tbuckley/cabot-search huggingface dataset:
Putting the Secure Examination to the Test
Authors: Rebecca S. Lipner, Catherine R. Lucey
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
Hyperthermia induces expression of transforming growth factor-beta s in rat cardiac cells in vitro and in vivo.
Authors: K C Flanders, T S Winokur, M G Holder, M B Sporn
Journal: Journal of Clinical Investigation (1993)

Hyperthermia causes changes in expression of TGF-beta mRNA and protein in cultured cardiac cells, as well as in the heart in vivo. 12 h after hyperthermia, primary cultures of neonatal rat cardiomyocytes show a two- to threefold decreased expression of TGF-beta mRNAs which returns to control levels by 48 h after heat shock. In cultures of cardiac fibroblasts, expression of TGF-beta mRNAs increases 5-25-fold, 12-48 h after heat shock, while fetal bovine heart endothelial cells show little change in TGF-beta expression after hyperthermia. In each case, mRNAs for TGF-beta s 1, 2, and 3 are regulated similarly. Hearts isolated from rats exposed to hyperthermia show an initial 20-fold decrease in TGF-beta 1 and 3 mRNA levels which return to control levels by 24 h and subsequently are elevated two- to threefold above normal 48-72 h after heat shock; there is little change in TGF-beta 2 mRNA. Expression of immunoreactive TGF-beta 1 and 3 protein, localized intracellularly in myocytes, follows the same pattern as the mRNA expression. By 72 h, some myocytes show hyperstaining for TGF-beta 1. Staining for extracellular TGF-beta 1/3 exhibits the opposite time course, being most intense 3-6 h after heat shock and returning to control levels by 48 h. The increase in TGF-beta s after hyperthermia could play a role in mediating the reported cardioprotective effects of heat shock.
Increased Diastolic Chamber Stiffness During Demand Ischemia
Authors: Niraj Varma, Franz R. Eberli, Carl S. Apstein
Journal: Circulation (2000)

Background —Increased diastolic chamber stiffness (↑DCS) during angina (demand ischemia) has been postulated to be generated by increased diastolic myocyte calcium concentration. Methods and Results —We reproduced demand ischemia in isolated isovolumically contracting red-cell–perfused rabbit hearts by imposing pacing tachycardia during global low coronary blood flow (32% of baseline). This increased lactate production without increasing oxygen consumption and resulted in ↑DCS (isovolumic left ventricular end-diastolic pressure [LVEDP] increased 10 mm Hg, P &lt;0.001, n=38). To determine the mechanism of ↑DCS, we assessed responses to a quick-stretch-release maneuver (QSR), in which the intraventricular balloon was rapidly inflated and deflated to achieve a 3% circumferential muscle fiber length change. QSR was first validated as an effective method of discriminating between calcium-driven and rigor-mediated ↑DCS. QSR imposed during demand ischemia when DCS had increased (LVEDP pretachycardia versus posttachycardia, 15±1 versus 27±2 mm Hg, P &lt;0.001, n=6) reduced DCS to pretachycardia values (LVEDP post-QSR, 15±1 mm Hg, P &lt;0.001), ie, elicited a response characteristic of rigor, without any component of calcium-generated tension. Conclusions —A rigor force, possibly resulting from high-energy phosphate depletion and/or an increase in ADP, appears to be the primary mechanism underlying increased DCS in this model of global LV demand ischemia.
The Medical Student as a Loner
Authors: John S. Kirkland
Journal: JAMA (1970)

A merican medical education has reached a point of crisis. Although the quality of education is for the most part excellent, the quantity is grossly insufficient to meet the needs of today's society for health services. The demand for additional health services in the '70s will, in all likelihood, outstrip our capacity to provide them, and it behooves each of us concerned with health education to consider innovative approaches to dealing with these problems. In this presentation I will consider only one of the many problems facing the American health care system. I will speak primarily from personal experience, both as an allied health professional and as a medical student, as I address myself to the academic isolation of medical students, in their training, from other health professions students. Medical education has undergone many progressive changes in the past decade and many of the newer schools are experimenting with innovative
F-18 FDG PET/CT Imaging of a Leydig Cell Tumor
Authors: Gilho Lee, Jai Hyuen Lee, Won Ae Lee
Journal: Clinical Nuclear Medicine (2010)

We report the F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of a patient with a testicular Leydig cell tumor. A 43-year-old man was referred for whole body FDG PET/CT imaging for health care screening. FDG PET/CT imaging demonstrated the presence of a focal hypermetabolic lesion in the right testicle and no specific findings in other areas. Based on the preoperative impression, right testis-sparing surgery was attempted. The tumor was pathologically confirmed as a Leydig cell tumor.
A Clinical Lecture ON LINITIS PLASTICA, OR LEATHER-BOTTLE STOMACH: Delivered at the Middlesex Hospital on November 11th, 1913
Authors: J. Bland-Sutton
Journal: BMJ (1914)

PHYSICIANs an1d surgeons of great experience, after examiiining patienlts Nvitlh tun nurs conniected with the abdom-ninal viscera, are oiten unatle to decide wlhetler tlle tiumours are innocenlt or malign ant.In a doubtful case they somlletimes acdvise the patient to lhave t II ctum-iour exposed by an operation in order that its nature may be deter- miined ; ilndeed, it is -'' not ui-ncommon W .n.. .-thetumlour lhas been tlhtus exposed for ,t le ,\ \?W douLbt to persist.In suitable cases tlih offendilig lump is excised and
Effects of Cardiac Sympathetic Innervation on Coronary Blood Flow
Authors: Marcelo F. Di Carli, Michael C. Tobes, Thomas Mangner, Arlene B. Levine, Otto Muzik, Pulak Chakroborty, T. Barry Levine
Journal: New England Journal of Medicine (1997)

The role of cardiac sympathetic nerves in regulating coronary blood flow is controversial. We sought to determine the degree to which cardiac efferent sympathetic signals modulate coronary blood flow. The heterogeneous sympathetic reinnervation in transplanted hearts provides a model for studying the vasomotor responses to adrenergic stimulation in reinnervated and denervated coronary territories of the same heart.
P245 Can clinical, radiological or laboratory parameters differentiate H1N1 associated pneumonia from community acquired pneumonia?
Authors: G. E. Hayes, C. D. Sheldon, B. D. Patel
Journal: Thorax (2011)

Pneumonia is a recognised complication of H1N1 influenza, and is an important cause of morbidity and mortality. The Department of Health (DoH) identified characteristics that may aid identification of individuals with H1N1 pneumonia (HNP) from those with community acquired pneumonia not associated with H1N1 infection (CAP). These include severe gastrointestinal symptoms, including diarrhoea and vomiting, myalgia, fever &gt;38<sup>°</sup>C, bilateral CXR changes, a low or normal total WCC, tachycardia and a CRP &gt;200. Lymphopaenia is also reported as a marker of H1N1infection. This study compared the clinical, physiological and radiological characteristics of patients with HNP with those of patients with CAP to determine if these characteristics can reliably identify those with HNP. <h3>Methods</h3> A retrospective case notes review of all patients admitted with CAP or HNP to our institution between December 2010 and February 2011. <h3>Results</h3> 16 patients with HNP and 52 patients with CAP were identified. Relative to patients with CAP, those with HNP were significantly younger (mean age 49 yrs ±22.1 vs 63 yrs ±23.2, p=0.03), were more likely to present in respiratory failure (92.3% vs 62.5%, p=0.05), or with a temperature &gt;38<sup>°</sup>C (62.5% vs 34.6%, p=0.05), and to report vomiting (71.4% vs 23.1%, p=0.02). There was no significant difference in reported myalgia (80.0% vs 85.0%), diarrhoea (93.8% vs 79.2%). There was no significant difference in the prevalence of unilateral multilobar consolidation (HNP 25.0% vs CAP 17.3%) or bilateral consolidation (31.3% vs 21.5%). Laboratory results showed no significant difference in lymphocyte count (HNP 0.84±0.47 vs CAP 0.95±0.53), CRP (234.3±204 vs 209.0±129) or neutrophil count (9.5±4.8 vs 12.5±7.5). <h3>Conclusions</h3> The features stated in the DoH guidelines do not reliably allow clinical differentiation between HNP and CAP. The presence of vomiting, younger age and high fever are suggestive, but not diagnostic, of HNP and viral PCR remains the gold standard diagnostic tool.
Undertreatment of Glaucoma among Black Americans
Authors: Jonathan C. Javitt, A. Marshall McBean, Geraldine A. Nicholson, J. Daniel Babish, Joan L. Warren, Henry Krakauer
Journal: New England Journal of Medicine (1991)

Cross-sectional studies and those using national data sets estimate that glaucoma-related blindness is between six and eight times more common among black Americans than among whites. Community-based studies have found that glaucoma is four to six times more prevalent among blacks. It is not known why blacks with glaucoma are more likely to become blind than whites with glaucoma.To investigate the possibility that undertreatment of glaucoma is an important factor contributing to this higher rate of blindness, we studied the population-based rates of incisional and laser surgery for open-angle glaucoma among blacks and whites in a 5 percent random sample of Medicare claims for 1986 through 1988.For all U.S. census divisions combined, the rate of surgery for glaucoma among black Medicare beneficiaries was 2.2 times higher than the rate among white beneficiaries (95 percent confidence interval, 2.1 to 2.3). We calculated an expected rate of treatment among blacks on the basis of the rate of treatment among whites and the assumption that glaucoma is four times more prevalent among blacks--a conservative estimate. The observed rate of glaucoma surgery among blacks was 45 percent lower than the expected rate we calculated, which may in part account for the excess rate of blindness among blacks. The magnitude of this difference in treatment rates varied from 29 percent in the Middle Atlantic states to 50 percent in the South Atlantic states.Older black Americans are not receiving potentially sight-saving care for open-angle glaucoma at the same rate as older white Americans.
A Case of Albuminuria without Eclampsia
Authors: A. E. A. Lawrence
Journal: BMJ (1877)

lated pedicle outside the peritoneum; and this method was improved upon in I858 by Mr. Jonathan Hutchinson, who devised the clamp now in common use in some form.Mr. Spencer Wells, who has had the largest experience of any ovariotomist, had his first case in I858; and since that time the operation has been performed by numerous surgeons, both in this and other countries, and is now a thoroughly established pro- ceeding.My own experience has been comparatively small ; the case you have seen being only my fifteenth; but the mortality has been small also, viz., three deaths, or one in five cases-this being, I believe, about the rate in Mr. Wells's much larger number of cases.One of my deaths was accidental, i.e., it resulted from slipping of the clamp some hours after the operation, when internal haemorrhage occurred before the pedicle could be secured.On the other hand, I have never had occa- sion to abandon an operation, though one or two cases have been rather desperate ones, one case having been already attempted by another
Problems of Antibiotic Usage
Authors: CALVIN M. KUNIN
Journal: Annals of Internal Medicine (1978)

Standardized surveillance methods are needed in order to obtain valid comparisons among institutions concerning use of antimicrobial agents. These include use of data from the hospital pharmacy and review of routine orders for prophylaxis in surgery and for specific infectious diseases. Audits of individual agents should be based on standardized guidelines for use. Attempts to improve the quality of use of antimicrobial agents require understanding of the constraints of medical practice that affect use of drugs to solve problems. These include the practice setting, cost and availability of laboratory support, and patient expectation. Promotion by the pharmaceutical industry capitalizes on the motivation of the physician to help his patient, often in settings in which diagnosis and management are uncertain. Promotion is a continuous process beginning early in medical school and extending to the media and university teaching staffs. The overall solution to inappropriate antibiotic use requires more than educational programs. There should also be a well-structured hospital program regulating pharmaceutical representatives, the formulary, antimicrobial susceptibility tests, justification for high-cost agents, and development of mutually agreed on guidelines for use.
High Incidence of IDDM Over 6 Years in Edmonton, Alberta, Canada
Authors: Ellen L Toth, Kwok-Choy Lee, Robert M Couch, Laurence F Martin
Journal: Diabetes Care (1997)

To determine the incidence of IDDM among children 0-14 years of age in Edmonton, Alberta, between 1990 and 1995 by means of a population-based registry.Children < 15 years of age diagnosed with IDDM between January 1990 and December 1995 were registered according to criteria of the World Health Organization (WHO) Multinational Project for Childhood Diabetes. The primary source of case ascertainment consisted of office records of pediatricians and endocrinologists. The secondary source consisted of inpatient records from the main city hospitals.Between 1990 and 1995, 211 IDDM patients < 15 years of age were detected by the two sources. All but 15 of them were of European ancestry. The ascertainment-corrected incidence rates of this ethnic group (constituting 77% of the population) for the 6 years were 38.6, 23.5, 23.3, 24.2, 22.0, and 24.3 per 100,000, respectively, with case ascertainment rates of 75-95%. The age-adjusted rate over the 6-year period was 25.7 per 100,000 with a case ascertainment rate of 84.3%. No sex difference was observed. The highest incidence occurred in the 10- to 14-year-old age-group, and more cases were detected between January and March than at other periods in the year.The incidence of IDDM among the European-derived population in Edmonton between 1990 and 1995 is the highest rate over a 6-year period to be reported in North America, comparable to that in Prince Edward Island, Canada, and to the highest rates in the world.
Recent advances in jaundice. Medical aspects of investigation and treatment.
Authors: R Williams
Journal: BMJ (1970)

which may be the reason that kernicterus does not occur in conjugated hyperbilirubinaemia. CholestasisCholestasis may be defined as stagnation of bile within the intrahepatic or extrahepatic biliary tree.Biochemically, there is retention of conjugated bilirubin, bile salts, and alkaline phosphatase; morphologically, there is at least dilatation of biliary canaliculi and loss of their microvilli, and later accu- This antigen was first found by B. S. Blumberg and his colleagues"' in the serum of an Australian aborigine-hence its name, which gives little indication of its probable associa- tion or identity with the virus of infective hepatitis.Charac- teristically a precipitin reaction occurs when Australia antigen on 17 August
Biology of Giardia lamblia. Detection of N-acetyl-D-glucosamine as the only surface saccharide moiety and identification of two distinct subsets of trophozoites by lectin binding.
Authors: H D Ward, J Alroy, B I Lev, G T Keusch, M E Pereira
Journal: The Journal of Experimental Medicine (1988)

Lectins and glycosidases of known sugar specificity were used as probes to analyze the surface carbohydrate moieties of G. lamblia trophozoites and in particular to determine whether chitin or oligomeric D-GlcNAc is present in the trophozoite form of the parasite as well as on the cyst. Of 13 lectins with varying sugar specificity, only D-GlcNAc-specific lectins bound specifically to the trophozoite surface as determined by light microscopy and EM. A striking finding was the identification of two distinct subsets of trophozoites, distinguished by reactivity with WGA and detected by light microscopy and EM as well as by flow cytometry. Unlike the cyst wall, the trophozoite D-GlcNAc residues were resistant to chitinase treatment. In contrast N-acetyl-beta-D-glucosaminidase abolished WGA binding suggesting that the lectin binds to terminal beta-linked D-GlcNAc residues. These residues were identified as being present on surface glycoproteins by Western blotting of parasite membrane proteins using WGA as a probe. This study identifies D-GlcNAc as the only saccharide moiety detectable by lectin binding on the surface of G. lamblia trophozoites and demonstrates that in contrast to the cyst, chitin is not present in the trophozoite. In addition two distinct subsets of trophozoites were identified based on reactivity with WGA and may represent varying stages of differentiation from trophozoite to cyst.
The intramural ganglia and chromaffin cells in guinea pig atria: an ultrastructural study
Authors: R. MALOR, S. TAYLOR, G. B. CHESHER, C. J. GRIFFIN
Journal: Cardiovascular Research (1974)

The intramural ganglia and chromaffin cells in guinea pig atria were examined with the electron microscope. Three possible types of synapses were identified associated with the ganglia; axo-dendritic, axo-somatic, and axo-axonal. In all cases the presynaptic nerve appeared to be cholinergic and no definite adrenergic fibres were seen in association with the ganglia. The chromaffin cells occurred in small clusters which were found both alone and in conjunction with the ganglia. The dense cored vesicles in the cytoplasm of the chromaffin cells resembled the granules in the noradrenergic cells of the adrenal medualla. No nerve terminations were found on these cells. From morphological considerations it seemed unlikely that the chromaffin cells released their contents directly into the blood.
Significance of ST Segment Elevations in Posterior Chest Leads (V7to V9) in Patients With Acute Inferior Myocardial Infarction: Application for Thrombolytic Therapy
Authors: Shlomi Matetzky, Dov Freimark, Pierre Chouraqui, Babeth Rabinowitz, Shmuel Rath, Elieser Kaplinsky, Hanoch Hod
Journal: Journal of the American College of Cardiology (1998)
Dr. Cohen's Healthy Sailor Book
Authors: William R. Barclay
Journal: JAMA (1984)

This is a delightful, well-written, and highly informative book. It describes the ills that often affect small-boat sailors from a physiological and causative standpoint, and its focus is one of prevention rather than simply treatment. The author, a neurologist, is obviously an experienced sailor who has read a large number of accounts by people who have made long ocean voyages in small boats and who have described the illnesses that befell them. The book deals with the following conditions: seasickness, cold weather sailing, heat and dehydration, sailors' skin problems, nutrition, hazardous marine life, infections, visual problems, keeping fit, sleep and fatigue, and sailing psychology. Dr Cohen writes in a clear and straightforward style, with nice touches of humor. The illustrations are excellent and greatly add to the understanding of the written text. At times, however, the text is too technical for people with no medical background, but this does not
How effective is screening for breast cancer?
Authors: L. Nystrom
Journal: BMJ (2000)

Papers p 665

Many countries initiated national screening programmes for breast cancer after the results of the Swedish two counties trial were published in 1985.1 This trial, which took place in Kopparberg and Ostergotland, found that mortality from breast cancer fell by 31% after seven years' follow up of women who had been aged 40-74 at the beginning of the trial. These findings confirmed the results of an earlier trial by Shapiro et al.2 Finland and Sweden started their programmes in 1986, the United Kingdom in 1988, and the Netherlands in 1989. Those in charge of health policy in these countries now want evidence that these programmes are achieving their goals.

Can the results of randomised controlled trials be generalised, and can the impact be maintained when findings are put into practice? The crucial point of this process is the setting of the goal, which for screening with mammography is usually a reduction in mortality from breast cancer within a certain number of years. In practice, the goals have often been based on the results of the two counties trial or sometimes just the Kopparberg part of the trial (in the latter the reduction in mortality was higher). However, sometimes the goal is set without considering the basic characteristics of the trial—for example, in Kopparberg the attendance rate for …
Abstract 227: Antitumor activity of glyceollins through induction of apoptosis
Authors: Hyo Jung Kim, Jiyeon Seo, Ji Sun Lim, Jia Park, Dae Hwan Nam, Annalene Garcia, Jong-Sang Kim
Journal: Cancer Research (2010)

Abstract Glyceollins, which are synthesized from daidzein in soybean infected with fungi, have been shown to have anti-fungal effects and cancer preventive properties. However, the effects of glyceollins on apoptosis of cancer cell are not well known. We have investigated the antitumor effects of glyceollins on murine hepatoma cell lines. Cell viability was tested with a MTT assay. In Hepa1C1C7, glyceollins markedly reduced cell viability which was due to apoptosis. Glyceollins were observed to induce apoptosis of Hepa1C1C7 cells as evidenced by cell-morphological changes, an early redistribution of plasma membrane phosphatidylserine, increases in membrane leakage (propidium iodide) staining), Annexin-V binding, sub G1 phase in the cell cycle, and DNA laddering. Western blot analysis showed that upon treatment of tumor cells with the glyceollins, cleavage of pro-caspases-3 and significant release of mitochondrial cytochrome c into the cytosol were readily observed. This study demonstrated that glyceollins caused cell death via an apoptotic pathway, which might be exploited for prevention of tumor development. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 227.