answers with irony. You analyzed each of our questions and tipped the wavering balance. And all the while you juggled adjectives or euphonious phrases with a dexterity mastered over decades. But all this stopped in the abbreviated seconds that a fleck of fibrin and fat wriggled free— a brief ride on arterial eddies— to wedge in your left middle cerebral branch. And now only eyes shout your struggle— not for an adjective not even for a phrase— but for a verb or noun to break the sinister silence. —Jay Liveson Reprinted by permission from<b>To Slay the Dragon: Poems by Jay Liveson</b>, 78 pp, paper, $14.95, ISBN 0-7734-2676-0, Lewiston, NY, Mellen Poetry Press, 1996. The book is a collection of new and reprinted work on medical and
Stress and Autonomic Nervous System in Type II Diabetes: A Hypothesis
Authors: Richard S Surwit, Mark N Feinglos
Journal: Diabetes Care (1988)

Many investigators have begun to speculate that the sympathetic nervous system is involved in the pathophysiology of type II (noninsulin-dependent) diabetes mellitus (1–4). Recalling the early observations of Claude Bernard, who found that hyperglycemia could be produced in normal rabbits by lesioning the area of the hypothalamus, several groups have noted that hyperglycemia can be produced by chemical stimulation of the brain with morphine as well as with a variety of endogenous neuropeptides and can be abolished by bilateral adrenalectomy (1,5). Similarly, hyperglycemia has been shown to result from slow intravenous infusion of epinephrine (6) as well as from certain forms of stress that produce prolonged sympathetic discharge (7).
Editors and their priorities about libel and fraud: External checks must be imposed to protect the public
Authors: P. Wilmshurst
Journal: BMJ (2004)

Diagnosis of autism Adequate funding is needed for assessment services2][3] One important additional reason for such provision, which their review does not emphasise, is that well coordinated, multiagency assessment teams for autism spectrum disorders have a better chance of accurately not giving a diagnosis of it.Our multiagency assessment service for autism spectrum disorders has seen 57 patients in the past two years.We request baseline speech and language therapy and (where applicable) educational psychology assessments on the likelihood of autism spectrum disorder in all cases before patients are seen by our team, so as to ensure best use of clinical resources.Despite this approach only 26 patients (46%) deemed to be likely cases of autism spectrum disorder received a positive diagnosis.This is not due to overzealous interpretation of ICD-10 diagnostic criteria (which are increasingly recognised as being in urgent need of review), as we tend, if anything, to err in favour of diagnosis, even if ICD-10 (or DSM-IV) criteria, are not strictly fulfilled.Relevant agencies must receive adequate funding for implementing the national autism plan for children. 3This is to benefit not only the children and their families who are struggling with the often devastating impact of this disorder but also the depressingly high number of children whom, we suspect, will be wrongly, or inaccurately, given diagnoses, if assessment services for autism spectrum disorders do not improve.
TCT-507 Racial/Ethnic Variation in Carotid Artery Revascularization Utilization and Outcomes: Analysis from the NCDR(r)
Authors: Siddharth A. Wayangankar, Herbert Aronow, Douglas E. Drachman, Kevin F. Kennedy, Faisal Latif, Bhavin C. Patel, Chittur A. Sivaram, Alfonso Tafur
Journal: Journal of the American College of Cardiology (2013)
APP Processing and Synaptic Plasticity in Presenilin-1 Conditional Knockout Mice
Authors: Huakui Yu, Carlos A. Saura, Se-Young Choi, Linus D. Sun, Xudong Yang, Melissa Handler, Takeshi Kawarabayashi, Linda Younkin, Bogdan Fedeles, Matthew A. Wilson, Steve Younkin, Eric R. Kandel, Alfredo Kirkwood, Jie Shen
Journal: Neuron (2001)
Quality assurance in RT-PCR-based BCR/ABL diagnostics – results of an interlaboratory test and a standardization approach
Authors: T Burmeister, J Maurer, M Aivado, AH Elmaagacli, F Grünebach, KR Held, G Heß, A Hochhaus, W Höppner, KU Lentes, M Lübbert, KL Schäfer, P Schafhausen, CA Schmidt, F Schüler, K Seeger, R Seelig, C Thiede, S Viehmann, C Weber, S Wilhelm, A Christmann, JH Clement, U Ebener, J Enczmann, R Leo, M Schleuning, R Schoch, E Thiel
Journal: Leukemia (2000)
Abnormal electrical properties of myocytes from chronically infarcted canine heart. Alterations in Vmax and the transient outward current.
Authors: W M Lue, P A Boyden
Journal: Circulation (1992)

BACKGROUND Reentrant ventricular arrhythmias can occur in the surviving muscle fibers of the epicardial border zone of the canine heart 5 days after coronary artery occlusion. To understand the cellular basis of these arrhythmias, we developed a method of dispersing myocytes (IZs) from the epicardial border zone. METHODS AND RESULTS We compared the electrophysiological properties of IZs with those of cells dispersed from the epicardium of control noninfarcted (NZs) and of sham-operated animals (NZsham). Transmembrane action potentials of IZs are reduced in total action potential amplitude and maximum upstroke velocity compared with NZs. However, resting potential of IZs is no different from that of NZs. Action potential duration at -10 mV is significantly reduced in IZs compared with control, and IZ potentials do not show the typical "spike and dome" morphology that is evident in all NZs. Using Vmax as an indirect measure of the peak inward current available for the upstroke of the action potential, we found that the availability curve for IZs is significantly different from the NZ curve. Furthermore, the time course of recovery of Vmax after a depolarizing voltage clamp step was significantly altered in IZs. Using whole-cell voltage clamp techniques, we determined that the voltage-dependent, Ca(2+)-independent, 4-aminopyridine-sensitive transient outward current (ito1) occurred in all NZs (n = 16) but existed in only 37% of IZs (n = 16). There was a significant reduction in the density of ito1 elicited by depolarizing steps in those IZs showing ito1 compared with ito1 density in NZs. CONCLUSIONS We have developed a single-cell model of cells that survive in the infarcted heart. Our studies indicate that there are changes in Vmax in IZs. In addition, there is no prominent phase 1 of repolarization in IZ action potentials. This is consistent with the dramatic loss in the function of the ionic channel responsible for the voltage-dependent transient outward current, ito1.
Mediators of Fever and Muscle Proteolysis
Authors: William R. Beisel
Journal: New England Journal of Medicine (1983)

The accelerated catabolism of skeletal-muscle protein that accompanies severe trauma or infection can now be ascribed to the actions of endogenously produced mediators. Two noteworthy studies described1 , 2 in this issue of the Journal have identified these actions by using in vitro preparations of rat skeletal muscle in a bioassay. Rates of proteolysis in muscle preparations were determined by measuring the release of free amino acid into the medium.Clowes et al.1 isolated and partially characterized a small glycopeptide from the plasma of patients with sepsis or trauma. When compared with control samples of normal plasma, samples containing the mediator were . . .
Intracoronary Fibrinolytic Therapy in Acute Myocardial Infarction
Authors: Fareed Khaja, Joseph A. Walton, James F. Brymer, Eric Lo, Luis Osterberger, William W. O'Neill, Harry T. Colfer, Robert Weiss, Tennyson Lee, Thomas Kurian, A. David Goldberg, Bertram Pitt, Sidney Goldstein
Journal: New England Journal of Medicine (1983)

We performed a randomized trial comparing intracoronary administration of streptokinase versus dextrose placebo within six hours after the onset of symptoms of acute myocardial infarction in 40 patients. The base-line clinical, hemodynamic, and angiographic findings were similar in the control and streptokinase-treated groups. Reestablishment of flow occurred in 12 of 20 patients treated with streptokinase and in 2 of 20 given placebo (P less than 0.05). Left ventricular function, angiographic ejection fraction, and regional wall motion, measured before and immediately after intervention, and serial radionuclide ejection fractions, measured at treatment, at 12 days, and at 5 months, were compared according to type of treatment (streptokinase vs. placebo) and outcome of therapy (reperfusion vs. no reperfusion). No statistically significant differences between groups were found. Thus, although streptokinase was more effective than placebo in achieving reperfusion, we detected no improvement of left ventricular function as a result of reestablished coronary flow.
Hospital criticised for not obtaining proper consent
Authors: A. Legge
Journal: BMJ (2000)

Tighter controls on clinical research in the NHS are to be introduced by the government in response to a highly critical review of a study carried out at North Staffordshire Hospital NHS Trust.

The review has raised serious concerns over the issue of consent for a trial on neonates with respiratory failure run by Professor David Southall, consultant paediatrician at the hospital. The randomised controlled trial looked at the effect of treating premature babies with continuous negative extrathoracic …
RELATIONSHIP BETWEEN CORONARY ARTERY CALCIFICATION, HIGH-RISK &amp;ldquo;VULNERABLE PLAQUE&amp;rdquo; CHARACTERISTICS, AND FUTURE ADVERSE CARDIAC EVENTS: THE PROSPECT STUDY
Authors: Takehisa Shimizu, Akiko Maehara, Tony Farah, Rui Teles, Amir Lerman, Christian Hamm, Barry Templin, Alexandra Lansky, Ke Xu, Giora Weisz, Patrick Serruys, Gary Mintz, Gregg Stone
Journal: Journal of the American College of Cardiology (2012)