tbuckley/cabot-search huggingface dataset:
Decreased levels of elafin in the lungs of patients with acute lung injury as a result of proteolytic cleavage by the proteasome
Authors: Clifford Taggart, Aoife Kerrin, Cecilia O'Kane, Sinead Weldon, Allen Chang, Rodney Levine, Thelma Craig, Danny McAuley
Journal: European Respiratory Journal (2012)

Unregulated protease activity may drive dysregulated pulmonary inflammation implicated in acute lung injury (ALI). Elafin is a potent serine protease inhibitor produced locally in the lung by epithelial and inflammatory cells with anti-inflammatory properties. In this study we assessed the temporal changes in elafin concentration in patients with ALI and evaluated whether a decrease in elafin levels are due to proteolytic degradation. Patients with ALI within 48 hours of onset of ALI (n=37), day 3 (n=19) and day 7 (n=9) as well as healthy volunteers underwent bronchoalveolar lavage (BAL). Elafin was measured by ELISA. To determine whether elafin was susceptible to proteolytic cleavage, western blot analysis of recombinant elafin incubated with BAL fluid ± protease inhibitors was carried out. Elafin was significantly increased at the onset of ALI compared to healthy volunteers (39±5 ng/ml vs 0.5±0.1 ng/ml; p
Lung cancer multi-disciplinary team (MDT) decisions audit
Authors: Brendan Mallia-Milanes, Jenny Graves, Jeffrey Meecham-Jones, SuLyn Leong, Ian Mortimore, Steve O'Hickey, Phillip Ryan
Journal: European Respiratory Journal (2011)

Background: Lung cancer resection and survival rates in the UK vary; the reasons for this are unclear.

Aims: To compare lung cancer MDT decision outcomes in 4 hospitals in one cancer network.

Methods: Each lung cancer MDT randomly selected 5 of their MDT cases and submitted them to the other MDTs for assessment. MDT decision outcomes for each case, including each MDT's own previously discussed MDT cases were collated. Mean percentage agreement of MDT outcomes was calculated for TNM staging and referrals for PET scan, curative surgery, radical radiotherapy and palliative chemotherapy.

Results: 3 hospital MDTs discussed 15 cases as well as having previously discussed their own 5 cases. 1 hospital submitted their 5 previously discussed cases but failed to discuss the other cases submitted to them. There were 17 non-small cell lung cancer cases, 2 indeterminate cases and 1 small cell lung cancer case. The number of cases referred for curative surgery varied between 6 to 7 cases per MDT. Percentage agreement was 83% for T staging, 91% for N staging, 98% for M Staging, 87% for referral for PET scan, 98% for curative surgery referral, 95% for radical radiotherapy referral and 93% for palliative chemotherapy referral.

Discussion: There was good agreement for staging and very high agreement for treatment referral. In this pilot study the high agreement for potentially curative treatment does not support the view that some MDTs are not referring patients for potentially curative treatment. As numbers are small we propose this issue be addressed by a national web-based quality assurance programme where each MDT assesses and reports sample cases each month and is given formative feedback.
Time to Therapy and Salvage in Myocardial Infarction 11This study was supported in part by a grant from E.I. duPont de Nemours and Company, North Billerica, Massachusetts.
Authors: James J Milavetz, Dan W Giebel, Timothy F Christian, Robert S Schwartz, David R Holmes, Raymond J Gibbons
Journal: Journal of the American College of Cardiology (1998)
Select Methods in Food Analysis.
Authors: Henry Leffmann, William Beam
Journal: JAMA (1901)

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
Mme Monet on Her Deathbed
Authors: Mary M. Gedo
Journal: JAMA (2002)

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 Journals 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 2024 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
Abstract 9523: Comparison of Guideline Based Pretest Probability Scores Applied to Patients Undergoing Coronary Computed Angiography - The Partners Registry
Authors: Marcio S Bittencourt, Edward Hulten, Khurram Nasir, Michael Cheezum, Suhny Abbara, Brian Gohshhajra, Udo Hoffmann, Marcelo Di Carli, Ron Blankstein
Journal: Circulation (2014)

Introduction: According to current guidelines, the initial test for the evaluation of coronary artery disease (CAD) in individuals with no known disease should be chosen according to the pre-test probability of obstructive CAD. While U.S. guidelines use the Diamond and Forrester (DF) classification, the recent European guidelines have proposed the use of other methods to estimate the pretest probability. Hypothesis: The performance of newer CAD prediction scores will be superior to the DF classification in patients referred to a coronary CTA. Methods: Exam findings were classified as non-obstructive (no CAD or &lt;50% stenosis) or obstructive (≥50%). For each individual we calculated a continuous version of the Diamond and Forrester score, the first version of the CAD consortium score (CAD1), and the two versions of the CAD consortium 2, the basic version (CAD2b), which includes the same variables as the DF classification, and a complete version (CAD2c), which also includes risk factors. We compared the calibration (predicted vs. observed prevalence of obstructive CAD) and discrimination (area under the ROC curves). Results: We included 2580 individuals (mean age 55±13 years, 58% males) with complete information on symptoms and risk factors needed to calculate the scores. 545 (21%) individuals had obstructive CAD on coronary CTA. The estimated probability of CAD by DF was higher than observed, especially among those with an intermediate-high pretest probability (Figure). When evaluating the discrimination, the c-statistic for the DF=0.718 (95%CI: 0.695 - 0.742), for CAD1= 0.7265 (0.703 - 0.750), for CAD2b =0.753 (0.730 - 0.776) and for the CAD2c = 0.791 (0.771 - 0.811). The CAD2c had a significantly higher c-statistic than the other models (p&lt;0.0001) Conclusions: The CAD2c provides better discrimination and calibration to predict obstructive CAD. Thus, the CAD consortium complete score should be preferred against current risk prediction strategies.
PAR-2 agonists induce TGF-β and EMT leading to lung fibrosis
Authors: Tomoko Suzuki, Masaya Suzuki, Gregory Downey, Koichi Hagiwara
Journal: European Respiratory Journal (2013)

Rationale:  The idiopathic interstitial pneumonias (IIPs) are characterized by variable degrees of pulmonary inflammation and fibrosis. However, the pathogenetic mechanisms leading to these responses remain unclear. Epithelial-to-mesenchymal transition (EMT) may play a role as a central process of pulmonary fibrosis. Transforming growth factor (TGF)-β is known to induce the transformation of fibroblasts to myofibroblasts and EMT of epithelium, which may contribute to lung fibrosis. Recently, protease activated receptor (PAR)-2, a G-protein-coupled receptor activated by serine proteases such as trypsin and tryptase has been recognized as a key molecule in inflammation and fibrosis. We hypothesized that activation of PAR-2 induces TGF-β expression and EMT which are associated with lung fibrosis.  Methods:  Cultured human lung epithelial cells (Calu-3) were exposed to trypsin or a specific activating peptide, PAR-2AP. Secreted TGF-β was measured using ELISA. E-cadherin and vimentin were assessed by Western blot.  Results:  The functional PAR-2 was expressed on Calu-3, lung epithelial cells. Activation of PAR-2 by trypsin or PAR-2AP induced TGF-β secretion with time-dependent manner. Cleavage of E-cadherin and induction of vimentin expression were seen by PAR-2 activation. This correlated with ERK activation.  Conclusion:  Activation of PAR-2 induces TGF-β secretion and features of EMT of lung epithelial cells leading to lung fibrosis. PAR-2 may be a key molecule driving lung fibrosis.
Abstract P211: Age-Related Trajectories of Lipids and Lipoproteins: The Impact of Cardiorespiratory Fitness
Authors: Yong-Moon Park, Xuemei Sui, Junxiu Liu, Haiming Zhou, Peter F Kokkinos, Carl J Lavie, Steven N Blair
Journal: Circulation (2015)

Introduction: Although age-related longitudinal changes of lipids and lipoproteins have been described, there are limited data on these trajectories for the life course in adults. Furthermore, evidence on the effect of cardiorespiratory fitness (CRF) on these trajectories is scarce. Hypothesis: We assessed the longitudinal, aging trajectory of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and non- high-density lipoprotein cholesterol (non-HDL-C), and then determined whether CRF modifies the age-associated trajectory of TC, LDL-C, TG, HDL-C, and non-HDL-C in healthy men. Methods: Data came from 11,418 men aged 20-90 years without known high cholesterol, high triglycerides, cardiovascular disease, and cancer at baseline and during the follow-up from the Aerobics Center Longitudinal Study. There were 43,821 observations spanning from 2 to 25 (mean, 3.5) health examinations between 1970 and 2006. CRF was quantified by a ma...
Abstract 16863: Does Maintenance Anticoagulation Variability Influence Adverse Outcomes in Patients with Continuous Flow Left Ventricular Assist Devices?
Authors: Nicholas A Haglund, Christine Lai, Patricia B Miller, Mary E Davis, John Stulak, Mary E Keebler, Jeffrey Boord, Simon Maltais
Journal: Circulation (2014)

Introduction: Anticoagulation (AC) with vitamin K antagonists (VKA) are used to reduce the risk of thrombus in patients with continuous flow left ventricular assist devices (CF-LVAD). Hypothesis: We sought to determine if AC variability was associated with adverse bleeding or thrombus outcomes in CF-LVAD patients. Methods: We analyzed VKA AC variability during the maintenance AC phase from 30 to 90 days in 91 CF-LVAD (HeartMate-II 49, HeartWare 42) patients between 2011 and 2014. Patients were divided into AE and NO AE groups based on bleeding and thrombus outcomes. VKA AC data (measured and interpolated INR values, INR frequency, VKA dose), medications that affect VKA metabolism, markers of hepatic function and anti-platelet agents were compared between groups. Results: Baseline (mean age 52±12, male 79%, INTERMACS 3/4 80%) and perioperative (bypass time 82±48, length of stay 15.4±7.3) characteristics were comparable between AE and NO AE groups (all p&gt;0.05). Adverse outcomes occurred in 12 (13%) patients (bleeding= 4, pump thrombus=6, stroke=2). In the overall cohort, patients spent a median time of 63% (47, 78) in therapeutic INR (2-3) range during maintenance phase VKA AC. Interestingly, variation in maintenance phase AC was comparable between AE and NO AE groups (all p&gt;0.05; Table). Medications that affect VKA metabolism, hepatic function and anti-platelet medications were similar between groups (all p&gt;0.05) (Table). Time in therapeutic range was comparable between devices (HM-II 56% vs HW 65%; p=0.09). Conclusions: During maintenance VKA anticoagulation, CF-LVAD patients spent 37% of time outside the therapeutic INR range. VKA anticoagulation variability, antiplatelet therapy and medications that affect VKA metabolism were not associated with bleeding or thrombus outcomes. Investigation into other variables that may account for recently reported increased adverse events are urgently needed.
Changing Patterns of Risk Factors and Mortality for Coronary Heart Disease Among Alaska Natives, 1979-2002RESEARCH LETTERS
Authors: Joseph B McLaughlin, John P Middaugh, Charles J Utermohle, Elvin D Asay, Andrea M Fenaughty, Jason E Eberhart-Phillips
Journal: JAMA (2004)

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Abstract 15952: Feasibility and Safety of Balloon Expandable Transcatheter Aortic Valve Implantation With Moderate or No Predilatation
Authors: Yigal Abramowitz, Hasan Jilaihawi, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, Abhijeet Dhoble, Jorge Castellanos, Mohammad Kashif, Nobuyuki Takahashi, Niraj Doctor, Mitch Gheorghiu, Raj R Makkar
Journal: Circulation (2014)

Background: Aortic valve preparation by performing balloon aortic valvuloplasty (BAV) has so far been considered mandatory during transcatheter aortic valve replacement (TAVR) procedures. We hypothesized that performing TAVR without predilatation (PD) could potentially reduce BAV complications during TAVR (e.g. stroke or conduction disorders), while yielding similar hemodynamic and clinical outcome. There is limited data on the safety of TAVR with moderate or with no PD and previous publications addressing this issue are mainly of self-expandable valves. Methods &amp; Results: Between September 2012 and January 2014, 95 patients underwent direct balloon expandable TAVR (no PD group) and 255 patients had moderate PD before valve deployment (mean balloon width-15mm; moderate PD group). The Transfemoral approach was used in 79% of patients. Device success was similar between groups (no PD -97%, moderate PD -95%; p=0.44), post procedural mean aortic valve gradients were 6.8 and 6mmHG. There was significantly less initial perivalvular leak (PVL) in the no PD group: 82%, 17%, 1%, 0% versus 66%, 23%, 9%, 2% for no/trace, mild, moderate and severe PVL respectively (p&lt;0.01). Postdilatation was performed in 5.3% of the patients in the no PD group compared to 8.2% in the moderate PD group (p=0.34). Thirty-day mortality and stroke rates were 2.1% and 2.1% in the no PD group compared to 3.5 and 2.4 in the moderate PD group (Table). Fewer permanent pacemaker implantations were needed in the no PD group (2.1% vs. 7.8%; p=0.048). All other in-hospital complications were similar between groups. Conclusions: TAVR with moderate or no PD is feasible and safe. The no PD approach was associated with lower rates of permanent pacemaker implantation and less PVL without affecting procedural success.
Abstract 328: Patients with Left Ventricular Function Improvement After Biventricular ICD Implantation Have a Persistent Risk of Ventricular Tachycardia or Fibrillation
Authors: Alexandra Joseph, Trevanne Matthews-Hew, Melissa Dakkak, Steve Hsu, Cynthia Gist
Journal: Circulation (2014)

Background: Ventricular arrhythmias such as Ventricular Tachycardia (VT) or Fibrillation (VF) are the leading causes of mortality in patients with advanced heart failure. The biventricular implantable cardioverter defibrillator (BiV- ICD) has evolved as a means of treating heart failure because it provides therapy for VT/VF as well as an improvement in left ventricular (LV) function by increasing left ventricular ejection fraction (LVEF). This study analyzed the risk of ventricular arrhythmias after BiV- ICD implantation in patients with improved LVEF versus those without improvement.

Methods: This is a retrospective study of 168 patients who were divided into two groups based on whether the LVEF improved after device implantation. Therapy was defined as shock or antitachycardic pacing (ATP) that terminates the ventricular arrhythmia. We determined patients characteristics based on ischemic, non-ischemic heart failure groups.

Results: Of all the patients with a BiV - ICD, 51% had improvement in their LVEF. Of the ischemic group, 41% had improved EF compared to 63% in the nonischemic group (p=0.005). A total of 29 patients received electrical therapy for VT/VF. Of the patients with improved LVEF, 14 (16%) were shocked compared to 15 patients (18%) in the group with no improvement in LVEF (P =0.730). At 1year, the difference in therapy was not significant between the ischemic (10%) and nonischemic (14%) groups (p=0.706). This same effect was observed up until 9.2 years (0.778). Patients on antiarrhythmic medications received more shocks (13.6% vs. 16.5%) compared to those not on any antiarrhythmic medications (p=0.039). There was no difference in mortality between the groups whether assessed according to ischemic, nonischemic (1.2% vs 6.9%) or improved, nonimproved EF status (1.2% vs. 7.3%) (P=0.095).

Conclusion: Improved LVEF after BiV-ICD implantation was not associated with lower likelihood of receiving therapy for VT/VF. There was no difference in electrical therapies in ischemic compared to non-ischemic HF. There was no difference in mortality between the groups after BiV-ICD implantation.
Abstract 645: Effect of Stun Gun Discharges on Pacemaker Function
Authors: Azamuddin Khaja, Gurushankar Govindarajan, Wayne McDaniel, Greg Flaker
Journal: Circulation (2008)

Introduction: Tasers are electronic controlled devices used by law enforcement to temporarily incapacitate individuals. They generate high voltage, low current repetitive pulsed waveforms which may adversely affect implanted pacemakers. Methods: A single chamber Medtronic bipolar lead was placed under fluoroscopic guidance in the RV apex of 4 pigs and connected to an Adapta generator placed in pre-pectoral pocket. After anesthesia, multiple stun gun shocks were fired every 3 minutes with Taser X-26, Taser M-26 and Stinger S-200. Intracardiac electrograms were continuously recorded during the taser discharges by placing the wand over the pacemaker pocket. Results: The taser did not produce any effects on the native rhythm which is easily seen underlying the distinctive noise signature from the taser shock (Fig-1A ). The Adapta device used for this testing has atrial tachycardia detection capability, explaining the atrial sense markers appearing with the taser noise. Figure 1B was recorded when the pig was 100% paced and the stun gun fired. The reversion pacing, observed in this strip, is functionally asynchronous from the native rhythm the entire time that the taser noise is present and goes away as soon as the taser noise is removed. Conclusions: Stun Gun discharges, were recognized by the pulse generator and sensed as either high rate atrial or ventricular activity depending on which vector is more in line with the electric field created by the two taser electrodes, did not affect the native rhythm, did not conduct down the lead systems to cause any extra systoles, and had no effect on paced rhythm. The use of these devices appears safe in victims with this type of pulse generator.
IgE-sensitization to the cough suppressant pholcodine and the effects of its withdrawal from the Norwegian market
Authors: E. Florvaag, S. G. O. Johansson, Å. Irgens, G. H. de Pater
Journal: Allergy (2011)

To cite this article: Florvaag E, Johansson SGO, Irgens Å, de Pater GH. IgE-sensitization to the cough suppressant pholcodine and the effects of its withdrawal from the Norwegian market. Allergy 2011; 66: 955–960. Background: IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBA), frequent in Norway, was proposed to be caused by exposure to pholcodine (PHO) carrying the allergenic quarternary ammonium ion epitope. Consequently, the PHO-containing drug was withdrawn from the market in March 2007. Objective: Describe the effects of withdrawal of PHO on IgE, IgE-antibodies and reported frequencies of anaphylaxis to NMBAs. Methods: Three hundred sera from supposedly allergic patients sampled yearly through 2006 to 2010 were analysed for IgE antibodies to PHO, suxamethonium (SUX) and morphine (MOR). Furthermore, IgE and preliminary reports from the Norwegian Network for Anaphylaxis under Anaesthesia (NARA) were monitored. Results: PHO exposure was associated with IgE sensitization to PHO, MOR and SUX. However, after withdrawal, within 1 year, antibody prevalences to PHO and SUX fell significantly from 11.0% to 5.0% and from 3.7% to 0.7%, respectively. At 3 years, SUX had fallen to 0.3%, PHO to 2.7% and MOR to 1.3%. By 2 years, the prevalence of elevated IgE was significantly reduced. After 3 years, the incidence of reported suspected anaesthetic anaphylaxis fell significantly, both the total number, the reactions related to NMBAs and those with IgE antibodies to SUX. Conclusions: Withdrawing of PHO lowered significantly within 1–2 years levels of IgE and IgE antibodies to PHO, MOR and SUX, and, within 3 years, the frequency of NMBA suspected anaphylaxis. The results strengthen the PHO hypothesis considerably and equally the need to question the existence of cough depressants containing PHO.