tbuckley/cabot-search huggingface dataset:
Oxygen delivery and consumption and P50 in patients with acute myocardial infarction.
Authors: S C Yang, V K Puri, R Raheja
Journal: Circulation (1986)

We investigated the relationship between oxygen delivery (DO2), oxygen consumption (VO2), and influence of oxyhemoglobin dissociation (P50) on VO2 in 40 patients with complicated myocardial infarction. A decrease in VO2 and an increase in P50 were observed as DO2 decreased due to pump failure. In a given range of DO2, VO2 was related to P50 in survivors (r values .472 to .647, p less than .01). Each millimeter of mercury increase in P50 was associated with a 5.2 to 6.5 ml/min X m2 increase in VO2 when DO2 was less than 450 ml/min X m2. No similar correlation was found for nonsurvivors. Lactate was higher in nonsurvivors despite the fact that DO2 and VO2 were similar in the two groups. The lack of compensatory increases in P50 may be pathologic in nonsurvivors. However, the value of VO2 as an indicator of tissue oxygenation or survival in patients with acute myocardial infarction is questionable.
Legal and Illegal Use of Methadone: One Year Later
Authors: RICHARD C. STEPHENS, ROBERT S. WEPPNER
Journal: American Journal of Psychiatry (1973)

This study (which replicated one conducted a year earlier) found that the use of methadone, both legal and illegal, had increased. The role of the pusher as supplier of illicit methadone declined, while other suppliers, particularly addict friends, became more important. The reasons for the use of illicit methadone changed dramatically; methadone's low cost and ease of procurement aided its emergence from a substitute drug to a drug of choice. The study seems to indicate that the black market in methadone was flourishing and had possibly grown in the short span of one year.
Treatment of Common Acute Poisonings
Authors: Jay M. Arena
Journal: JAMA (1968)

This compendium on the treatment of common acute poisonings reflects the authors' experience in Scotland, where 80% of the incidence is due to self-poisoning in an age group of 18 to 25 years. This is in marked contrast to the United States, where the reverse is true. Because of the preponderance of small children involved, acute poisoning here is mainly a pediatric problem.  The lack of enthusiasm for the use of syrup of ipecac as an emetic will be questioned by most pediatricians and others working in this area. The same might be said for the safe dose of apomorphine (followed by levallorphan tartrate [Lorfan], a narcotic antagonist), which is being used in some medical centers exclusively and effectively because of its prompt action. The chapter on Basic Principles of Psychiatric Treatment, necessitated by the self-poisoning group, is brief and informative, with material usually not found in books of this
Italians are forced to go abroad for assisted reproduction
Authors: Fabio Turone
Journal: BMJ (2006)

Thousands of Italian couples are having to travel abroad if they need assisted reproduction or preimplantation diagnosis, because of the highly restrictive law in their own country. 

Italy's law, passed in January 2004, restricts assisted reproduction techniques to infertile, “stable” heterosexual couples and bans preimplantation genetic testing for couples who are not infertile, even when the partners carry recessive genes for serious genetic defects such as thalassaemia ( BMJ 2004;328:9; 2006;333:934, 4 Nov). 

A survey report presented last week in Rome at a press conference held by the Reproductive Tourism Observatory said that the …
Genomic risk of hepatitis C-related hepatocellular carcinoma
Authors: Yujin Hoshida, Bryan C. Fuchs, Kenneth K. Tanabe
Journal: Journal of Hepatology (2011)

To identify the genetic susceptibility factor(s) for hepatitis C virus-induced hepatocellular carcinoma (HCV-induced HCC), we conducted a genome-wide association study using 432,703 autosomal SNPs in 721 individuals with HCV-induced HCC (cases) and 2890 HCV-negative controls of Japanese origin. Eight SNPs that showed possible association (P <1 10(⁻5)) in the genome-wide association study were further genotyped in 673 cases and 2596 controls. We found a previously unidentified locus in the 50 flanking region of MICA on 6p21.33 (rs2596542, P(combined) = 4.21 10(⁻13), odds ratio = 1.39) to be strongly associated with HCV induced HCC. Subsequent analyses using individuals with chronic hepatitis C (CHC) indicated that this SNP is not associated with CHC susceptibility (P = 0.61) but is significantly associated with progression from CHC to HCC (P = 3.13 10(⁻8)). We also found that the risk allele of rs2596542 was associated with lower soluble MICA protein levels in individuals with HCV-induced HCC (P = 1.38 10(⁻13)).
Combination Therapy in Head and Neck Cancer
Authors: Bernard S. Aron
Journal: JAMA (1975)

CANCER in the head and neck area is relatively easy to diagnose and usually remains localized; few patients die from distant metastases. However, it remains an important cause of morbidity and mortality in the United States. The American Cancer Society estimates that there will be 32,400 new cases in 1975 and that 11,450 patients will die from this disease. Surgery and radiation therapy have proved effective methods of therapy; chemotherapy may be useful in the future. These three modalities have their greatest effectiveness on different portions of the tumor: surgery in removing the central core, radiationin destroying the peripheral margin, and chemotherapy in ablating microscopic metastases. Small early epithelial cancers (T<sub>1</sub>, N<sub>0</sub>[tumor-node classification according to the American Joint Committee for Cancer Staging and End Results Reporting, 1968]) in the head and neck region are adequately treated by either surgery or radiation therapy, with high local
Cellular Origin of Human B-Cell Lymphomas
Authors: Ralf Küppers, Ulf Klein, Martin-Leo Hansmann, Klaus Rajewsky
Journal: New England Journal of Medicine (1999)

The origin of human lymphomas has been studied by various approaches, including histology and immunophenotyping. In some types of lymphoma these studies suggested the cellular origin, but in many instances the origin could not be identified. When somatic mutations of the genes for the variable region of the B-lymphocyte antigen receptor proved to be a hallmark of germinal-center B cells and their descendants, sequence analysis of the variable-region genes of B-cell lymphomas offered a molecular approach to studying the origin of the tumors. Before discussing the results of these studies, we outline the human peripheral B-cell repertoire and its generation. . . .
Validation of continuous-wave Doppler echocardiographic measurements of mitral and tricuspid prosthetic valve gradients: a simultaneous Doppler-catheter study.
Authors: G T Wilkins, L D Gillam, G L Kritzer, R A Levine, I F Palacios, A E Weyman
Journal: Circulation (1986)

For patients with stenotic native valves, the modified Bernoulli equation (delta P = 4V2) may be applied to Doppler-measured transvalvular velocities to yield an accurate estimate of transvalvular gradients. Although it would be useful if the same approach could be used for those with stenotic prosthetic valves, no previous study has validated the Doppler technique in this setting. We therefore recorded simultaneous continuous-wave Doppler flow profiles and transvalvular manometric gradients in 12 catheterized patients in whom all atrial and ventricular pressures were directly measured (transseptal left atrial catheterization and transthoracic ventricular puncture were performed where necessary). A total of 13 prostheses were studied: 11 mitral (seven porcine, three Starr-Edwards, and one Björk-Shiley) and two tricuspid (one porcine and one Björk-Shiley). The Doppler-determined mean gradient was calculated as the mean of the instantaneous gradients (delta P = 4V2) at 10 msec intervals throughout diastole. The correlation of simultaneous Doppler (DMG) and manometric mean gradients (MG) for the whole group (n = 13) demonstrated a highly significant relationship (MG = 1.07 DMG + 0.28; r = .96, p = .0001). The correlation was equally good for porcine valves alone (n = 8) (MG = 1.06 DMG + 0.55; r = .96, p = .001) and for mechanical valves alone (n = 5) (MG = 1.06 DMG - 0.04; r = .93, p = .02). In a subset of patients without regurgitation (n = 8), prosthetic valve areas were estimated by two Doppler methods originally described by Holen and Hatle, as well as by the invasive Gorlin method. As expected from theoretical considerations, a close correlation was not demonstrated between results of the Gorlin method and those of either Hatle's Doppler method (r = .65, fp = NS) or Holen's method (r = .14, p = NS). Comparison of the results of the two Doppler methods yielded a somewhat closer correlation (r = .73, p less than or equal to .05). These results suggest that in patients with disk-occluder, ball-occluder, and porcine prosthetic valves, Doppler estimates of transvalvular gradients are virtually identical to those obtained invasively.
HLA-DR (Ia) immune phenotype predicts outcome for patients with diffuse large cell lymphoma.
Authors: T P Miller, S M Lippman, C M Spier, D J Slymen, T M Grogan
Journal: Journal of Clinical Investigation (1988)

The clinical utility for establishing the immune phenotype in patients with non-Hodgkin's lymphoma is controversial. To help resolve this dilemma, we studied 104 consecutive patients with diffuse large cell lymphoma, the most common subtype of potentially curable non-Hodgkin's lymphomas. The presence or absence of the human class II histocompatibility antigen was determined using the monoclonal antibody anti-HLA-DR (Ia), and the results correlated with pretreatment clinical features and survival. We found that eight HLA-DR negative patients had similar pretreatment clinical characteristics compared with 96 HLA-DR positive patients, but HLA-DR negative patients had a significantly shorter survival duration compared with HLA-DR positive patients (P = 0.003 log-rank). The median survival of the HLA-DR negative patients was 0.5 years compared to 2.8 yr for the HLA-DR positive patients. No HLA-DR negative patient survived beyond 1.5 yr. A multi-variate analysis, adjusting for prognostic factors of known clinical significance, confirmed the importance of HLA-DR as a prognostic factor (P = 0.016). We conclude that determining the presence of HLA-DR is a relatively simple pretreatment study that identifies a small but important group of patients who are not curable using currently available combination chemotherapy.
Do You Have a Minute?
Authors: Janet R. Gilsdorf
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
Irinophore C, a Novel Nanoformulation of Irinotecan, Alters Tumor Vascular Function and Enhances the Distribution of 5-Fluorouracil and Doxorubicin
Authors: Jennifer H.E. Baker, Jeffrey Lam, Alaistair H. Kyle, Jonathan Sy, Thomas Oliver, Steven J. Co, Wieslawa H. Dragowska, Euan Ramsay, Malathi Anantha, Thomas J. Ruth, Michael J. Adam, Andrew Yung, Piotr Kozlowski, Andrew I. Minchinton, Sylvia S.W. Ng, Marcel B. Bally, Donald T.T. Yapp
Journal: Clinical Cancer Research (2008)

Abstract Purpose: To examine the antitumor effects of Irinophore C, a nanopharmaceutical formulation of irinotecan, on the tissue morphology and function of tumor vasculature in HT-29 human colorectal tumors. Experimental Design: Fluorescence microscopy was used to map and quantify changes in tissue density, tumor vasculature, hypoxia, and the distribution of Hoechst 33342, a perfusion marker, and the anticancer drug, doxorubicin. Noninvasive magnetic resonance imaging was used to quantify Ktrans, the volume transfer constant of a solute between the blood vessels and extracellular tissue compartment of the tumor, as a measure of vascular function. Following treatment with Irinophore C, 19F magnetic resonance spectroscopy was used to monitor the delivery of 5-fluorouracil (5-FU) to the tumor tissue, whereas scintigraphy was used to quantify the presence of bound [14C]5-FU. Results: Irinophore C decreased cell density (P = 8.42 × 10−5), the overall number of endothelial cells in the entire section (P = 0.014), tumor hypoxia (P = 5.32 × 10−9), and Ktrans (P = 0.050). However, treatment increased the ratio of endothelial cells to cell density (P = 0.00024) and the accumulation of Hoechst 33342 (P = 0.022), doxorubicin (P = 0.243 × 10−5), and 5-FU (P = 0.0002) in the tumor. Vascular endothelial growth factor and interleukin-8, two proangiogenic factors, were down-regulated, whereas the antiangiogenic factor TIMP-1 was up-regulated in Irinophore C-treated tumors. Conclusions: Irinophore C treatment improves the vascular function of the tumor, thereby reducing tumor hypoxia and increasing the delivery and accumulation of a second drug. Reducing hypoxia would enhance radiotherapy, whereas improving delivery of a second drug to the tumor should result in higher cell kill.
The Beginning of Ergot
Authors: S. Galeski
Journal: BMJ (1964)

p. 1133), prompted me to examine the case records of 489 cases treated with buccal pitocin.There was no incidence of uterine rupture, maternal mortality, or foetal mor- tality, and there were only three cases of excessive uterine action.All three responded quickly (15-20 minutes) to withdrawal of the tablets from the buccal pouch.Hyperactivity of this nature (contractions at one-minute intervals) has occurred in the control group.Furthermore, in 31 cases where buccal oxy- tocin failed intravenous Pitocin (oxytocin) was successful in 10 cases only.No one can deny that a risk of uterine rupture exists-as reported by Dr. P. M. Leney (12 September, p. 689) and Dr. H. 0. Nicholson (3 October, p. 876), but spon- taneous rupture does also occur and in fact did so in one case of the non-buccal group.I do not think that obstetricians using buccal oxytocin deny the place, or better con- trol, of intravenous oxytocin.However, oral administration is generally preferred to the parenteral even if there is some slight loss in performance-cf.oral iron and Ferrivenin (saccharated iron oxide).Thus I cannot agree that buccal pitocin is a retrograde step, and the evaluation of 489 cases treated with the buccal hormone would support
Early Discharge of Newborns
Authors: William L. Lupatkin
Journal: JAMA (1997)

<h3>To the Editor.</h3> —The articles by Dr Liu and colleagues<sup>1</sup>and Dr Edmonson and colleagues<sup>2</sup>and the Commentary by Dr Braveman and colleagues<sup>3</sup>raise interesting questions and alluded to several issues without making them explicit. Hidden in the descriptions of the details of the statistical methods and statistical power in various conflicting studies is the underlying fact that the differences sought are insignificant from the standpoint of any one infant or mother. The Commentary by Braveman et al points out that there is more to clinical practice than is available in studies of outcomes and urges that policymakers recognize that fact. To be useful either clinically or as tools for the formation of public policy, studies of outcome have to choose measures appropriately. Certainly, if early discharge were causing severe medical harm to infants or their mothers, that practice would have to be stopped immediately, but it is intuitively obvious
Older women with ovarian cancer are less likely than younger women to be referred for tests
Authors: Z. Kmietowicz
Journal: BMJ (2010)

The time to referral for tests among women with suspected ovarian cancer increases with age, a study has found. The variation may go some way towards explaining why survival from cancer is worse in the United Kingdom than in other parts of Europe, the authors say.

The researchers, from the Brighton and Sussex Medical School, looked at records from the General Practice Research Database of 1057 women aged between 40 and 84 years who had a diagnosis of …
Hypertension diagnosis should be based on ambulatory blood pressure monitoring, NICE recommends
Authors: S. Mayor
Journal: BMJ (2011)

Primary hypertension should be diagnosed only after patients have undergone ambulatory blood pressure monitoring rather than a series of measurements in a clinic, recommend UK guidelines published this week.

In one of the biggest changes to previous guidance from the National Institute for Health and Clinical Excellence (NICE), the updated guideline recommends that people who are found to have a blood pressure of 140/90 mm Hg or higher during a clinic visit should be offered ambulatory blood pressure monitoring—measurement of blood pressure at regular intervals throughout the day—to confirm the diagnosis of primary hypertension.

At least two measurements an hour should be recorded during a person’s usual waking hours, and the average should be taken of at least 14 measurements to confirm a diagnosis of hypertension. Home blood pressure monitoring can be an alternative for patients unable or unwilling …
Reversal of shortened platelet survival in rats by the antifibrinolytic agent, epsilon aminocaproic acid.
Authors: P D Winocour, R L Kinlough-Rathbone, M Richardson, J F Mustard
Journal: Journal of Clinical Investigation (1983)

Platelet survival in rabbits and rats is shortened by placing indwelling catheters in the aorta; this shortening appears to be at least partly related to the extent of vessel wall injury and platelet interaction with the repeatedly damaged wall. Treatment of rabbit platelets with plasmin and other proteolytic enzymes in vitro shortens their survival when they are returned to the circulation. Because platelets may be exposed to plasmin and other proteolytic enzymes in rabbits and rats with indwelling aortic catheters, we examined the effect of epsilon-aminocaproic acid (EACA) on platelet survival in rats. At a dose of 1 g/kg every 4 h, EACA significantly reduced whole blood fibrinolytic activity and prolonged the shortened platelet survival in rats with indwelling aortic catheters. Mean platelet survival for untreated rats with indwelling aortic catheters was 38.6 +/- 1.9 h, and for rats treated with EACA, 53.8 +/- 3.8 h. Scanning electron microscopy showed that the injured vessel wall of these animals was mainly covered with platelets and fibrin, whereas in control animals that did not receive EACA, the injured surface was mainly covered with platelets and little fibrin was observed. Thus shortened platelet survival during continuous vessel wall injury may result from the local generation of plasmin or the release of proteolytic enzymes at sites where platelets (and possibly leukocytes) interact with the vessel wall.
Pulse oximetry during conscious sedation
Authors: M. A. Chaney
Journal: JAMA (1994)

To the Editor.  —As an anesthesiologist who uses pulse oximeter technology daily, I read with great interest the American Medical Association Council on Scientific Affairs report.1It is vital to realize that pulse oximetry reveals nothing regarding adequacy of ventilation. Although this important point was addressed briefly in the Council's report, I feel it deserves greater emphasis. Too often, physicians become complacent when arterial oxygen saturation is normal.  In pioneering work detailing physiology of apneic oxygenation, Frumin and colleagues2induced periods of apnea in eight subjects lasting 18 to 55 minutes while simultaneously insufflating oxygen endotracheally at rates of 200 mL/min. The lowest arterial oxygen saturation recorded was 98%, yet profound hypercarbia was documented. In one individual, apnea lasted 53 minutes and the lowest arterial oxygen saturation recorded was 98%, yet at the same time the arterial carbon dioxide tension has increased to 250 mm Hg and the
An unusual form of localized papulonodular cutaneous histiocytosis in a 6-month-old boy
Authors: C.W. HASELEN, I. TOONSTRA, C.W. HENGST, W.A. VLOTEN
Journal: British Journal of Dermatology (1995)

We report a 6-month-old boy with an unusual form of cutaneous histiocytosis. The lesions were noticed shortly after birth, and there was no evidence of systemic disease. This histiocytic disorder could not be classified according to the Histiocyte Society classification, and was therefore designated an ‘unclassified’ group II histiocytic disorder. The clinical picture was characterized by dark-red papulonodules with a tendency to coalesce into plaques. Histologically, the infiltrate was characterized by non-epidermotropic histiocytes showing varying degrees of differentiation, eosinophils and lymphocytes, and by the absence of foamy cells and Touton giant cells. As a most conspicuous feature, electron microscopic examination revealed laminated dense bodies, whereas Birbeck granules and comma-shaped bodies were absent. This further distinguished this uncommon variant from the well-known class II histiocytoses. During a 6-month follow-up period all the lesions showed marked regression.
Comparison of branched DNA probe assay and multicyclic RT-PCR as a predictig marker of IFN therapy for type C chronic hepatitis
Authors: Y KARINO
Journal: Hepatology (1995)

Hepatitis C virus (HCV) virus load is one of the most important predictive factors for the outcome of interferon (IFN) therapy. Recent technological advances have allowed a more precise measurement of HCV load. However, the exact cutoff values that could be used to predict the outcome of IFN have not been established for each assay. Five recent quantitative assays were evaluated for the measurement of HCV (Amplicor monitor ver 1.0, Amplicor monitor ver 2.0 (GT), Amplicor monitor ver 2.0 (Cobas), Quantiplex branched DNA amplification (bDNA) ver 2.0 and HCV core protein level by enzyme immunosorbent assay) in 209 consecutive patients with chronic hepatitis C, who received IFN therapy. The results of the two second generation Amplicor monitor tests (GT and Cobas) showed the best correlation (r=0.930), but the other tests also showed relatively good correlations (r=0.646–0.925). Each method predicted the effect of IFN with comparable predictive efficacy, ranging from 77.0 to 80.8%. Receiver operating characteristic (ROC) curve analysis showed that Amplicor monitor ver 2.0 and bDNA ver 2.0 are superior in predicting the response in genotype 2a. The best cutoff value for predicting the response to IFN was different by genotype, which should be considered in selecting candidates for IFN treatment.