tbuckley/cabot-search huggingface dataset:
Changing the face of whistleblowing
Authors: P. Gooderham
Journal: BMJ (2009)

Regular salbutamol use can exacerbate allergen-induced airway eosinophilia in asthmatics, but its effect on airway eosinophil chemokine responses is unknown. Asthmatic subjects (n=14) were treated for 10 days with placebo or salbutamol in a double-blind, cross-over study, then given same-dose allergen challenges. Their sputa were then analysed 1 and 7 h later for a panel of eosinophil-related cytokines. Eosinophils from five test and three control subjects were tested for expression of CXCL8/interleukin (IL)‐8, and its receptors and responsiveness to CCL11/eotaxin and CXCL8/IL‐8. Sputum CXCL8/IL‐8, but not IL‐5, CCL5/regulated on activation, T‐cell expressed and secreted, CCL7/monocyte chemotactic protein‐3, CCL11/eotaxin, granulocyte-macrophage colony-stimulating factor or tumour necrosis factor levels, were increased (42%) by the salbutamol treatments. The CXCL8/IL‐8 levels correlated with the proportions of sputum eosinophils and these cells, but not other sputum cells, stained strongly for CXCL8/IL‐8. The circulating eosinophils of the tested subjects (n=5) expressed CXCL8/IL‐8 receptors and secreted high levels of this chemokine. Neutralisation of sputum CXCL8/IL‐8 reduced eosinophil chemotactic responses to these samples by 19±5%. These data suggest that regular use of salbutamol can augment airway CXCL8/interleukin‐8 responses to allergen challenge and that this CXCL8/interleukin‐8 could contribute to the airway inflammatory response.
Epidermal adenylate cyclase system is regulated by diacylglycerol-protein kinase C signal, but not by calcium signal
Authors: H. IIZUKA, H. SAKAI, M. KINOUCHI
Journal: British Journal of Dermatology (1990)

The breakdown of inositol phospholipids is an important transmembrane signalling system that is composed of two kinds of signals: the diacylglycerol-protein kinase C signal, and the inositol trisphosphate-Ca2+ signal. Using membrane-permeable diacylglycerol, 1-oleoy-2-acetylgly-cerol (OAG), and calcium ionophore, A-23187, the effects of these chemicals on the epidermal adenylate cyclase system were investigated. OAG increased forskolin- and cholera toxin-induced cyclic AMP accumulations, but receptor adenylate cyclase responses were markedly decreased by treatment with OAG. The effects of OAG were inhibited by the protein kinase C inhibitor, H-7. Calcium ionophore, A-23187, had no effect on the epidermal adenylate cyclase responses. Combinations of OAG and A-23187 (as well as the calcium chelator, EGTA), showed that the action of OAG was mostly unaffected by the modulation of intracellular and extracellular Ca2+ concentrations. The results suggest that among the signals triggered by the breakdown of inositol phospholipids, only diacylglycerol-protein kinase C signal is involved in the regulation of the epidermal adenylate cyclase system.
Clinical Experience with Fluorescence Retinal Cinematography
Authors: JOSEPH W. LINHART, HENRY D. MCINTOSH, ALBERT HEYMAN, LEONARD M. HART
Journal: Circulation (1964)

Clinical experience with fluorescence retinal cinematography in 70 patients is presented. The sequence of normal retinal vascular filling is described. Of particular interest is the demonstration that the retinal circulation consists of a number of vascular segments, each of which may have different flow characteristics. The pathologic alterations in patients with diabetic and hypertensive retinopathy, papilledema, and other disease states are discussed. The dynamic portrayal of the retinal circulation, enabling moment-to-moment evaluation, and the efficiency of the cinematographic technic are distinct advantages over the singlefilm method.
Ravel at Swim
Authors: Floyd Skloot
Journal: JAMA (1992)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors 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
Toward an Epidemiology and Natural History of SIRS (Systemic Inflammatory Response Syndrome)
Authors: Roger C. Bone
Journal: JAMA (1992)

New definitions for sepsis and the systemic inflammatory response syndrome (SIRS) have been established. Comparatively little is known, however, about the types of patients who will be included within these new definitions.To determine what is--and what is not--known about the epidemiology and natural history of severe sepsis and SIRS.A comparative analysis of patient characteristics in the Methylprednisolone, Veterans Administration Systemic Sepsis, HA-1A, and E5 studies.At least 15% of patients in these studies had no documented infection; the proportion of all patients with severe SIRS and no documented infection is probably higher. Even among patients with presumed infection, less than half had bacteremia, and only about half had gram-negative infection or shock. The difference in the mean mortality rate of the combined studies at 14 days was 26%, while at 1 month it was 42%. Gram-negative sepsis and gram-positive sepsis seem to have similar mortality rates. Whether shock increases 30-day mortality is unclear.Patients with severe SIRS should not be assumed to have gram-negative infection; furthermore, data derived from studies of patients with gram-negative infection should be applied cautiously to all patients with SIRS. Studies of patients with sepsis or SIRS should include at least a 1-month follow-up if mortality is an end point. More consistent definitions of these disorders should permit more effective comparisons across studies.
Risk factors for loss of residual renal function in children treated with chronic peritoneal dialysis
Authors: Il-Soo Ha, Hui K. Yap, Reyner L. Munarriz, Pedro H. Zambrano, Joseph T. Flynn, Ilmay Bilge, Maria Szczepanska, Wai-Ming Lai, Zenaida L. Antonio, Ashima Gulati, Nakysa Hooman, Koen van Hoeck, Lina M.S. Higuita, Enrico Verrina, Günter Klaus, Michel Fischbach, Mohammed A. Riyami, Emilja Sahpazova, Anja Sander, Bradley A. Warady, Franz Schaefer
Journal: Kidney International (2015)

In dialyzed patients, preservation of residual renal function is associated with better survival, lower morbidity, and greater quality of life. To analyze the evolution of residual diuresis over time, we prospectively monitored urine output in 401 pediatric patients in the global IPPN registry who commenced peritoneal dialysis (PD) with significant residual renal function. Associations of patient characteristics and time-variant covariates with daily urine output and the risk of developing oligoanuria (under 100 ml/m(2)/day) were analyzed by mixed linear modeling and Cox regression analysis including time-varying covariates. With an average loss of daily urine volume of 130 ml/m(2) per year, median time to oligoanuria was 48 months. Residual diuresis significantly subsided more rapidly in children with glomerulopathies, lower diuresis at start of PD, high ultrafiltration volume, and icodextrin use. Administration of diuretics significantly reduced oligoanuria risk, whereas the prescription of renin-angiotensin system antagonists significantly increased the risk oligoanuria. Urine output on PD was significantly associated in a negative manner with glomerulopathies (-584 ml/m(2)) and marginally with the use of icodextrin (-179 ml/m(2)) but positively associated with the use of biocompatible PD fluid (+111 ml/m(2)). Children in both Asia and North America had consistently lower urine output compared with those in Europe perhaps due to regional variances in therapy. Thus, in children undergoing PD, residual renal function depends strongly on the cause of underlying kidney disease and may be modifiable by diuretic therapy, peritoneal ultrafiltration, and choice of PD fluid.
Understanding the nature and outcome of childhood wheezing
Authors: M. Scott, R. J. Kurukulaaratchy, A. Raza, S. H. Arshad
Journal: European Respiratory Journal (2009)

<h3>Introduction</h3> Clinical depression is usually treated in primary care with psychological therapies and antidepressant medication. However, when patients do not respond to at least two or more antidepressants within a depressive episode, they are considered to have treatment resistant depression (TRD). Previous small randomised controlled trials suggested that pramipexole, a dopamine D2/3 receptor agonist, may be effective for treating patients with unipolar and bipolar depression as it is known to influence motivational drive and reward processing. PAX-D will compare the effects of pramipexole vs placebo when added to current antidepressant medication for people with TRD. Additionally, PAX-D will investigate the mechanistic effect of pramipexole on reward sensitivity using a probabilistic decision-making task. <h3>Methods and analysis</h3> PAX-D will assess effectiveness in the short- term (during the first 12 weeks) and in the longer-term (48 weeks) in patients with TRD from the UK. The primary outcome will be change in self-reported depressive symptoms from baseline to week 12 post-randomisation measured using the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Performance on the decision-making task will be measured at week 0, week 2 and week 12. Secondary outcomes include anhedonia, anxiety and health economic measures including quality of life, capability, well-being and costs. PAX-D will also assess the adverse effects of pramipexole including impulse control difficulties. <h3>Discussion</h3> Pramipexole is a promising augmentation agent for TRD and may be a useful addition to existing treatment regimes. PAX-D will assess its effectiveness and test for a potential mechanism of action in patients with TRD. <h3>Trial registration number</h3> ISRCTN84666271
Informed Consent for Genetic Research-Reply
Authors: Ellen Wright Clayton
Journal: JAMA (1996)

In Reply.  —Our article represents the best efforts of a diverse group of people who attempted to reach some agreement about emerging ethical and legal issues surrounding informed consent for genetics research using stored tissues.  The Centers for Disease Control and Prevention was one of the conveners of the meeting that led to the writing of this article. As a result of their guidance, the authors and supporters of the document directly considered concerns about epidemiologic research as raised by Dr Kelsey. Current federal regulations require that institutional review boards (IRBs) review all proposals that use identifiable tissue samples for research, not just protocols involving genetics. 1 However, IRBs are directed to require investigators to obtain informed consent from subjects (including identifiable individuals from whom samples were obtained) unless the IRB determines that all four criteria for waiving or limiting consent are met. 2 The recommendations included in our article
Short-Course, Low-Dose Amphotericin B Lipid Complex Therapy for Visceral Leishmaniasis Unresponsive to Antimony
Authors: Shyam Sundar
Journal: Annals of Internal Medicine (1997)

Background: Visceral leishmaniasis (kala-azar) is a world-wide, disseminated intracellular protozoal infection for which prolonged, conventional therapy with pentavalent antimony has become increasingly less effective. Objective: To determine the efficacy and minimal effective dose of short-course therapy with amphotericin B lipid complex in visceral leishmaniasis. Design: A randomized, open-label study. Setting: Inpatient kala-azar treatment unit in the state of Bihar in northeast India, where visceral leishmaniasis is endemic. Patients: 60 patients with active infection who had not responded to or who had relapse after receiving conventional (>30 days) treatment with pentavalent antimony. Intervention: Intravenous amphotericin B lipid complex was given once daily for 5 consecutive days by 2-hour infusion. Patients were randomly assigned to receive 1, 2, or 3 mg/kg of body weight per day (total doses of 5, 10, or 15 mg/kg, respectively). Measurements: Clinical and parasitologic responses (the latter were measured by parasite density score of the splenic aspirate) were determined 14 days after treatment. Definitive responses were assessed 6 months after treatment according to clinical outcomes and findings on examination of bone marrow aspirate. Results: All 60 patients responded to 5 days of treatment. Fourteen days after therapy, all patients had parasite-free splenic aspirates and were considered to have an apparent clinical and parasitologic response. Six months after therapy, definitive responses were documented in 16 of 19 (84% [95% CI, 60% to 97%]), 18 of 20 (90% [CI, 68% to 99%]), and 21 of 21 (100% [CI, 84% to 100%]) patients who received total doses of 5, 10, and 15 mg/kg, respectively. Conclusion: Short-course therapy with low-dose amphotericin B lipid complex is effective for visceral leishmaniasis and is an important therapeutic alternative in the management of this serious intracellular protozoal infection.
Lines that connect: assessing the causality inference in the case of particulate pollution.
Authors: D V Bates
Journal: Environmental Health Perspectives (2000)

The question of when it would be appropriate to conclude that the associations between particulate pollution and various outcomes (including mortality) should be judged as causal in nature has been difficult and controversial. Although such a judgment must be subject to revision, the volume of new information and new experimental findings has been so great that such a reevaluation is required at frequent intervals. The useful summary by Gamble [PM(2. 5) and Mortality in Long-Term Prospective Cohort Studies: Cause-Effect or Statistical Associations? Environ Health Perspect 106:535-554 (1998)] of the reasons why a causal inference was, in his opinion, not justified provides a basis for reevaluation in the light of new data. Such a reexamination indicates that the associative evidence is now stronger and that the biologic basis for a number of adverse effects has now been demonstrated. All of the useful guideline criteria customarily applied to such questions seem to have been met, although there is still much to be learned about interactive effects and the possibility of statistical thresholds.
Primary hypertension refractory to triple drug treatment: a study on central and peripheral hemodynamics.
Authors: O Andersson, L Hansson, R Sivertsson
Journal: Circulation (1978)

Cardiac output, plasma volume and regional hemodynamic factors involved in blood pressure regulation were investigated in hypertensive patients refractory to the combined treatment with diuretics, propranolol and hydralazine.The patients were compared to hypertensive patients, matched for sex, age, weight, glomerular filtration rate and initial untreated blood pressure, responding adequately to the corre- sponding therapy.Cardiac output was determined with the dye-dilution technique (indocyanine green) and plasma volume with Evans Blue.Blood flow and vascular resistance at rest and at maximal vasodilatation in a skin (hand) and a muscle (calf) vascular bed were determined using venous occlusion plethysmography and intra-arterial and auscultatory blood pressure recordings, respectively.Maximal vasodilatation was obtained by direct and indirect heating, arterial occlusion and hand muscle work (hand), or by arterial occlusion and muscle work (calf).The refractory patients had increased total peripheral resistance in comparison with the responders, while cardiac output and plasma volume did not differ between the groups.This suggests that increased peripheral resistance is the important factor for sustained blood pressure elevation during the influence of the actual therapy.Furthermore, compared with the controls, the refractory patients had increased vascular resistance at maximal dilatation.This indicates a vascular abnormality in this group.Since the dilatation procedure abolishes smooth muscle tone in the resistance vessels almost completely, the vascular abnormality is inter- preted as a structural change most likely, an adaptive thickening of the vessel wall associated with hyperten- sion.The results indicate that this abnormality is more pronounced in the patients refractory to treatment.SOMETIMES, PATIENTS DO NOT RESPOND satisfactorily to antihypertensive treatment.In our homogeneously investigated and treated series of un- selected hypertensive men the frequency of patients responding inadequately to therapy was 29% during the first year.'All these patients, however, should not be designated as "refractory" or "non-responders," since the reason for inadequate response was usually poor compliance or administration of doses of the antihypertensive drugs which were too low.2The term "frefractory" should be limited to patients who, in spite of adequate treatment and good compliance, still do not respond, or respond inadequately.The prevalence of refractory hypertension in this sense was
Clinics in Rheumatic Diseases. Seronegative Spondyloarthropathies
Authors: A C S Keat
Journal: Annals of the Rheumatic Diseases (1986)

valvular mechanism, are well documented in rheumatoid arthritis.'This patient had been seen one year previously when a popliteal cyst had ruptured, resulting, as it usually does,2 in an acute inflammatory reaction in the calf tissues.Treatment on that occasion consisted of lavage of the knee joint with recovery of a moderate amount of fine fibrinous debris, followed by injection of 50 mg of hydrocortisone with good results.This intervention does not, however, seem to have had any effect in preventing the development of the present suprapatellar collection.
BMA criticises increased funding for boxing
Authors: N. Hawkes
Journal: BMJ (2012)

The British Medical Association has criticised the decision by UK Sport to award greatly increased funding to boxing in the run up to the next Olympic Games. 

“It’s a setback to our campaign against boxing, and it’s worrying,” said Vivienne Nathanson, director of professional activities at the BMA. “We worry about how many go into it without knowing the risks.”

British boxers did very well at the London Olympics, winning three gold medals, a silver, and a bronze, putting them top of the medal table. This represents something of a rebirth for amateur boxing in the United Kingdom, which in 2004 sent a single representative to the Athens Olympics, Amir Khan, who came home with a silver. Half of this year’s 10 team members won medals.

UK Sport has adopted the policy of rewarding the successful; and boxing’s share of the pot for the …
Effects of Policies Designed to Keep Firearms from High-Risk Individuals
Authors: Daniel W. Webster, Garen J. Wintemute
Journal: Annual Review of Public Health (2015)

This article summarizes and critiques available evidence from studies published between 1999 and August 2014 on the effects of policies designed to keep firearms from high-risk individuals in the United States. Some prohibitions for high-risk individuals (e.g., those under domestic violence restraining orders, violent misdemeanants) and procedures for checking for more types of prohibiting conditions are associated with lower rates of violence. Certain laws intended to prevent prohibited persons from accessing firearms-rigorous permit-to-purchase, comprehensive background checks, strong regulation and oversight of gun dealers, and requiring gun owners to promptly report lost or stolen firearms-are negatively associated with the diversion of guns to criminals. Future research is needed to examine whether these laws curtail nonlethal gun violence and whether the effects of expanding prohibiting conditions for firearm possession are modified by the presence of policies to prevent diversion.
Pulmonary mass in an infant
Authors: D. E. Lumsden, O. Olsen, N. J. Sebire, C. E. Wallis, S. Sonnappa
Journal: European Respiratory Journal (2009)

Caucasian young female born at term weighing 3.4 kg, presented to her general practitioner at 4 weeks of age and repeatedly after that with cough, fever and ''noisy breathing''.She was treated with multiple courses of oral antibiotics.The symptoms persisted, and at 6 months of age a chest radiograph (CXR) showed dense consolidation affecting the right upper lobe.She was admitted to her local hospital for a course of intravenous antibiotics.The patient was afebrile on admission and oxygen saturation was 96% in room air, but she had mild respiratory distress and tachypnoea.Auscultation of the chest revealed scattered crepitations and transmitted sounds.Haematological indices and inflammatory markers were normal.She was an only child, born to unrelated parents who were heavy smokers.Immunisations were up-to-date and she was developing normally.Weight gain was along the 50th centile for the first 6 months but had dropped down towards the 25th centile since weaning had started.There was no other family history of note.After 2 weeks of intravenous antibiotics she remained afebrile but continued to have mild tachypnoea and a cough with persisting CXR changes.A computed tomography scan (CT) of the chest (fig. 1) and flexible bronchoscopy were performed 1 month after initial presentation to the local hospital.Bronchoscopy demonstrated an anatomically normal right upper lobe with partially occluded segmental bronchi.There was no microbial growth from bronchoalveolar lavage.At 10 months of age she was referred to a tertiary hospital for children for a surgical opinion and was admitted for an elective excision of the mass.A pre-operative CXR (fig.2) and magnetic resonance imaging (MRI) of the chest were performed (fig.3).A right postero-lateral thoracotomy was performed to explore the mass 1 week later.Histopathological findings of the surgical specimens are shown in figure 4.
Hot Flushes in a 76-Year-Old Man-Reply
Authors: Theodore B. Schwartz
Journal: JAMA (1986)

<h3>In Reply.—</h3> Drs Harris and Schwartz are to be congratulated for finding so satisfying a solution to the problem of Dr Harris' patient. They are wise to emphasize that the resolution of the patient's symptoms after the administration of doxepin cannot be adduced as proof that the hot flushes were due to depression or a panic disorder. Objectively verifiable hot flushes, particularly those that awaken a patient at night, must be a quite unusual manifestation of a purely emotional disorder. Confessing openly my inbred and too often misguided reluctance to abandon a diagnosis as well as my vast ignorance of psychopharmacology, I suggest still that this patient's symptoms may result from a cerebral discharge that was controlled by an unpredicted action of a psychotropic drug. Nevertheless, the patient is doing well and I agree heartily that "if it ain't broke, don't fix it." In response to Dr Kreider, hot flushes