tbuckley/cabot-search huggingface dataset:
Efficacy of pentoxifylline in the treatment of pruritic papular eruption of HIV-infected persons
Authors: Brian Berman, Francisco Flores, George Burke
Journal: Journal of the American Academy of Dermatology (1998)

Pruritic papular eruption (PPE) of HIV/AIDS is a common manifestation of HIV infection. Unfortunately, treatments for the unremitting pruritus have yielded only partial relief.Our purpose was to assess the clinical efficacy of pentoxifylline in the treatment of pruritus in HIV-infected patients with PPE while measuring its effects on HIV viral load and levels of serum triglycerides, tumor necrosis factor (TNF)-alpha, and interleukin (IL)-4.Eleven of the 12 patients with PPE and HIV infection placed on a regimen of oral pentoxifylline completed the 8-week study. The degree of pruritus both before and after therapy was measured by means of a patient-reported visual analog scale (0 = none and 10 = worst experienced). A global assessment of the number and size of PPE lesions was performed by the investigator, and serum TNF-alpha, IL-4, and triglyceride levels, as well as HIV viral load, were measured.The average degree of pruritus was significantly reduced (p = 0.0009) from 6.5 at baseline examination to 3.6 at the end of the study. Ten of 11 patients experienced a reduction in their pruritus, ranging from 22.6% to 87.3%. The global assessment of PPE lesions decreased from baseline in most patients and increased slightly in one patient. Serum TNF-alpha was detectable in one patient at baseline, but was undetectable at the end of the study period. Similarly, the two patients who had detectable serum IL-4 at baseline had undetectable serum IL-4 levels at the end of the study. Triglyceride levels in six patients decreased an average of 23.9% by week 8. Although when compared with baseline values, HIV viral loads in seven patients decreased, one patient had no change, and three patients had an increase in their viral load at the end of the study, the magnitude of the changes were of little clinical importance.Pentoxifylline is a safe and efficacious treatment of pruritus in HIV-infected patients with PPE. Future controlled studies are needed to confirm the effectiveness of this treatment.
Reply to Matsushita et al.
Authors: J. García-Cano
Journal: Endoscopy (2008)

I appreciate the interest of Dr. Matsushita and colleagues in our report [1]. Nowadays, 40 years after the first endoscopic retrograde cholangiopancreatography (ERCP) procedure [2], biliary endoscopy is usually the technique of choice to drain the bile duct [3]. By the same token, it is also very well known that complications cannot be completely avoided in ERCP, despite extensive operator experience and refinement in devices and techniques. This is what we have also experienced over the years [4] [5].
Paradoxical embolism complicating massive pulmonary embolus.
Authors: P A Poole-Wilson, A R May, D Taube
Journal: Thorax (1976)

Paradoxical embolism is an unusual but well recognized complication of venous thromboembolic disease. This case report of a patient with massive pulmonary embolism, who had a paradoxical embolus through a patent foramen ovale, emphasizes that in these circumstances surgical intervention is indicated.
The Net Value of Health Care for Patients With Type 2 Diabetes, 1997 to 2005
Authors: Karen N. Eggleston, Nilay D. Shah, Steven A. Smith, Amy E. Wagie, Arthur R. Williams, Jerome H. Grossman, Ernst R. Berndt, Kirsten Hall Long, Ritesh Banerjee, Joseph P. Newhouse
Journal: Annals of Internal Medicine (2009)

Background: The net economic value of increased health care spending remains unclear, especially for chronic diseases. Objective: To assess the net value of health care for patients with type 2 diabetes. Design: Economic analysis of observational cohort data. Setting: Mayo Clinic, Rochester, Minnesota, a not-for-profit integrated health care delivery system. Patients: 613 patients with type 2 diabetes. Measurements: Changes in inflation-adjusted annual health care spending and in health status between 1997 and 2005 (with health status defined as 10-year cardiovascular risk), holding age and diabetes duration constant across the observation period ("modifiable risk"), and simulated outcomes for all diabetes complications based on the UKPDS (United Kingdom Perspective Diabetes Study) Outcomes Model. Net value was estimated as the present discounted monetary value of improved survival and avoided treatment spending for coronary heart disease minus the increase in annual spending per patient. Results: Assuming that 1 life-year is worth $200 000 and accounting for changes in modifiable cardiovascular risk, the net value of changes in health care for patients with type 2 diabetes was $10 911 per patient (95% CI, −$8480 to $33 402) between 1997 and 2005, a positive dollar value that suggests the value of health care has improved despite increased spending. A second approach based on diabetes complications yielded a net value of $6931 per patient (CI, −$186 901 to $211 980). Limitation: The patient population was homogeneous and small, and the wide CIs of the estimates are compatible with a decrease as well as an increase in value. Conclusion: The economic value of improvements in health status for patients with type 2 diabetes seems to exceed or equal increases in health care spending, suggesting that those increases were worth the extra cost. However, the possibility that society is getting less value for its money could not be statistically excluded, and there is opportunity to improve the value of diabetes-related health care. Primary Funding Source: None.
Clinical scores in the differential diagnosis of acute stroke
Authors: R F Logan, S M Poulton, M P Severs
Journal: BMJ (1994)

EDITOR, - Routine computed tomography for all patients with stroke is not available to some doctors, and this poses management problems. The Guy's Hospital score and the Siriraj score are the “poor man's computed tomography” in terms of reliability, but Maria Grazia Celani and colleagues suggest that they may be used as a temporary guide to management pending computed tomography,1 and Poungvarin et al suggested that they could be used as a means of targeting computed tomography at cases in which uncertainty exists.2 If …
PRE-OPERATIVE CT ANGIOGRAPHY FOR PLANNING OF MINIMALLY INVASIVE ROBOTIC MITRAL VALVE SURGERY: IMPACT ON DECISION MAKING
Authors: Sashidaran Moodley, Paul Schoenhagen, A. Gillinov, Tomislav Mihaljevic, Scott Flamm, Brian Griffin, Milind Desai
Journal: Journal of the American College of Cardiology (2012)
Metastatic Melanoma in the Breast Masquerading as Fibroadenoma
Authors: Peter R. Jochimsen
Journal: JAMA (1976)

OCCASIONALLY the radiologic appearance of a common benign lesion is indistinguishable from a metastatic tumor within the same organ. A case in point is malignant melanoma, metastatic to the breast, which may be identical in appearance to a benign fibroadenoma of the breast. The two following cases demonstrate the impossibility of differentiating these lesions using only physical examination and xerographic confirmation. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 27-year-old woman went to her local physician complaining of a tender lump in the right axilla. After examination, which showed only an axillary mass and two discrete, freely movable "adenomas of the breast," she was referred to a surgeon who felt she probably had a lymphoma. The patient underwent lymph node biopsy of the solitary axillary lymph node, which measured 2×2 cm. The pathologic diagnosis was anaplastic adenocarcinoma, metastatic to the axillary node. The patient was referred to University of Iowa Hospitals and
Rapid identification of low level hepatitis B-related viral genome in serum.
Authors: T J Liang, K J Isselbacher, J R Wands
Journal: Journal of Clinical Investigation (1989)

A sensitive and specific method has been developed to detect hepatitis B virus (HBV) in serum. The method involves two steps: the capture of viral genome from serum using a high affinity IgM monoclonal antibody directed against a common a domain epitope found on the envelope, and the amplification of viral DNA by the polymerase chain reaction (PCR). The amplification is initiated using "generic" primers derived from the core and pre-core sequences which are highly conserved amongst the hepadnaviruses. This rapid technique detects less than 10 infectious virions and may be useful in the study of individuals with acute and chronic liver disease of unknown etiology.
Elevated production of interleukin-4 and interleukin-5 by T cells in a child with idiopathic hypereosinophilic syndrome
Authors: Masaru Takamizawa, Tsutomu Iwata, Katsuyu Watanabe, Hiroshi Hayakawa, Takenori Takahashi, Matsutaka Furue, Takeshi Fukuda, Takeo Juji, Mutsuhiko Minami
Journal: Journal of Allergy and Clinical Immunology (1994)
Antiviral efficacy of NS3-serine protease inhibitor BILN-2061 in patients with chronic genotype 2 and 3 hepatitis C
Authors: Markus Reiser, Holger Hinrichsen, Yves Benhamou, Henk W. Reesink, Heiner Wedemeyer, Cristina Avendano, Neus Riba, Chan‐Loi Yong, Gerhard Nehmiz, Gerhard G. Steinmann
Journal: Hepatology (2005)

BILN-2061, a specific and potent peptidomimetic inhibitor of the HCV NS3 protease, has recently been shown to markedly lower serum hepatitis C virus (HCV)-RNA levels in patients chronically infected with HCV genotype 1 in three 2-day proof of principle studies. The aim of the current study was to assess the antiviral efficacy of BILN-2061 in patients with genotypes 2 and 3 HCV infection. The antiviral efficacy, pharmacokinetics, and tolerability of 500 mg twice-daily BILN-2061 given as monotherapy for 2 days in 10 patients chronically infected with non-genotype 1 HCV (genotype 2: n = 3; genotype 3: n =7) and minimal liver fibrosis (Ishak score 0-2) were assessed in a placebo-controlled (placebo n = 2), double-blind pilot study. HCV-RNA levels decreased by > or =1 log(10) copies/mL in 4 of 8 patients treated with BILN-2061. One patient showed a weak response of <1 log(10) copies/mL. Three of 8 treated patients showed no response. There was no correlation between baseline viral concentration or genotype and response. BILN-2061 exhibited good systemic exposure after oral administration and was well tolerated. In conclusion, the antiviral efficacy of the HCV serine protease inhibitor BILN-2061 is less pronounced and more variable in patients with HCV genotype 2 or 3 infection compared with previous results in patients with HCV genotype 1. A lower affinity of BILN-2061 for the NS3 protease of genotypes 2 and 3 HCV is most likely a major contributor to these findings.
Comparison of vascular nitric oxide production and systemic hemodynamics in cirrhosis versus prehepatic portal hypertension in rats
Authors: M Niederberger, P Gines, P Martin, P Tsai, K Morris, I McMurtry, R W Schrier
Journal: Hepatology (1996)

Nitric oxide (NO) is postulated to play a role in the pathogenesis of arterial vasodilation in chronic portal hypertension. This present study investigates the relationship between systemic hemodynamics and the vascular production of NO, as estimated by measuring cyclic guanosine monophosphate (cGMP) in aortic tissue in two models of chronic portal hypertension in the rat: the partial portal vein ligation (PVL) model and CCl4–induced cirrhosis. NOS was also examined by Western blotting in aortic and mesenteric vessels. Sham–operated rats and rats given phenobarbital were used as controls. PVL rats and rats with cirrhosis and ascites showed a typical pattern of a hyperdynamic circulatory state, when compared with their respective controls: mean arterial pressure; PVL: 113 ± 2 versus 124 ± 2, P &lt; .01 and cirrhotics: 103 ± 5 versus 130 ± 4 mm Hg, P &lt; .01. Cardiac index; PVL: 32 ± 2 versus 26 ± 1, P &lt; .01 and cirrhotics: 51 ± 3 versus 30 ± 1 mL · min–1 · 100 gm–1, P &lt; .0001. Systemic vascular resistance; PVL: 3.7 ± 0.1 versus 4.9 ± 0.2, P &lt; .01 and cirrhotics: 2.1 ± 0.2 versus 4.4 ± 0.2 mm Hg · min–1 100 g–1, P &lt; .0001. Aortic cGMP was markedly increased in cirrhotic rats with ascites (728 ± 83 fmol/ mg protein) as compared with phenobarbital– treated controls (244 ± 31 fmol/mg, P &lt; .001). This increase was abolished by chronic administration of N(omega)–nitro–L–arginine methyl ester. By contrast, PVL rats had an aortic cGMP concentration similar to sham–operated controls (282 ± 16 fmol/mg vs. 274 ± 33 fmol/mg, P = not significant) and significantly lower than that found in cirrhotic rats with ascites. Expression of cirrhotic aortic endothelial nitric oxide synthase (eNOS) was increased but PVL aortic eNOS did not differ from that of controls, whereas the mesenteric eNOS was increased in both PVL and cirrhotic rats as compared with the controls. These results suggest that vascular NO production is higher in cirrhotic rats than in PVL rats. This increased production may contribute to the more marked abnormalities in systemic hemodynamics seen in experimental cirrhosis as compared with PVL.
Malabsorption of Antimycobacterial Medications
Authors: Charles A. Peloquin, Allan A. MacPhee, Shaun E. Berning
Journal: New England Journal of Medicine (1993)

To the Editor: Malabsorption of antimycobacterial drugs has been reported in one person with AIDS coinfected with Mycobacterium tuberculosis and 26 patients with AIDS coinfected with M. avium compl...
VACCINATION AND RE-VACCINATION.Read in the Section on State Medicine at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8. 1894.
Authors: EZRA M. HUNT
Journal: JAMA (1894)

Vaccination for the prevention of smallpox was the first indication that an animal disease could supervene a human disease; that one disease could modify or prevent another, and that a great plague could possibly be abolished from the earth. It is not our plan just now to outline, even in brief, the marvelous historical record, or the clinical facts as to it for the last hundred years, but only to specify and briefly note changes of view that have modified what we may call the Jenner impression as to it. 1. We have probably come to know that more than one animal disease has the power by inoculation of modifying smallpox. Jenner thought that it was the disease known as "grease" in horses, modified by passage through the cow, and again in man so as to prevent smallpox. Now it is probable that there are two or three forms of
Biliary Cryptosporidiosis in HIV-Infected People after the Waterborne Outbreak of Cryptosporidiosis in Milwaukee
Authors: N B Vakil, S M Schwartz, B P Buggy, C F Brummitt, M Kherellah, D M Letzer, I H Gilson, P G Jones
Journal: New England Journal of Medicine (1996)

In March 1993, the municipal water supply in Milwaukee became contaminated with cryptosporidium and a widespread outbreak of cryptosporidiosis occurred.We retrospectively studied the relations among the clinical presentation, CD4 count, and survival in a group of 82 patients infected with the human immunodeficiency virus (HIV) in whom cryptosporidiosis developed during the outbreak. Infection was documented by the finding of cryptosporidium in stool.There was a sharp increase in the number of HIV-infected patients with cryptosporidiosis after the period of water contamination. Four of 24 patients with biliary symptoms (17 percent) and 30 of 58 without biliary symptoms (52 percent) were alive one year after the outbreak (P = 0.003). Twenty-one of the patients with biliary symptoms had CD4 counts < or = 50 per cubic millimeter, as compared with 36 of 57 patients without biliary symptoms (88 percent vs. 63 percent, P = 0.03). The CD4 count was not available for one patient in the latter group. Within one year, 41 of the patients with CD4 counts < or = 50 per cubic millimeter had died, as compared with 6 of those with higher counts (72 percent vs. 25 percent, P < 0.001). After adjustment for the CD4 count, independent predictors of death were older age and the presence of nausea and vomiting.When HIV-infected patients are exposed to cryptosporidium, those with CD4 counts < or = 50 per cubic millimeter are at increased risk for biliary symptoms and for death within one year after the infection.
Screening for Colorectal Cancer by Colonoscopy
Authors: Timothy R. Church
Journal: JAMA (2006)

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
Time-to-Event Analyses for Long-Term Treatments — The APPROVe Trial
Authors: Stephen W. Lagakos
Journal: New England Journal of Medicine (2006)

The Adenomatous Polyp Prevention on Vioxx (APPROVe) trial1 compared rofecoxib with placebo in the prevention of recurrent colorectal polyps, but the researchers also collected data on adverse cardiovascular events, including confirmed serious thrombotic events. Assessment of the cardiovascular data raises important issues about the analysis and interpretation of a time-to-event end point in a randomized, placebo-controlled trial evaluating a long-term treatment. These issues include the appropriate period of follow-up for safety outcomes after the discontinuation of treatment; the purpose and implications of checking the assumption of proportional hazards, which underlies the commonly used log-rank test and Cox model; and what . . .
The Study of the Federation: Part I
Authors: Prerna Mona Khanna
Journal: JAMA (1996)

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
Raised LIGHT Levels in Pulmonary Arterial Hypertension
Authors: Kari Otterdal, Arne K. Andreassen, Arne Yndestad, Erik Øie, Wiggo J. Sandberg, Christen P. Dahl, Turid M. Pedersen, Thor Ueland, Lars Gullestad, Frank R. Brosstad, Pål Aukrust, Jan K. Damås
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Thrombus formation and inflammation are involved in the pathogenesis of pulmonary arterial hypertension (PAH), and LIGHT (Lymphotoxin-like Inducible protein that competes with Glycoprotein D for Herpesvirus entry mediator on T lymphocytes) has been shown to promote vascular inflammation.We sought to investigate the role of the tumor necrosis factor superfamily ligand LIGHT in the pathogenesis of PAH.We studied 73 patients with severe PAH and 10 control subjects. LIGHT and pro- and antithrombotic markers were assessed by enzyme immunoassays.(1) Patients with idiopathic PAH (n = 21), patients with PAH related to risk factors or associated conditions (n = 31), and those with chronic thromboembolic PAH (n = 21) all had raised serum levels of LIGHT compared with control subjects (n = 10). (2) LIGHT levels in femoral artery were significantly related to mortality in the patients with PAH. (3) Immunostaining of LIGHT and its receptors was seen in alveolar macrophages, vascular smooth muscle cells, and endothelial cells in lungs from patients with PAH. (4) Thirteen patients received prostacyclin infusion (3 mo), and all showed hemodynamic improvement, accompanied by decreased LIGHT levels. (5) Prostacyclin abolished the release of LIGHT from activated platelets in vitro, suggesting that the decrease in LIGHT during prostacyclin therapy could involve direct effects on platelets. (6) LIGHT increased tissue factor and plasminogen activator inhibitor type 1 and decreased thrombomodulin levels in endothelial cells, inducing a prothrombotic state in these cells.Our findings suggest prothrombotic effects of LIGHT in PAH involving endothelium-related mechanisms, potentially contributing to the progression of this disorder.
Effects of an inhaled steroid (budesonide) on skin collagen synthesis of asthma patients in vivo.
Authors: P Autio, J Karjalainen, L Risteli, J Risteli, U Kiistala, A Oikarinen
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Skin atrophy has been observed after prolonged use of inhaled corticosteroids. We therefore studied the effect of inhaled budesonide and nedocromil in patients with asthma on concentrations of procollagen propeptides in suction blister fluid reflecting skin collagen synthesis in vivo. Both types I and III procollagen propeptide concentrations decreased significantly after 6 wk of either 1,600 micro g/day (n=10) or 400 micro g/day (n=9) of inhaled budesonide but not in control subjects using inhaled nedocromil 16 mg/day (n=9). The reduction in mean propeptide concentrations ranged from 39 to 63%; the effects of the two budesonide doses did not differ significantly. Thus, even a low dose of inhaled corticosteroid represses skin collagen synthesis within a relatively short period.
Mucosal blood flow in the human nose following local challenge with histamine
Authors: K. Holmberg, B. Bake, U. Pipkorn
Journal: Allergy (1989)

Nasal blood flow was measured using the 133 Xe wash‐out method in 10 non‐allergic subjects and 13 asymptomatic hay fever patients. Determinations were made before and 15 min after challenge with diluent, 0.13 mg, 1.3 mg and 13 mg of histamine/nasal cavity. Nasal symptom scores were recorded. The nasal inspiratory peak flow was determined simultaneously in the hay fever patients. No differences in blood flow or symptom score recordings were found between the normal subjects and allergic patients under basal conditions or after histamine challenge. The nasal blood flow increased after challenge with the highest histamine dose. The increase was 34% ( P &lt; 0.05) from baseline in normals and 47% ( P &lt;0.05) in allergies. There was a dose‐dependent increase in nasal symptom scores following histamine challenge, again with no difference between normal and allergic subjects. The nasal peak flow decreased in a similar manner with a maximum decrease of 74% ( P &lt; 0.001). The present study gives further support to the notion that histamine is not the only mediator involved in vascular reactions during allergic rhinitis.