tbuckley/cabot-search huggingface dataset:
Oxygen metabolites stimulate thromboxane production and vasoconstriction in isolated saline-perfused rabbit lungs.
Authors: R M Tate, H G Morris, W R Schroeder, J E Repine
Journal: Journal of Clinical Investigation (1984)

Generation of reactive oxygen metabolites, thromboxane increases, and vasoconstriction have been implicated in the pathogenesis of acute edematous lung injury, such as that seen in patients with the Adult Respiratory Distress Syndrome (ARDS), but their interactions are unknown. We hypothesized that reactive O2 products would stimulate arachidonic acid metabolism in lungs and that vasoactive products of arachidonate, such as the potent vasoconstrictor thromboxane A2, might then mediate O2-metabolite-induced pulmonary vasoconstriction. We found that O2 metabolites generated by injection of purine plus xanthine oxidase caused increases in mean pulmonary artery perfusion pressures (27 +/- 4 mmHg) in isolated perfused lungs. In addition, purine plus xanthine oxidase also caused 30-fold increases in perfusate levels of thromboxane B2 (the stable metabolite of thromboxane A2) compared with only twofold increases in 6-keto-PGF1a (the stable metabolite of prostacyclin). Moreover, prior addition of catalase inhibited both vasoconstriction and the thromboxane B2 production seen in isolated lungs following injection of purine plus xanthine oxidase. Similarly, pretreatment with cyclooxygenase inhibitors, either aspirin or indomethacin, also completely blocked thromboxane generation and markedly attenuated pressor responses usually seen after purine plus xanthine oxidase (increase in mean pulmonary artery perfusion pressures, 4.4 +/- 1.5 mmHg). Furthermore, imidazole, a thromboxane synthetase inhibitor, also decreased O2-metabolite-induced thromboxane generation and vasoconstriction. These results suggested that thromboxane generation might participate in O2-metabolite-induced vasoconstriction. However, since a significant correlation between thromboxane levels and the degree of vasoconstriction could not be demonstrated, and since addition of superoxide dismutase reduced thromboxane generation but did not affect the intensity of vasoconstriction, it is possible that thromboxane is not the only vasoactive mediator in this model. We conclude that exposing lungs to O2 metabolites results in thromboxane generation and that thromboxane is a major mediator of oxidant-induced vasoconstriction.
Tracheostomy and Hemodynamic Changes in Sleep-Induced Apnea
Authors: JORGE MOTTA
Journal: Annals of Internal Medicine (1978)

Because pulmonary hypertension and systemic hypertension occur during sleep-induced obstructive apnea, six patients underwent overnight hemodynamic monitoring before and after tracheostomy. Variables studied included heart rate, pulmonary artery pressure, femoral artery pressure, and arterial oxygen tension (PO2). After tracheostomy, significant reductions were noted during sleep in mean pulmonary artery pressure from 45 ± 6 mm Hg (mean ± SEM)to 22 ± 2 mm Hg (P < 0.05) and in mean femoral artery pressure from 137 ± 6 mm Hg to 97 ± 3 mm Hg (P < 0.005). There was also a significant increase for the group in arterial PO2 recorded during the apneic episodes from 38 ± 3 mm Hg before tracheostomy to 71 ± 2 mm Hg (P < 0.001) after tracheostomy. We conclude that tracheostomy improves the hemodynamic abnormalities and hypoxemia that occur during sleep in patients with sleep-induced obstructive apnea.
The Sounds of Silence
Authors: John G. Spangler
Journal: JAMA (2007)

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
Regional myocardial free fatty acid extraction in normal and ischemic myocardium.
Authors: K Vyska, H J Machulla, W Stremmel, D Fassbender, W H Knapp, G Notohamiprodjo, U Gleichmann, H Meyer, E J Knust, R Körfer
Journal: Circulation (1988)

The rate constant for free fatty acid influx (k1) was studied in normal and ischemic myocardium. In 15 normal subjects and 30 patients with coronary artery disease, 201Tl and 15-(p-123I-iodophenyl)-pentadecanoic acid (IPPA) were administered during exercise under fasting conditions and at rest. In 10 patients, the study was repeated after percutaneous transluminal coronary angioplasty; in three patients, the study was repeated after infarction. The initial accumulation of IPPA, related to that of 201Tl (both background and crossover corrected), was used for determinations of the regional rate constant of IPPA influx into myocardial tissue (k1*). In normal subjects, no significant differences in k1* between major myocardial segments were found; the average value of k1* was 0.57 +/- 0.13/min (mean +/- SD) at rest and 0.42 +/- 0.06/min at exercise (average workload, 123 +/- 47 W). With increasing free fatty acid plasma concentration and perfusion, free fatty acid influx increased in a saturable fashion. The Michaelis-Menten constant (KM*) and the maximal velocity (Vmax*) for IPPA influx into myocardial tissue were estimated to be 470 nmol/g and 430 nmol/g.min, respectively. In ischemic areas, k1* was reduced to 57 +/- 18% of k1* value in nonaffected segments. The areas were larger than those showing reduced 201Tl uptake. Preinfarction and postinfarction studies showed that the size of 201Tl defects in postinfarction images corresponded with the size of the area with reduced k1* observed in preinfarction scintigrams. Revascularization led to an increase of 201Tl uptake and to normalization of k1*.
Perianal Hematoma — A Sign of Leakage after Rupture of Aortic Aneurysm
Authors: Spiros K. Tamvakopoulos, William P. Corvese, Lester L. Vargas
Journal: New England Journal of Medicine (1969)

SIGNS and symptoms in a patient with ruptured aneurysm of the abdominal aorta vary, according to the site of the rupture, which may occur into the free peritoneal cavity, into the small bowel, most commonly the duodenum, into the inferior vena cava1 2 3 or into the sigmoid mesocolon. In the case reported below, a rapidly expanding hematoma, which followed rupture of an aortic aneurysm, dissected posteriorly to the sigmoid colon, through the pelvic wall, between the levators and, and appeared around the anus as a perianal hematoma. This sign, if early detected and properly considered may lead to the correct diagnosis . . .
CUTANEOUS AND CONJUNCTIVAL MANIFESTATIONS OF SULFATHIAZOLE INTOXICATION
Authors: ITALO F. VOLINI
Journal: JAMA (1941)

The introduction of the newer chemotherapeutic drugs has produced several clinical patterns of toxic manifestations. These effects are encountered in several organs and tissues of the body. One of the most common of these is the untoward reaction encountered in the skin. Indeed, if the nausea and vomiting induced by sulfapyridine are eliminated from consideration, cutaneous rashes are probably the most frequent toxic reaction.  Attention has been directed repeatedly to these cutaneous manifestations with the use of sulfanilamide and sulfapyridine. Experience indicates the former as the more frequent offender in this regard. For example, the types of rashes encountered are indicated by such varied descriptions as erythematous, morbilliform, maculopapular, erythema multiforme, vesicular, bullous, urticarial, exfoliative and purpuric. On the other hand, rashes produced by sulfapyridine have been infrequent. The morbilliform eruption is most commonly encountered on sulfanilamide administration. Nevertheless, specific rashes probably cannot be ascribed to the specific sulfanilamide drug. There may be an exception to this statement because we have encountered a nodular type of rash only with the use of sulfathiazole.  Sulfathiazole, 2-sulfanilamidothiazole, has been recently introduced as an addition to the chemotherapeutic armamentarium. The advantages of this
Altered collagen subpopulations and the matrix metalloproteinase regulation in the development of atrial fibrillation in atrial dysfunction
Authors: Jun Xu, Guanggen Cui, Fardad Esmailian, Mark Plunkett, Daniel Marelli, Abbas Ardehali, Jonah Odim, Hillel Laks, Luyi Sen
Journal: Journal of the American College of Cardiology (2003)
Management of Cancer
Authors: William R. Barclay
Journal: JAMA (1976)

Cancer is viewed by the public and the federal government as a major health problem, deserving of large expenditures of public and private funds. However, the public holds a somewhat simplistic view of the problem, perceiving it as a single disease awaiting the discovery of a single cure that can be found if a sufficiently large sum of money is spent on the search. Actually, of course, the term "cancer" encompasses many diseases with different etiologies and widely varying clinical courses. The treatment of cancer involves a wide variety of approaches, and a single curative agent is not in prospect. The medical profession views cancer as a major challenge, fully appreciates the complexity of the problem, and devotes major efforts to research, diagnostic studies, and treatment methods.The Journalattempts to keep physicians abreast of current developments in the field of cancer with a regular feature, "Topics in Oncology," and
Use of First Names
Authors: Jane Ann Cunningham
Journal: JAMA (1982)

<h3>To the Editor.—</h3> Mrs Natkins' article (1982;247:2415) should be read by every physician, dentist, and hospital employee. I have been infuriated for years by the practice she describes. As Mrs Natkins points out, those in the medical field who call patients (mostly women) by their first names are subtly relegating them to an inferior level. This is a dehumanizing process. Hospital patients who are often in pain, worried, and frightened do not need any more problems. Having their last shred of dignity stripped away when strangers young enough to be their children call them by their first names is not conducive to helping morale. (As a retired RN from the era when all patients, regardless of social class, were respectfully addressed by their last names, I realize that there are a few occasions when calling a patient by his first name can stimulate consciousness.) My childrens' friends do not call
Emergency admission to hospital for colitis due to inflammatory bowel disease Reply
Authors: M H GLEESON, B F WARREN, T M MacDONALD
Journal: Gut (1998)

Editor,—We were interested to read the study by Evans et al ( Gut 1997; 40 :619–22) as we have recently reported a prospective study of colitis drawing similar conclusions.1Our study, however, showed a much stronger association. Forty five of 62 (72.4%) new cases of colitis were taking non-steroidal anti-inflammatory drugs (NSAIDs) or salicylates compared with 38 (7%) of 513 of a control population sample (odds ratio 33.1, 95% confidence interval 17.31 to 63). This difference between the two papers is almost certainly owing to the fact that our group of colitics comprised a much broader spectrum of disease than those reported by Evans et al , who were clearly only studying patients with colitis in relapse.

In addition, we enquired about the usage of over-the-counter NSAIDs and salicylates which was not possible in the study design of Evans et al . We would maintain that exposure misclassification could easily have occurred if over-the-counter usage of these compounds was not considered.

The incident cases of Evans et al were de novo cases of …
Dermal Interstitial Glucose as an Indicator of Ambient Glycemia
Authors: F John Service, Peter C O'Brien, Steven D Wise, Sheryl Ness, Suzanne M LeBlanc
Journal: Diabetes Care (1997)

Using a novel minimally invasive (< or = 1.4 mm) technique to sample minuscule (0.5 microliter) amounts of dermal interstitial fluid (ISF), we assessed the accuracy of its glucose concentrations in predicting concurrently measured venous plasma and capillary plasma glucose concentrations.A total of 67 adult (37 male and 30 female) volunteers (57 with and 10 without diabetes) with venous plasma glucose levels from 1.6 to 28.4 mmol/l underwent forearm ISF, antecubetal venous, and fingertip capillary sampling.Rank correlations were 0.974 for ISF 1 vs. 2, 0.954 for ISF vs. venous, 0.935 for ISF vs. capillary, and 0.987 for venous vs. capillary. Median absolute differences were 0.53 mmol/l for ISF 1 vs. 2, 1.33 mmol/l for ISF vs. venous, 1.06 mmol/l for ISF vs. capillary, and 0.56 mmol/l for capillary vs. venous. Equations expressing ISF glucose as a function of venous and capillary glucose and equations expressing capillary glucose as a function of venous glucose had slopes of 0.995, 0.936, and 1.021, respectively (none significantly different from unity), and intercepts of 1.03 mmol/l (P = 0.024), 0.94 mmol/l (P = 0.131), and 0.56 mmol/l (P = 0.041), respectively. Error grid analysis of ISF vs. venous glucose and of capillary vs. venous glucose showed that 97% of the measurements fell within grids A and B.Dermal ISF sampling is a bloodless minimally invasive technique that provides a medium for glucose measurement, the concentrations of which closely reflect ambient glycemia to a degree comparable with that of capillary glucose measurements.
Older Age, Aggressiveness of Care, and Survival for Seriously Ill, Hospitalized Adults
Authors: Mary Beth Hamel, Roger B. Davis, Joan M. Teno, William A. Knaus, Joanne Lynn, Frank Harrell, Anthony N. Galanos, Albert W. Wu, Russell S. Phillips
Journal: Annals of Internal Medicine (1999)

Background: Older age is associated with less aggressive treatment and higher short-term mortality due to serious illness. It is not known whether less aggressive care contributes to this survival disadvantage in elderly persons. Objective: To determine the effect of age on short-term survival, independent of baseline patient characteristics and aggressiveness of care. Design: Secondary analysis of data from a prospective cohort study. Setting: Five academic medical centers participating in SUPPORT (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Patients: 9105 adults hospitalized with one of nine serious illnesses associated with an average 6-month mortality rate of 50%. Measurements: Survival through 180 days of follow-up. In Cox proportional-hazards modeling, adjustment was made for patient sex; ethnicity; income; baseline physical function; severity of illness; intensity of hospital resource use; presence of do-not-resuscitate orders on study day 1; and presence and timing of decisions to withhold transfer to the intensive care unit, major surgery, dialysis, blood transfusion, vasopressors, and tube feeding. Results: The mean (± SD) patient age was 63 ± 16 years, 44% of patients were female, and 16% were black. Overall survival to 6 months was 53%. In analyses that adjusted for sex, ethnicity, income, baseline functional status, severity of illness, and aggressiveness of care, each additional year of age increased the hazard of death by 1.0% (hazard ratio, 1.010 [95% CI, 1.007 to 1.013]) for patients 18 to 70 years of age and by 2.0% (hazard ratio, 1.020 [CI, 1.013 to 1.026]) for patients older than 70 years of age. Adjusted estimates of age-specific 6-month mortality rates were 44% for 55-year-old patients, 48% for 65-year-old patients, 53% for 75-year-old patients, and 60% for 85-year-old patients. Similar results were obtained in analyses that did not adjust for aggressiveness of care. Acute physiology and diagnosis had much larger relative contributions to prognosis than age. Conclusions: We found a modest independent association between patient age and short-term survival of serious illness. This age effect was not explained by the current practice of providing less aggressive care to elderly patients.
Review to consider shorter training for consultants in England
Authors: S. Mayor
Journal: BMJ (2003)

The postgraduate training and deployment of doctors in England is to undergo a major review designed to reduce the length of training and to provide more generalist consultants, the Department of Health and the medical royal colleges agreed last week.

The Department of Health and the Academy of Royal Colleges, which includes all the royal colleges, have set out recommendations for improving the care of patients and providing better training and career opportunities for doctors. This will be done, they say, by increasing the number of trained doctors and modernising training programmes for specialist registrars.

Senior registrar training will place greater emphasis on assessment and demonstration of practical competence and on equipping doctors …
Prostate cancer: summary of updated NICE guidance
Authors: J. Graham, P. Kirkbride, K. Cann, E. Hasler, M. Prettyjohns
Journal: BMJ (2014)

Prostate cancer poses a major health problem in many countries and is the commonest cancer in men in the UK.1 Its incidence and mortality rate are higher in men of African-Caribbean origin. Since publication of the original NICE guideline in 2008,2 there have been several changes in diagnosis and management of prostate cancer. Great improvements in the treatment of hormone relapsed metastatic disease with the introduction of several new treatments (cabazitaxel, abiraterone, enzalutamide, and radium-223) have been assessed by NICE's Technology Appraisal Programme3 4 and are not covered by this guidance. This article summarises recently updated recommendations from the National Institute for Health and Care Excellence (NICE) on the diagnosis and care of men with prostate cancer.5 Many recommendations have not been updated from the previous guidance and can be found in a previous BMJ summary.6 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Information and support for patients ### Initial assessment and diagnosis
PAROXYSMAL ATRIAL FIBRILLATION IS ASSOCIATED WITH EXERCISE INTOLERANCE AMONG INDIVIDUALS WITH HYPERTROPHIC CARDIOMYOPATHY
Authors: Farnaz Azarbal, Maneesh Singh, Gherardo Finocchiaro, Vy–Van Le, Ingela Schnittger, Paul Wang, Jonathan Myers, Marco Perez, Euan Ashley
Journal: Journal of the American College of Cardiology (2013)
Echographic study of the pancreas
Authors: B. Felson
Journal: JAMA (1975)

ALTHOUGH diagnostic ultrasound has become widely accepted for the evaluation of the abdominal aorta, renal masses, and a host of obstetrical and gynecological conditions, its use in the study of pancreatic disorders is relatively recent. While hypotonic duodenography, radionuclide imaging, retrograde pancreatography, and selective angiography have all advanced our understanding of this inaccessible organ, these studies are costly, sometimes difficult to accomplish and interpret, unsuitable for repeated determinations, and are occasionally accompanied by morbidity. Ultrasound, on the other hand, is simple to perform, carries no morbidity, and is relatively inexpensive. It is therefore the method of choice in screening patients with suspected pancreatic disease and is often helpful in deciding which, if any, of the other studies are most appropriate. Since it can be performed serially, important information regarding the evolution of pancreatic disorders can often be obtained. Although initial results have been encouraging, recent technological improvements in imaging now
Drugs for neuropathic pain
Authors: E. Kalso, D. J. Aldington, R. A. Moore
Journal: BMJ (2013)

The patient is a 63 year old freelance editor with type 2 diabetes diagnosed about five years ago that is relatively well controlled with insulin. He has early signs of retinopathy, with normal kidney function and electrocardiogram. Lipid values are normal with diet and atorvastatin 20 mg/day. He developed autonomic and peripheral neuropathy a few months ago, and now experiences postural hypotension and burning pain and clumsiness in his feet. His pain makes concentration and falling asleep difficult. He asks his general practitioner for painkillers to help him continue working. Neuropathic pain can have many causes (box 1),1 with diabetic neuropathy among the commonest. The International Association of the Study of Pain defines neuropathic pain as "pain caused by a lesion or disease of the somatosensory system."2 This article focuses on drugs for treating neuropathic pain, mainly antiepileptics and antidepressants, including those used off-label in the UK (box 2). National Institute for Health and Care Excellence (NICE) guidance1 recommends offering a choice of amitriptyline, duloxetine, gabapentin, or pregabalin as initial treatment, with switching between these drugs if pain relief is not obtained or the treatment not tolerated. Successful clinical management requires balancing the benefits and adverse effects of available drugs, lifestyle interventions, and treating the underlying cause if possible. Possible comorbidities (anxiety, depression) need to be considered when choosing the best treatment for an individual patient. #### Box 1: Common conditions that might cause neuropathic pain Neuropathic pain is defined as peripheral or central depending on the site of injury. The central nervous system is always involved in the processing of pain. Some neuropathic pains may be mixed—that is, they have both peripheral and central components (such as postherpetic neuralgia, post-amputation pain1). ##### Peripheral pain ###### Common
Public involvement in research should be "second nature" by 2025, review concludes
Authors: I. Torjesen
Journal: BMJ (2015)

The National Institute for Health Research (NIHR) is a trailblazer for public involvement in research but needs a more strategic approach for engaging the public in setting goals and designing research to ensure consistency, a review has concluded.

The Breaking Boundaries review was commissioned by the director general of research and development and chief medical officer in March 2014 to assess how successful the institute has been in achieving public involvement and to make recommendations to build on the achievements so far. The review was led by INVOLVE, an organisation funded by the NIHR to support public involvement in NHS, public health, and social care research. Its report, published last month, set out a vision for public involvement with NIHR by 2025.1

In a …