tbuckley/cabot-search huggingface dataset:
Lesson of the week: Haemophilus influenzae type b epiglottitis as a cause of acute upper airways obstruction in children
Authors: K Tanner
Journal: BMJ (2002)

Haemophilus influenzae type b epiglottitis still occurs despite immunisation, and requires emergency intubation 

In the United Kingdom, infection with Haemophilus influenzae type b has considerably declined since the introduction of the conjugated H influenza type b vaccine in 1992, although isolated vaccine failures do occur. In countries without routine immunisation against the disease, it continues to be a major cause of morbidity and mortality. We report on three children who presented over a three month period with epiglottitis due to H influenzae type b infection. Each child had been fully immunised.

Case 1 —A 4 year old boy presented to the emergency department with a 12 hour history of fever and drowsiness, and later drooling and soft stridor. Three days previously he had visited his doctor for red inflamed ears. No antibiotics were prescribed. He had a history of glue ear and campylobacter gastroenteritis. On examination he was feverish (39.3°C) and had stridor and tachycardia. An x ray film of the neck showed swelling of the epiglottis; subsequent difficult intubation in theatre revealed a large cherry red epiglottis. He remained intubated for 36 hours and required a 20 ml/kg bolus of fluid. Blood cultures and a throat swab grew H influenzae type b. Intravenous cefotaxime was continued for 10 days, and he made an uneventful recovery. The table shows the results of blood tests performed during the acute and convalescent stages of the …
Primary care in the United States: Innovations in primary care in the United States * Commentary: What can primary care in the United States learn from the United Kingdom?
Authors: T. Bodenheimer
Journal: BMJ (2003)

<h3>Abstract</h3> There are thousands of distinct disease entities and concepts, each of which are known by different and sometimes contradictory names. The lack of a unified system for managing these entities poses a major challenge for both machines and humans that need to harmonize information to better predict causes and treatments for disease. The Mondo Disease Ontology is an open, community-driven ontology that integrates key medical and biomedical terminologies, supporting disease data integration to improve diagnosis, treatment, and translational research. Mondo records the sources of all data and is continually updated, making it suitable for research and clinical applications that require up-to-date disease knowledge.
544. Strong, Long-Lasting Immune Responses Against Lentivirus Antigens Using rSV40 Vectors Carrying HIV Tat and Envelope
Authors: Hayley J. McKee, David S. Strayer
Journal: Molecular Therapy (2004)

Background: Analysis of blood and cells from HIV-positive patients has demonstrated specific cytotoxic T cells and antibodies directed vs. most HIV proteins. These findings suggest that even proteins that are predicted to be sub-dominant epitopes, can be targeted by the immune system. Thus, just as it is unclear what form(s) an effective prophylactic or therapeutic immune response against HIV might take, the critical antigenic targets are also unknown. A promising approach to HIV vaccine development is use of live viral vectors to deliver HIV antigens in vivo. However, this approach has been hampered by the inability to reinoculate any individual vector more than once: thus one cannot both prime and boost responses using the same vector. Uniquely, recombinant SV40 vectors (rSV40s) circumvent this limitation: they do not elicit neutralizing responses against themselves. rSV40s thus may be administered multiple times. We tested the ability of two rSV40s bearing HIVNL4-3 antigens to prime and boost immune responses: SV(gp120), carrying the cDNA for HIV Env gp120, and SV(Tat) which bears the coding sequences for Tat. Most importantly, the longevity of these immune responses, particularly cytotoxic lymphocyte responses, was assessed.
Aiming Higher to Enhance Professionalism
Authors: Mark R. Chassin, David W. Baker
Journal: JAMA (2015)

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
Uveal Melanomas Near the Optic Disc or Fovea
Authors: Johanna M. Seddon, Evangelos S. Gragoudas, Kathleen M. Egan, Robert J. Glynn, John E. Munzenrider, Mary Austin-Seymour, Michael Goitein, Lynn Verhey, Marsha Urie, Andreas Koehler
Journal: Ophthalmology (1987)
Abstract #4411: AMP-activated protein kinase (AMPK) activation reduces prostate tumor cell growth via inhibition of fatty acid synthase
Authors: Giorgia Zadra, Giuseppe Fedele, Cornelia Photopoulos, Raffaella Zamponi, Carmen Priolo, Joshua Rose, Neal Birnberg, Massimo Loda
Journal: Cancer Research (2009)

AACR Annual Meeting-- Apr 18-22, 2009; Denver, CO

De novo fatty acid (FA) synthesis resulting from fatty acid synthase (FASN) upregulation is associated with aggressive prostate cancer. FASN overexpression is oncogenic in immortalized prostate epithelial cells and when expressed as a transgene in the murine prostate. Its suppression induces apoptosis in cancer cells, implying that tumor survival is dependent on FASN-driven FA biogenesis. However, since FASN inhibitors have shown limited clinical relevance, alternative mechanisms to inhibit FASN are needed. To this end, a potential strategy is the activation of the upstream serine/threonine AMP-activated protein kinase (AMPK). AMPK is a heterotrimeric complex comprised of a catalytic \#945; and regulatory \#946; and \#947; subunits. It acts as a fuel sensor of the increase in AMP/ATP ratio due to cellular stress, starvation, hormones, cytokines, 5-aminoimidazole-4-carboxamide-1-s-D-ribofuranoside (AICAR), and the anti-diabetic drug Metformin. Once activated, AMPK restores cellular energy levels by stimulating catabolic pathways while curtailing ATP-consuming cellular events, including synthesis of proteins, cholesterol, and FA. The latter is known to occur by transcriptional regulation of FASN.Our results showed that AMPK activation by AICAR in LNCaP cells not only results in downregulation of FASN expression after 24 hr but also in a significant reduction of its activity starting from 1 hr. This is consistent with an AMPK-mediated inhibitory phosphorylation of FASN, as demonstrated by anti-phospho-threonine and phospho-serine antibodies. In-silico prediction of PK-specific phosphorylation sites suggested a region around residue Ser1174 (IPRDPSQQEL) corresponding to the AMPK consensus motif. Mass spectrometry and co-immunoprecipitation experiments will determine the precise residue and the existence of a direct AMPK-FASN interaction, respectively. The inhibition of cancer cell proliferation by AICAR and Metformin as well as the lower incidence of cancer observed in diabetic patients under Metformin treatment prompted us to evaluate the efficacy of more specific AMPK activators. The small molecule MT47-100, an AMPK activator that directly binds to the \#946; subunit, induced AMPK phosphorylation and activity in LNCaP and PC3 cells at nanomolar concentrations as well as a significant reduction in cell proliferation. PC3 xenografts in nude mice are currently undergoing treatment to test its toxicity and efficacy in vivo. In conclusion, our study suggests a direct inhibition of oncogenic FASN by AMPK activators representing a novel therapeutic strategy in prostate cancer therapy.

Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 4411.
Cardiovascular Drugs and the Management of Heart Disease.
Authors: Gordon A. Ewy, Rubin Bressler
Journal: Annals of Internal Medicine (1983)

Inotropic agents diuretics vasodilators antiarrythmic drugs beta-adrenergic blocking drugs calcium channel blocking drugs anticoagulants and antiplatelet drugs thrombolytics and management AMI hypolipdemic agents drugs with important cardiovascular implications costs of drugs.
Abstract 4044: Effect of adjuvant chemotherapy on the phenotype of circulating tumor cells in patients with triple negative breast cancer
Authors: Galatea Kallergi, Melina Dragolia, Dimitris Mavroudis, Vassilis Georgoulias, Sofia Agelaki
Journal: Cancer Research (2014)

Abstract Introduction: Recent studies revealed phenotypic discrepancies between Circulating Tumor Cells' phenotype (CTCs) and the corresponding primary tumor in patients with breast cancer. Patients with triple negative (TN) (ER-negative, PR-negative, HER2-negative) primary tumors are considered as a poor prognosis group for whom no targeted therapies are currently available. The aim of the current study was to characterize CTCs in TN breast cancer (BC) patients before and after adjuvant chemotherapy in order to explore additional therapeutic approaches based on the phenotype of chemoresistant CTCs. Methods: Cytospins were prepared from peripheral blood mononuclear cells (PBMC), obtained by ficoll density gradient centrifugation of 31 TN BC patients, before and after adjuvant treatment. The expression of Cytokeratins (CK), Estrogen Receptor (ER), Progesterone Receptor (PR), EGFR and HER2 in CTCs was assessed using double immunofluorescent experiments and ARIOL analysis. Results: CTCs were detected in 25 out of 31 (81%) patients before and in 18 out of 31 (58%) after adjuvant chemotherapy. ER, PR, EGFR and HER2 expression was detected in 33.7%, 23.0%, 69.3%, 42.8% of the total examined CTCs before adjuvant chemotherapy and in 4.2%, 0%, 61.79% and 15.73% after treatment. The frequency of ER- and PR- expressing CTCs was significantly (p=0.05, p=0.007) reduced post-chemotherapy. The absolute number of ER and PR positive-CTCs per patient was also statistically decreased (p=0.02, p=0.001) Triple staining experiments could not reveal co-expression of CK/EGFR/ER in CTCs; however, there was one patient with CTCs co-expressing CK/HER2/ER. Conclusions: A significant percentage of CTCs in triple negative breast cancer patients express HER2 and EGFR before treatment, implying that these receptors could be a potential target for the limitation of metastasis in these patients. EGFR-expressing CTCs persist after adjuvant chemotherapy, suggesting that additional treatment with EGFR-targeting agents could be used post-chemotherapy to eliminate chemo-resistant CTCs. Citation Format: Galatea Kallergi, Melina Dragolia, Dimitris Mavroudis, Vassilis Georgoulias, Sofia Agelaki. Effect of adjuvant chemotherapy on the phenotype of circulating tumor cells in patients with triple negative breast cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4044. doi:10.1158/1538-7445.AM2014-4044
Abstract 20109: Impact of Text Message Medication Reminders on Medication Adherence and Blood Pressure in a High Risk Urban Emergency Department Population
Authors: Lorraine Buis, Aaron Brody, Lynn Marie Mango, Rachelle Dawood, Loren Schwiebert, Hossein Yarandi, Nancy Artinian, Phillip D Levy
Journal: Circulation (2014)

Background: Hypertension disproportionately affects urban African Americans, where medication adherence is often poor. Text message (TM) interventions have shown promise in improving medication adherence.

Objectives: To assess the feasibility, acceptability, and impact of daily, automated, and customized TM medication reminders on medication adherence and blood pressure (BP).

Methods: We conducted a randomized controlled trial of TM medication reminders with a convenience sample of cell phone owning African Americans with asymptomatic uncontrolled BP. Participants were recruited from an urban emergency department and received a 35-day supply of antihypertensive medications. Outcomes were measured at 30-day follow-up.

Results: In total, 65 participants were randomized equally between control and intervention groups, and 57 (88%) completed the study. Our sample was largely male (54%), unemployed (47%), with a high school education (56%), and a total annual household income <$10,000/year (53%). Preliminary analyses revealed great support for the intervention. Out of 29 intervention participants, 100% agreed/strongly agreed that the program was easy to use, 97% would like to keep using the program, 97% were satisfied with the program, and 90% thought the program was helpful. Despite overwhelming acceptability among intervention participants, after 30 days, only 37% of control and 43% of intervention group participants were adherent to medications according to pill counts, and the difference between groups was not statistically significant. Using the Morisky Medication Adherence Scale, there were slight, yet non-significant improvements in medication adherence at 30 days (M = .63 and 1.0 points, respectively). Both groups exhibited improved BP at 30 days (M = -17.6 and -19.4 mm Hg in systolic BP and M = -4.0 and -5.3 mm Hg in diastolic BP for control and intervention groups, respectively), but differences between groups were not significant.

Conclusions: The intervention was feasible and acceptable among participants, but no significant differences were found between intervention and control groups at 30-day follow-up. Further work with longer follow-up and a larger sample is warranted to more adequately determine intervention efficacy.
Abstract P264: Circulating and Dietary Magnesium and Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis of Prospective Studies
Authors: Liana C Del Gobbo, Fumiaki Imamura, Jason H Wu, Marcia C de Oliviera Otto, Stephanie E Chiuve, Dariush Mozaffarian
Journal: Circulation (2013)

Background: Clinical hypomagnesemia and experimental dietary magnesium (Mg) restriction diets are associated with cardiac arrhythmias. Relationships between circulating or dietary Mg at usual concentrations or intakes and risk of cardiovascular disease (CVD), including fatal coronary heart disease (CHD), are not well established. Objective: We performed a systematic review and meta-analysis to summarize all available evidence from prospective studies on the associations between circulating and dietary Mg intake with incidence of total CVD, total CHD, and fatal CHD. Methods: Multiple literature databases and grey literature were systematically searched without language restriction from the earliest online index date to May 2012 for all prospective cohort or nested case-control studies examining the association of circulating or dietary Mg intake with incident total CVD, total CHD and fatal CHD. Two investigators evaluated full text articles for inclusion/exclusion and extracted data, independently and in duplicate. Linear dose-response relationships were assessed using generalized least-squares trend estimation, with pooled RR’s determined using fixed-effects or random-effects in the presence of heterogeneity (I2&gt;30%). Potential non-linear associations were assessed using restricted cubic splines. Prespecified sources of heterogeneity were explored using meta-regression. Publication bias was assessed using formal statistical testing and visual inspection of funnel plots. Results: Of 2,303 abstracts reviewed, 16 studies met eligibility criteria, comprising 761,742 individuals and 11,995 total CVD, 7,534 total CHD, and 2,686 fatal CHD events. In pooled analyses, circulating Mg (per 0.2mmol/L increment) was associated with a 30% lower risk of total CVD (RR=0.70, 95% CI=0.56-0.88; I2=50%) and trends towards lower risk of total CHD (RR=0.83, 95% CI=0.75-1.05; I2=47%) and fatal CHD (RR=0.61, 95% CI=0.37-1.00; I2=80%). Dietary Mg (per 200mg/day increment) was not significantly associated with total CVD (RR=0.89, 95% CI=0.75-1.05; I2=67%), but was associated with a 22% lower risk of total CHD (RR=0.78, 95% CI=0.67-0.92; I2=44%). The association between dietary Mg and fatal CHD was non-linear (p&lt;0.0001), with an inverse association observed up to a threshold of ~250 mg/day (compared to lower intakes, RR=0.73, 95% CI=0.62-0.86). Funnel plot asymmetry was evident for the association between circulating Mg and total CVD, explained by heterogeneity due to stronger associations (p=0.02) in studies including participants with prevalent CVD at baseline and evaluating fatal CHD. Conclusions: Circulating Mg and dietary Mg intake are associated with lower risk of CVD, in particular fatal CHD. These findings support the need for randomized clinical trials and experimental studies to evaluate the possible role of Mg in the prevention of CVD and CHD death.
Abstract 19496: Development of a Novel Model to Mimic Ischemic Microenvironments
Authors: Akshay Menon, L. Christian Napp, Paolo Galuppo, Johann Bauersachs, Jörn Tongers
Journal: Circulation (2014)

Targeting the harsh ischemic microenvironment cell-based therapies have been limited due to altered viability, homing, retention, and functionality of injected cells. To mimic the complexity of ischemia, hypoxia, hypercapnia, excess potassium, metabolic waste accumulation, acidosis, nutrient depletion, and oxidative/inflammatory stress need to be included. Since current models do not reflect this complexity, we aimed to develop a novel model that closely mimics tissue ischemia. Bone-marrow mononuclear cells (BMNC), largely been used for cell-based therapy, were isolated from 8-weeks-old, male FVB mice. Cells were subjected to standard (ctrl) or novel ischemic conditions (IS; 1% O2, 20% CO2, nutrient depletion, metabolic waste accumulation). In addition, BMNCs were co-cultured with muscle slices from ischemic hind-limbs to account for oxidative/inflammatory stress. As determined by microscopy (HE, TUNEL/sarcomeric actin) tissue slices were stable for >7 days. In serial gas analyses (n=3 for all) the cultur...
Impure Science. AIDS, Activism and the Politics of Knowledge, by
Authors: R. Porter
Journal: BMJ (1997)

Steven Epstein / University of California Press, $29.95, pp 465 / ISBN 0 520 20233 3

Just 20 years ago it was all simple. With the global eradication of smallpox, the scourge of infectious disease seemed finally defeated. Drug companies had developed production line techniques of drug innovation, and the routine use of randomised, double blind trials would ensure that tragedies like thalidomide would be a thing of the past. Research scientists would develop cures, doctors prescribe them, and grateful patients swallow them; the expert was in his heaven, the public was in its place, and all was right with the medical world.

The main reason why that “golden age” of the 1970s now seems so far away is AIDS. The lethal new disease that broke up the party is still–a decade and a half and a billion dollars later–without vaccine or cure and is spreading globally out of …
For and against: Direct to consumer advertising is medicalising normal human experience: Against
Authors: S. N Bonaccorso
Journal: BMJ (2002)

# Direct to consumer advertising is medicalising normal human experience {#article-title-2}

In direct to consumer advertising, drug companies target advertisements for prescription drugs directly at the public. Barbara Mintzes argues that this type of advertising risks medicalising normal human conditions, with the drug companies raking in increasingly healthy profits. Silvia N Bonaccorso and Jeffrey L Sturchio argue that, through advertising, drug companies can enable patients to make better informed choices about their health and treatment

# Against {#article-title-3}

Medicalisation refers to the theory that people seek to categorise life's normal vicissitudes as medical problems. The term is also used in medical sociology, to suggest that those with a pecuniary or territorial interest in ill health—not least doctors and the pharmaceutical industry—try to foster exaggerated anxiety about disease and potential disease, so as to encourage essentially healthy people to seek unnecessary medical products and services. 1 2 In this latter sense “medicalisation” has become a theory of social control and has been used as an argument against direct to consumer communication by pharmaceutical companies.

In stark contrast to these theoretical constructs, epidemiological evidence shows a substantial under-diagnosis of many of the major diseases and known risk factors for which effective treatments exist (hypertension, hyperlipidaemia, diabetes, osteoporosis, depression, and childhood asthma). Even after diagnosis, these diseases are massively undertreated.3 4 This failure to treat—together with non-compliance (estimated as some 50% for prescribed medicines across all the major chronic diseases)—leads to a considerable …