tbuckley/cabot-search huggingface dataset:
Intermittent Reversal of Flow in a Case of Patent Ductus Arteriosus
Authors: ROBERT E. JOHNSON, PAUL WERMER, MARVIN KUSCHNER, ANDRÉ COURNAND
Journal: Circulation (1950)

The direction of blood shunts between abnormally communicating ventricles or large vessels is dependent upon blood pressure differences in the adjacent structures, and upon the respective vascular resistance in both circulating systems distal to the communication. In a case of patent ductus arteriosus, physiologic measurements suggested that the direction of blood flow through the ductus was reversed intermittently during the systolic phase of the cardiac cycle. Pathologic studies confirmed the hypothesis by demonstrating the presence of "impingement" plaques on the aortic as well as on the pulmonary artery walls opposite the lumen of the ductus. They also gave information concerning the lesions in the pulmonary vascular bed which might be held responsible for the considerable increase in resistance, the pulmonary systolic hypertension and, attendant to it, the cyclic reversal of blood flow.
Dental Therapy During Anticoagulant Therapy-Reply
Authors: I. S. Wright
Journal: JAMA (1961)

<h3>To the Editor:—</h3> In the interim since the preparation of the paper referred to, we have continued to conduct dental extractions while patients have been under therapeutic levels of anticoagulant drugs. This markedly decreases the risk to many patients suffering from thromboembolic conditions. This procedure has been carried out in approximately 50 additional patients without complications. In our paper we described the control of the therapy and surgical techniques which has proved to be safe. We recommend that others adopt this approach. The fact that the conclusions of Ziffer et al. have been requoted and "condoned" by others has not contributed new knowledge. On the other hand, the original paper and the recent letter of Dr. J. M. Askey (<i>JAMA</i><b>176:</b>746 [May 27] 1961) are based on actual experience with this problem. This technique is now being widely adopted in leading medical centers.
Primary Care Physician–Led Health Reform
Authors: James A. Talcott
Journal: JAMA (2014)

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
Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study
Authors: Melanie A Wakefield, Frank J Chaloupka, Nancy J Kaufman, C Tracy Orleans, Dianne C Barker, Erin E Ruel
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objective:</b> To determine the relation between extent of restrictions on smoking at home, at school, and in public places and smoking uptake and smoking prevalence among school students. <b>Design:</b> Cross sectional survey with merged records of extent of restrictions on smoking in public places. <b>Setting:</b> United States. <b>Participants:</b> 17 287 high school students. <b>Main outcome measures:</b> Five point scale of smoking uptake; 30 day smoking prevalence. <b>Results:</b> More restrictive arrangements on smoking at home were associated with a greater likelihood of being in an earlier stage of smoking uptake (P&lt;0.05) and a lower 30 day prevalence (odds ratio 0.79 (95% confidence interval 0.67 to 0.91), P&lt;0.001). These findings applied even when parents were smokers. More pervasive restrictions on smoking in public places were associated with a higher probability of being in a earlier stage of smoking uptake (P&lt;0.05) and lower 30 day prevalence (0.91 (0.83 to 0.99), P=0.03). School smoking bans were related to a greater likelihood of being in an earlier stage of smoking uptake (0.89 (0.85 to 0.99), P&lt;0.05) and lower prevalence (0.86 (0.77 to 0.94), P&lt;0.001) only when the ban was strongly enforced, as measured by instances when teenagers perceived that most or all students obeyed the rule. <b>Conclusions:</b> These findings suggest that restrictions on smoking at home, more extensive bans on smoking in public places, and enforced bans on smoking at school may reduce teenage smoking.
Catheter-Induced Intra-Hisian and Intrafascicular Block During Recording of His Bundle Electrograms
Authors: LESTER B. JACOBSON, MELVIN SCHEINMAN
Journal: Circulation (1974)

Mechanical injury of the atrioventricular (A-V) node, His bundle, and right bundle branch is a potential complication of His bundle recording. In the presence of left bundle branch block, catheter-induced injury of the right bundle branch may cause prolongation of A-V conduction time or even complete A-V block. Two cases are reported in which catheter-induced transient high grade Mobitz II A-V block, acute reversible prolongation of infranodal conduction time with probable intra-Hisian conduction delay, and persistent (6 hours duration) complete A-V block occurred in patients with left bundle branch block. The observations made indicate that A-V conduction times and the appearance of "split His" potentials may be influenced by the recording catheter itself, and suggest that the operators be prepared to institute immediate right ventricular pacing when His bundle recordings are obtained in patients with left bundle branch block.
Responsiveness of superficial hand veins to phenylephrine in essential hypertension. Alpha adrenergic blockade during prazosin therapy.
Authors: H G Eichler, G A Ford, T F Blaschke, A Swislocki, B B Hoffman
Journal: Journal of Clinical Investigation (1989)

Patients with essential hypertension show an increase in vascular resistance. It is unclear whether this is caused by structural changes in the arterial wall or by hyperresponsiveness of vascular smooth muscle to endogenous alpha adrenergic agonists. Using the dorsal hand vein compliance technique we compared the changes in diameter of superficial veins in response to phenylephrine, an alpha 1 adrenergic receptor agonist, and to nitroglycerin, a venorelaxant, in patients with essential hypertension and in normotensive subjects. The dose of phenylephrine that produced 50% of maximal venoconstriction (ED50) in the hypertensive subjects was 257 ng/min (geometric mean; log mean +/- SD was 2.41 +/- 0.54). In the control subjects the ED50 was 269 ng/min (geometric mean; log mean was 2.43 +/- 0.43). Maximal response (Emax) for phenylephrine was 84 +/- 13% in the hypertensive subjects and 90 +/- 6% in the control subjects. Differences in the group means of the ED50 (P = 0.92) or the Emax (P = 0.27) were not significant. There were no significant differences in the ED50 (P = 0.54) or the Emax (P = 0.08) for nitroglycerin between the two groups. These results show no evidence for a generalized change in alpha adrenergic responsiveness in hypertension and support the concept that increased blood pressure responses to alpha adrenergic stimulation in hypertensives are due to structural and geometric changes in the arterial wall rather than to an increased responsiveness of postsynaptic alpha adrenergic receptors. The phenylephrine studies were repeated in seven hypertensive patients during treatment with prazosin, an alpha 1 adrenergic antagonist. The mean dose ratio of the shift in phenylephrine ED50 (ED50 during prazosin therapy/ED50 before prazosin therapy) was 6.1. This indicates that small doses of prazosin (1-2 mg) cause significant in vivo shifts in the dose-response relationship of alpha adrenergic agonists. The dorsal hand vein compliance technique is useful in detecting systemic effects of alpha adrenergic antagonists.
Reply to S. Kusumoto et al
Authors: Nozomi Niitsu
Journal: Journal of Clinical Oncology (2010)

We appreciate the comments raised in the correspondence from Kusumoto et al regarding our recently published article. Recently, Kusumoto et al reported that hepatitis B virus (HBV) reactivation can occur in hepatitis B surface antigen–negative patients with a history of HBV infection on administration of rituximab combination chemotherapy (R-chemotherapy) for B-cell lymphoma. Therefore, among patients who receive R-chemotherapy, those who are negative for the hepatitis B surface antigen should be additionally tested for antibodies to the hepatitis B surface antigen and hepatitis B core antigen. We believe that it is best to measure the HBV-DNA level in all patients with B-cell lymphoma who are scheduled to receive R-chemotherapy. However, HBV-DNA testing is not covered by the National Health Care Insurance program in Japan. Because of the expense of this testing, HBV-DNA is not measured until the antibodies to the hepatitis B surface antigen decrease to a level of less than 200 mU/mL. In our study, HBV-DNA was measured in all patients with B-cell lymphoma before the start of chemotherapy. We believe that measurement of HBV-DNA before treatment can result in detection of an escape mutant. In a report by Westhoff et al, HBV-DNA was measured 15 months before the start of chemotherapy in a patient with lymphoma, and an HBV-DNA level of 1.7 log copies/mL (50 copies/mL) was detected. Therefore, it seems that escape mutants can be detected by measuring HBV-DNA just prior to administration of R-chemotherapy. With respect to the method of measurement of HBV-DNA: in the prospective HBV-DNA monitoring performed in our study, HBV-DNA was measured in plasma and serum samples at Saitama Medical University. Between October 2006 and January 2008, HBVDNA was measured with a real-time polymerase chain reaction (PCR) assay using the LightCycler DNA Master SYBR Green I kit (Roche Diagnostics Japan, Tokyo, Japan), which has a detection limit of 1.7 log copies/mL. Between February 2008 and July 2009, HBV-DNA was measured with the COBAS TaqMan HBV Test, version 1.0 (Roche Diagnostics Japan), and since July 2009, HBV-DNA has been measured with COBAS TaqMan HBV Test, version 2.0 (Roche Diagnostics Japan). The cutoff values of the TaqMan version 1.0 and version 2.0 PCR assays were set at 1.8 log copies/mL and 2.1 log copies/mL, respectively. Both version 1.0 and version 2.0 TaqMan PCR assays have a detection limit of 1.7 log copies/mL. In our study, the median follow-up period for the 314 patients with diffuse large B-cell lymphoma was 26 months. Two patients were observed for less than 2 years. One patient could not be observed because of relocation, and another patient died after 24 months of treatment. It is necessary to investigate how long HBV-DNA monitoring should be performed after the end of R-chemotherapy, and to investigate the ideal timing for the start of entecavir administration after serum HBV-DNA becomes detectable. For these reasons, we believe that a future multicenter prospective study is necessary.
Electrophysiological characterization of SCN5A mutations causing long QT (E1784K) and Brugada (R1512W and R1432G) syndromes
Authors: I Deschênes
Journal: Cardiovascular Research (2000)

Familial long QT syndrome (LQTS) and Brugada syndrome are two distinct human hereditary cardiac diseases known to cause ventricular tachyarrhythmias (torsade de pointes) and idiopathic ventricular fibrillation, respectively, which can both lead to sudden death. Objective: In this study we have identified and electrophysiologically characterized, in patients having either LQTS or Brugada syndrome, three mutations in SCN5A (a cardiac sodium channel gene). Method: The mutant channels were expressed in a mammalian expression system and studied by means of the patch clamp technique. Results: The R1512W mutation found in our first patient diagnosed with Brugada syndrome produced a slowing of both inactivation and recovery from inactivation. The R4132G mutation found in our second patient who also presented Brugada syndrome, resulted in no measurable sodium currents. Both Brugada syndrome patients showed ST segment elevation and right bundle-branch block, and had experienced syncopes. The E1784K mutation found in the LQTS showed a persistent inward sodium current, a hyperpolarized shift of the steady-sate inactivation and a faster recovery from inactivation. Conclusion: The different clinical manifestations of these three mutations most probably originate from the distinct electrophysiological abnormalities of the mutant cardiac sodium channels reported in this study.
Role of the faecal stream in the maintenance of Crohn's colitis.
Authors: P H Harper, E C Lee, M G Kettlewell, M K Bennett, D P Jewell
Journal: Gut (1985)

The role of the faecal stream in the maintenance of the inflammation in Crohn9s disease has been studied. Small bowel effluent and a sterile ultrafiltrate of it were reintroduced into the defunctioned colon of patients with Crohn9s colitis treated by split ileostomy. The systemic effect of these challenges on the patients was assessed clinically and by laboratory tests, and the effect on the local disease was assessed by endoscopy, histology, and quantitative analysis of lamina propria plasma cell populations. There was little response to the ultrafiltrate challenge. In contrast the clinical responses to challenge with ileostomy effluent were marked in some patients. One patient relapsed and eight others had clinically detectable responses. On the other hand changes in laboratory, endoscopic, histological, and morphometric tests in response to the faecal challenge were less pronounced. The only significant changes in the laboratory results were a relative lymphopenia (p less than 0.05) and a raised ESR (p less than 0.02) after seven days challenge with the effluent. The plasma cell density also increased but not significantly. In conclusion, these results suggest that factors greater than 0.22 microns in the faecal stream are responsible for the maintenance and exacerbation of inflammation in Crohn9s disease.
Absorption of electrolytes from the colon in cases of ulcerative colitis and in control subjects.
Authors: D Gooptu, S C Truelove, G T Warner
Journal: Gut (1969)

Although ulcerative colitis was described as a disease entity by Wilks in 1874, it was not until 1950 that electrolyte depletion was recognized as a major complication.The deficiency may be so severe as to cause death.Accounts of the losses of the monovalent cations, sodium and potassium, have been published by Posey and Bargen (1950), Lubran and McAllen (1951), and by Smiddy, Gregory, Smith, and Goligher (1960).The divalent cations, magnesium and calcium, are also lost from the body (Posey and Bargen, 1950; Thoren, 1962 and 1963).The present study had two main objects.The first was to see the extent to which the normal human colon could absorb sodium, potassium, magnesium, and calcium ions.The second was to look for differences in absorption between a healthy colon and one affected with ulcerative colitis.As secondary investigations the rates of clearance of sodium and potassium from the blood were measured and an attempt was also made to measure the loss of potass- ium from the blood into the colonic lumen. MATERIALSRadioactive isotopes were used for these observations.Chemically pure 24Na, 42K, 47Ca, and 28Mg were supplied by the Radiochemical Centre, Amersham, as sterile solutions of the chloride salt.These particular isotopes were chosen because of their short half-lives.Before embarking on the use of the radioactive sub- stances, particulars of the isotopes to be studied, the dosages envisaged, and the criteria proposed for the selection of the human volunteers were furnished to the Medical Research Council.The subjects were selected on July 17,
496 Efficacy and safety of 2 years adefovir dipivoxil (ADV) in chinese patients with HBeAg positive chronic hepatitis B (CHB)
Authors: M.D. Zeng, Y.M. Mao, G.B. Yao, H. Wang, J.L. Hou, Y.Z. Wang, J.S. Dixon, K.E. Barker
Journal: Journal of Hepatology (2006)
Divided Labor: The Doctor as Specialist
Authors: WAYNE G. MENKE
Journal: Annals of Internal Medicine (1970)

Specialization is both a product of and a contributor to the scientific information explosion in medicine. It subdivides both doctor and patient, increases the difficulty of attaining a clear sense of medical identity for students and young physicians, and places additional strain on the traditional doctor-patient relationship. Specialization emphasizes the science of medicine and its rational processes in the treatment of disease and contributes to depersonalization, aggravates patient anxieties, and implicitly encourages quackery. It is probably the major factor disturbing traditional ethical and economic patterns in medicine, and it dominates medical education and research and medical practice, promotes jurisdictional disputes within the profession, and weakens organizational strength and professional power.
Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia
Authors: Sarah J. Barsam, Bethan Psaila, Marc Forestier, Lemke K. Page, Peter A. Sloane, Julia T. Geyer, Glynis O. Villarica, Mary M. Ruisi, Terry B. Gernsheimer, Juerg H. Beer, James B. Bussel
Journal: Blood (2011)
Follow‐up of sickle cell disease patients with priapism treated by hydroxyurea
Authors: Sara T.O. Saad, Camila Lajolo, Simone Gilli, José Francisco C. Marques, Carmen S. Lima, Fernando F. Costa, Valder R. Arruda
Journal: American Journal of Hematology (2004)

Hydroxyurea is one of the most successfully used therapies for sickle cell disease. Results of many clinical trials point to hydroxyurea administration for patients with frequent painful crises and acute chest syndrome. Priapism is one of the complications that could be prevented by hydroxyurea, but there are few reports demonstrating the results. Since November 1993, hydroxyurea has been used in our clinic for preventing priapism in patients with stuttering or major attacks who are still capable of achieving intercourse on demand. Five patients were enrolled in the study, and 4 cases benefited by this treatment. After the initial treatment for the acute attack, all five patients developed stuttering priapism. Hydroxyurea was then introduced at the initial dose of 10 mg/kg, and as the hydroxyurea dosage increased, the number or length of priapism episodes decreased. One to two months after the maximal dose (20-35 mg/kg) was introduced, the episodes disappeared. In two patients, we were forced to administer over 30 mg hydroxyurea/kg to abort the episodes, and, in another patient, 25 mg/kg was necessary. All patients present normal sexual activity. Hydroxyurea was discontinued in two patients, but stuttering priapism reappeared. Hydroxyurea was then re-introduced, and priapism disappeared. One patient, using 20 mg hydroxyurea/kg, had a 6-year remission of priapism after hydroxyurea administration; however, he experienced stuttering priapism, 1 month before a major attack, that progressed to impotence. During that month, he did not seek medical attention. In conclusion, the data here presented suggests that hydroxyurea may prevent priapism attacks in sickle cell disease, probably at higher doses than usually prescribed for painful crisis prevention.
Flight attendant response to AED instruction: results of a survey and implications for training public access defibrillation
Authors: Theodore S. Takata, Robert C. Kowal, Jose A. Joglar, Mohamed H. Hamdan, Carol L. Nguyen, Jian-Ming Li, Nguyen H. Phan, Ali M. Kizilbash, Linda A. Campbell, David K. McKenas, Richard L. Page
Journal: Journal of the American College of Cardiology (2002)
Organizational Consultation in a Combat Unit
Authors: DOUGLAS R. BEY, WALTER E. SMITH
Journal: American Journal of Psychiatry (1971)

The authors describe a method of unit consultation employing a paramedical participant observer that was developed and used successfully in a combat division in Viet Nam. Consultation made the unit's problems legitimate ones for discussion, provided an opportunity for expression of frustrations, opened up communication between levels of command, and brought the unit members together. The authors suggest that this approach may have wider application in military psychiatry and in civilian community psychiatry.
Mapping collective behavior – beware of looping
Authors: Markus Christen, Peter Brugger
Journal: Behavioral and Brain Sciences (2014)

Abstract We discuss ambiguities of the two main dimensions of the map proposed by Bentley and colleagues that relate to the degree of self-reflection the observed agents have upon their behavior. This self-reflection is a variant of the “looping effect” which denotes that, in social research, the product of investigation influences the object of investigation. We outline how this can be understood as a dimension of “height” in the map of Bentley et al.
Pomalidomide (CC4047) plus low dose dexamethasone (Pom/dex) is active and well tolerated in lenalidomide refractory multiple myeloma (MM)
Authors: M Q Lacy, S R Hayman, M A Gertz, K D Short, A Dispenzieri, S Kumar, P R Greipp, J A Lust, S J Russell, D Dingli, S Zeldenrust, R Fonseca, P L Bergsagel, V Roy, J R Mikhael, A K Stewart, K Laumann, J B Allred, S J Mandrekar, S V Rajkumar, F Buadi
Journal: Leukemia (2010)
Current concepts in cancer. Cancer of the GI tract: colon, rectum, anus. The colostomy
Authors: J. H. Morton
Journal: JAMA (1975)

THERE are four general reasons for the construction of a colostomy in the management of rectal carcinoma: (1) as a palliative measure when an unresectable cancer is present; (2) as a temporary expedient to divert the fecal stream during a course of tumor coagulation or of radiation therapy; (3) as a temporary measure to protect a difficult, low-lying anastomosis; and (4) as a part of an abdominoperineal resection done for cure or palliation. When a rectal cancer cannot be cured by surgery, an abdominoperineal resection nevertheless provides the best palliative procedure. A colostomy alone, even a double-barrel stoma in the sigmoid colon, provides only partial relief. Although bleeding is controlled to a great degree, the very bothersome symptom of tenesmus, produced when the bowel attempts to move an intraluminal mass forward by a peristaltic wave, is not controlled. Nevertheless, if the cancer is frozen into the pelvis or if the