tbuckley/cabot-search huggingface dataset:
Provision or Distribution of Growth Hormone for “Antiaging”
Authors: Thomas T. Perls, Neal R. Reisman, S. Jay Olshansky
Journal: JAMA (2005)

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
Chloramphenicol- and Ampicillin-Resistant Typhoid Fever
Authors: Chiraphun Duangmani
Journal: JAMA (1975)

<h3>To the Editor.—</h3> The report of chloramphenicol-resistant<i>Salmonella typhi</i>in Saigon (231:162, 1975) emphasized the poor clinical response of patients infected with chloramphenicol-resistant strains of<i>S typhi</i>to chloramphenicol alone. Chloramphenicol-resistant typhoid fever has also been noted in Bangkok, Thailand, with evidence of in vitro and in vivo resistance to chloramphenicol.<sup>1-3</sup> During 1974, thirty-two percent (22 of 67) of the<i>S typhi</i>strains from Children's Hospital, Bangkok, were resistant to chloramphenicol. Fortyone percent (9 of 22) of these chloramphenicol-resistant strains were resistant to ampicillin also (minimal inhibitory concentrations &gt; 128μg/ ml). Ampicillin has been ineffective therapy in patients with<i>S typhi</i>isolates resistant to ampicillin and chloramphenicol. One such patient receiving 150 to 200 mg/kg/day of ampicillin intravenously remained febrile, in a toxic condition, and had positive blood cultures after seven days of therapy. Recovery occurred following therapy with trimethoprimsulfamethoxazole. All of the<i>S typhi</i>isolates have been sensitive
Saphenous Nerve Injury Caused by Stripping of the Long Saphenous Vein
Authors: S. J. Cox, J. M. Wellwood, A. Martin
Journal: BMJ (1974)

Sensory impairment in the cutaneous distribution of the saphenous nerve was measured in 30 patients after bilateral stripping of the long saphenous vein. The vein was stripped upwards in one leg and downwards in the other. Three months after operation a significantly greater incidence of sensory loss was found in those legs in which the vein was stripped upwards (13 out of 26) compared with those which had been stripped downwards (6 out of 26). We recommend that the long saphenous vein should be stripped downwards.
Case of acute lymphoblastic leukemia presenting with t(14;18)/<i>BCL2</i>, t(8;14)/cMYC, and t(1;2)/<i>FCGR2B</i>
Authors: Wenda L. Greer, Christine L.Y. Lee, Mary B. Callanan, Ekram Zayed, Irene Sadek
Journal: American Journal of Hematology (2003)

Abstract The majority of follicular lymphoma and Burkitt's lymphoma are associated with reciprocal translocations involving BCL2 and cMYC , respectively. Unusual reports of aggressive lymphoma presenting with both translocations have been described as well as rare cases with a third structural alteration usually involving BCL6 . The patient described here presented with aggressive high‐grade lymphocytic leukemia, FAB subtype L2 (ALL‐L2), and three reciprocal translocations, t(14;18)(q32;q21), t(8;14)(q24.1;q32), and t(1;2) (q22–23;p13). Despite immature morphology the leukemic blasts had a mature B‐cell phenotype; they were positive for surface immunoglobulin heavy chains and negative for CD34, TdT, and CD10. Most reported dual t(14;18)/t(8;14) cases have not shown sIg and were positive for CD10. Molecular genetic analyses showed the typical rearrangements of BCL2 and cMYC as well as the FCGR2B gene on chromosome 1q23. The occurrence of a third oncogene rearrangement in association with the dual BCL2 , cMYC translocations in ALL patients is very rare. To our knowledge, this is the first case where the third hit involves the FCGR2B locus. This report reiterates the poor prognosis associated with activation of cMYC together with elevated Bcl‐2 expression. These data also support recent evidence that dysregulation of FCGR2B may play a role in tumor progression. Am. J. Hematol. 74:112–118, 2003. © 2003 Wiley‐Liss Inc.
Cholinergic modulation of the coronary vasoconstriction induced by cocaine in conscious dogs.
Authors: R P Shannon, B S Stambler, K Komamura, T Ihara, S F Vatner
Journal: Circulation (1993)

The effects of cocaine on the coronary circulation were examined in conscious dogs chronically instrumented to measure arterial and left ventricular pressures, coronary blood flow, and arterial and coronary sinus oxygen content.With heart rate held constant, the peak effects of cocaine (1 mg/kg i.v.) occurred within 2 minutes, when mean arterial pressure increased by 42 +/- 5 mm Hg, coronary blood flow increased by 13 +/- 3%, and coronary vascular resistance increased by 24 +/- 3%. The arterial oxygen content increased significantly (by 2.8 +/- 0.3 vol%), the arterial-coronary sinus oxygen difference increased by 2.5 +/- 0.6 vol%, and myocardial oxygen consumption increased by 41 +/- 9%. The increase in coronary vascular resistance induced by cocaine was attenuated (p < 0.05) in the presence of cholinergic blockade (12 +/- 3%) despite a similar increase in MVO2 (49 +/- 8%). The increase in coronary vascular resistance was enhanced (p < 0.05) in the presence of beta-adrenergic receptor blockade (46 +/- 8%), whereas the MVO2 response was less (28 +/- 3%). Again, the addition of cholinergic blockade to beta-blockade attenuated the increase in coronary vascular resistance (23 +/- 6%) without affecting the increase in MVO2 (25 +/- 4%). Combined alpha-, beta-, and cholinergic blockades abolished the systemic hemodynamic and coronary vasoconstrictor response to cocaine.In conscious dogs, cocaine induces coronary vasoconstriction, which competes with coronary vasodilator responses to increases in myocardial oxygen consumption. The mechanisms of cocaine's coronary vascular effects are mediated via adrenergic stimulation, and the intensity of the vasoconstrictor effects was reduced significantly by cholinergic blockade, in both the presence and absence of beta-adrenergic receptor blockade.
Skin defect in a bedbound patient
Authors: A. W. N. Reid, O. P. Shelley
Journal: BMJ (2011)

A 54 year old man with multiple sclerosis which has rendered him quadriplegic, bedbound, and doubly incontinent was referred to the outpatients department with a non-healing skin defect in the presacral area (figure⇓), which he said had been present for four years. He had no other comorbidities. He previously smoked 20 cigarettes a day for 10 years.

He was otherwise well, pain free, and having silver-alginate dressings applied by the district nurses in the community. He had not had any skin complications in the recent past.



Skin defect in the presacral area of a 54 year old man with multiple sclerosis





### 1 What is the lesion?

#### Short answer

This is a sacral pressure ulcer: the photo shows that it is a clean shiny ulcer with undermined edges.

#### Long answer

Pressure ulcers are soft tissue injuries caused by unrelieved pressure over a bony prominence.1 Ischaemia occurs when external pressure exceeds the capillary pressure (normally 12-32 mm Hg). The higher the external pressure, the shorter the duration needed for soft tissue injury.1 Pressure relief is therefore essential for treatment.2 Shear and friction may cause additional trauma to the skin,2 and excessive moisture is an aggravating factor because it causes maceration of the epidermis.

Some pressure ulcers are known as “decubitus ulcers,” but these ulcers develop over bony prominences while the patient is in the …
Abstract 1918: Anti-metastasis effect of EW-7197, a novel ALK5 inhibitor in both breast cancer cells <i>in vitro</i> and mouse model <i>in vivo</i>
Authors: Seung W. Kim, Sol J. Kim, Sang A. Park, Min J. Kim, Dae-Kee Kim, Yhun Y. Sheen
Journal: Cancer Research (2012)

Abstract We have synthesized new ALK5 inhibitor, EW-7197 and investigated their effects of on breast cancer cells as well as tumor bearing MMTV/cNeu transgenic mouse, 4T1 or 4T1-Luc cell-orthotopic implanted mouse models. The level of ß-casein or the number of metastatic nodule in the lung of the breast tumor bearing MMTV/cNeu transgenic mice or 4T1 cell-orthotopic implanted mice, respectively, were decreased by EW-7197 treatment. The treatment of the EW-7197 also inhibited the luciferase activity in the lung of 4T1-Luc cell-orthotopic implanted mouse compared to that of untreated animal. The levels of MMP2 and MMP9 were decreased in the lung and breast tumor of the EW-7197 treated mice. To determine the inhibitory effect of EW-7197 on TGF-β1-induced transcriptional activation, we performed luciferase reporter gene assay in breast cancer cells. EW-7197 effectively blocked TGF-β1-induced luciferase activity in the cells in a dose-dependent manner. TGFß signaling, the phosphorylation of smad2/3 was decreased by EW-7197. TGFß-stimulated mesenchymal markers of epithelial mesenchymal transition (EMT) were inhibited by ALK5 inhibitor concomitant treatment. Furthermore, EW-7197 rescued TGF-β-induced loss of E-cadherin in NMuMG cells. And also, EW-7197 showed higher inhibition on cell motility and cell invasion based on wound healing assay or invasion assay than SB-505124 and LY-2157299. In summary, EW-7197 have anti-metastatic effect on breast cancer cells in vitro as well as breast cancer models in vivo. This data strongly argue that the ALK5 inhibitor have anti-metastasis effects via inhibiting ALK5 activity in vivo and in vitro. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1918. doi:1538-7445.AM2012-1918
Classification criteria for Sjogren's syndrome
Authors: C Vitali
Journal: Annals of the Rheumatic Diseases (2002)

I read with great interest the editorial by R Manthorpe published in the June issue of the Annals of the Rheumatic Diseases .1 The author reviewed the different criteria that have been proposed for the classification of patients with Sjögren's syndrome (SS) and, in particular, commented on the US-European Consensus Group criteria,2 which were reported for the first time in this same issue. As the first author of the paper, I would like to discuss certain points and criticisms which he raised about our criteria set. First of all I would like to discuss briefly the meaning of "classification criteria" and the methods by which the European3,4 and US-European criteria for SS2 were derived. Classification criteria are not meant to be used for diagnosis. Diagnosis is an often complex process by which a doctor arrives at the suspicion of a specific disease in a given patient, and then must collect enough clinical data to confirm that suspicion. Classification criteria, on the other hand, represent a tool for research and communication, providing uniform criteria for the scientific community to classify patients with the same disease, select patients for clinical-therapeutic trials, and make the data obtained by different researchers in different series of patients comparable. As any experienced rheumatologist knows, it is not uncommon to diagnose a specific rheumatic disease in a patient who does not meet the classification criteria proposed for that disease. Given these considerations we can argue that:
Health effects of organophosphate sheep dips.
Authors: P. Sims
Journal: BMJ (1992)

tection should be available in time for the dipping season next year.General practitioners in rural areas can help by impressing on patients the importance of following the safety advice on the labels of all farm chemicals, including sheep dips, whether they contain organophosphates or not.Occasional reports are received of patients sus- pected to be suffering long term, recurrent effects from use of organophosphate sheep dips.Such effects do not equate with the known symptoms due to organophosphates used in sheep dips in Britain.The vague, flu-like symptoms of organophosphate poisoning resemble those of several zoonotic diseases (leptospirosis, brucellosis) en- countered in farm livestock.Awareness of the possibility of zoonotic disease is essential for a doctor faced with such symptoms in a patient who is associated with a farm.
Significant Synergistic Effect of Peroxisome Proliferator–Activated Receptor γ C-2821T and Diabetes on the Risk of Ischemic Stroke
Authors: Fang-I Hsieh, Wei-Cheng Lo, Huey-Juan Lin, Yi-Chen Hsieh, Li-Ming Lien, Chyi-Huey Bai, Hung-Pin Tseng, Hung-Yi Chiou
Journal: Diabetes Care (2009)

OBJECTIVE To explore the relationship between the genetic polymorphisms of PPARγ (Pro12Ala, C1431T, and C-2821T) and the risk of ischemic stroke and to investigate whether these genetic polymorphisms of PPARγ would modify the risk of ischemic stroke among patients with hypertension or diabetes. RESEARCH DESIGN AND METHODS The case-control study was conducted with 537 ischemic stroke patients and 537 control subjects. A structured questionnaire was used to collect information on conventional cardiovascular risk factors and laboratory results. The genetic polymorphisms of PPARγ were determined by PCR–restriction fragment–length polymorphism. RESULTS A significant interaction was seen between the −2821C allele and diabetes but not between this allele and hypertension. A markedly elevated risk of ischemic stroke (odds ratio 9.7) was found in the subjects with diabetes and the −2821C allele compared with that in those without these two risk factors. CONCLUSIONS The −2821C allele of PPARγ was a strong predictor of ischemic stroke for diabetic patients.
Delayed healing of percutaneous endoscopic gastrostomy site during chemotherapy
Authors: K. Garsed, R. Armstrong, B. B Scott
Journal: Gut (2007)

with high serum HBV DNA, which corresponded to a sensitivity of 87%.When only patients with a positive HBeAg test were referred, the number eligible for referral could be reduced to the 15% of patients who were HBeAg positive.However, although the predictive value of a positive HBeAg test was high at 88%, the sensitivity was unacceptably low, and almost 40% of patients with a high viral load would have been missed.The sensitivity of an increased ALT level in patients who were HBeAg negative was also low at 68%, but the combination of both test results in the guideline improved the sensitivity to an acceptable 87%.Of 12 patients with high viral loads who were not selected for referral by the guideline, 11 had a viral load of 10 5 -10 6 copies/ml.We checked whether these patients had, in one way or another, been seen by a specialist at the Department of Gastroenterology and Hepatology of Erasmus Medical Center, Rotterdam, The Netherlands, which was the case for three of them.All three were referred back to their general practitioner after exclusion of significant liver disease.Another patient had an extremely high viral load of 2610 10 copies/ml.He was a 65-year-old Dutch man who was tested because of dialysis, and was already under the care of a specialist.We conclude that a guideline based on HBeAg and a single ALT determination can successfully predict viral load in patients with chronic HBV and can be used in primary care to select patients for referral to specialist care.
Clinical Observations Relating to Incidence and Aetiology of Urinary-tract Infections in Children
Authors: J. M. Stansfeld
Journal: BMJ (1966)

Observations have been made on 350 children with urinary tract infections, all having significant pyuria and bacilluria and some also with radiological or histological evidence of pyelo nephritis. Of these, 193 were seen at a urological clinic for children held in the Royal Victoria Infirmary, a teaching hos pital in Newcastle upon Tyne, and 157 at Dryburn, a non teaching hospital in Durham. The experiences at the two hospitals differed. Cases were selected in both, but in different ways, those at the teaching hospital being mainly referred by paediatricians because of suspected or revealed abnormalities in the renal tract, while those at the peripheral hospital were referred by family doctors. Certainly the cases seen at the teaching hospital were more severe, with frequent abnormalities, and were both more difficult to control and more liable to relapse.
Lessons learned at the intersection of immunology and neuroscience
Authors: Lawrence Steinman
Journal: Journal of Clinical Investigation (2012)

Neurobiologists and immunologists study concepts often signified with identical terminology. Scientists in both fields study a structure known as the synapse, and each group analyzes a subject called memory. Is this a quirk of human language, or are there real similarities between these two physiological systems? Not only are the linguistic concepts expressed in the words “synapse” and “memory” shared between the fields, but the actual molecules of physiologic importance in one system play parallel roles in the other: complement, the major histocompatibility molecules, and even “neuro”-transmitters all have major impacts on health and on disease in both the brain and the immune system. Not only are the same molecules found in diverse roles in each system, but we have learned that there is real “hard-wired” crosstalk between nerves and lymphoid organs. This issue of the JCI highlights some of the lessons learned from experts who are working at this scintillating intersection between immunology and neuroscience.
Therapeutic ratio and defined phases: proposal of ethical framework for palliative care.
Authors: M Ashby, B Stoffell
Journal: BMJ (1991)

radiation and surgical intervention and, in addition, resources are wasted. Large studies of children who have swallowed foreign bodies do not show that ingested coins that have passed beyond the cardia cause complications in children with a normal gastro? intestinal tract13; only one such case seems to have been described.4 Furthermore, the potential hazard of prolonged asymptomatic gastric retention of swallowed coins (more than two weeks) may have been exag? gerated. In our experience such coins eventually pass spontaneously and, under experimental conditions of gastric acidity, the dissolution of toxicologically significant quantities of metal is unlikely to occur (I M House, National Poisons Unit, Guy's Hospital, London, personal communication). The management of swallowed coins in children in the United Kingdom could be improved. Adopting the scheme outlined in the figure would reduce the radiation dose received by many children and produce a considerable financial saving. An initial single antero posterior radiograph of the neck and chest is advisable even in asymptomatic patients because of the dangers from silent oesophageal impaction.5 A lateral radio? graph may then be necessary to localise coins in the neck and upper chest. When the coin is below the cardia only symptomatic patients require further assessment. Searching of stools is both unpleasant and inaccurate.
Persistent erythema and pruritus, with a confluent histiocytic skin infiltrate, following the use of a hydroxyethylstarch plasma expander
Authors: N.H. COX, A.W. POPPLE
Journal: British Journal of Dermatology (1996)

A 40-year-old woman developed a persistent pruritus with erythema of the head and upper trunk, which started within 2 weeks of a hydroxyethylstarch (HES) infusion and was still present 2 years later. Histological examination demonstrated a striking dermal infiltrate of KP1-positive foamy macrophages which had electron-lucent vacuoles. The timing of the onset, the body site distribution, the exclusion of other possibilities and an appropriate history of high dosage HES infusion, suggested that this was the cause of the eruption. Staining with periodic acid-Schiff (PAS) surprisingly was negative but we could not stain HES in vitro with this histochemical stain, and we postulate that the unique extent of the infiltrate and the negative PAS stain in our patient may indicate an impaired ability to degrade this chemical. This may be an important factor in the poorly understood pathogenesis of persistent pruritus induced by HES.
Smallpox and Its Eradication
Authors: Swailem S. Hennein
Journal: JAMA (1988)

This is an unparalleled comprehensive, detailed, and careful record of the greatest global public health achievement. The authors are renowned international authorities who were personally involved in the smallpox eradication program by serving in leadership roles on World Health Organization commissions and units and/or being active in field operations. Moreover, they sifted through published literature and the World Health Organization's pertinent archives to gather data for this book. They also engaged 78 other knowledgeable scientists and practitioners in the review of the program's various components. The result is a treasury of facts, figures, tables, charts, and photographs in support of a well-written text—which amounts to a great deal of learning for generations to come.  Clinical and basic science foundations dealing with the relationship of the variola virus to other orthopoxviruses and vaccine development set the stage for a fair-handed treatment of historical-epidemiologic antecedents. Despite discouragement with programs for the eradication of yellow fever and malaria,
Plasma Retinol-Binding Protein-4 Concentrations Are Elevated in Human Subjects With Impaired Glucose Tolerance and Type 2 Diabetes
Authors: Young Min Cho, Byung-Soo Youn, Kyong Soo Park
Journal: Diabetes Care (2007)

Gavi et al. (1) investigated the association between visceral adipose tissue (VAT) mass by computed tomography and circulating retinol-binding protein-4 (RBP4) concentrations in nondiabetic subjects. They could not find a correlation between VAT and serum RBP4 concentrations, while VAT was inversely correlated with serum adiponectin concentrations in their subjects. The study by Gavi et al. did not support specific association between circulating …
THE NATURE OF A DELUSION.
Authors: J. SANDERSON CHRISTISON
Journal: JAMA (1895)

My article entitled, " The Essential of Insanity," which appeared in theJournalof October 19 contained an argument supporting the proposition that " where there is no delusion there is no insanity, for the mind that is competent to comprehend facts and their bearings within the scope of its education and the limits of ordinary surroundings is a mind capable of correction on any error; and conversely, a mind that is not thus competent must of necessity beget delusion of one form or another which it is as incompetent to discharge, no matter what the evidence combating." Since the presentation of that article for publication (last spring) I find in the present autumn number of<i>Brain</i>, p. 328, the following words of Prof. C. Mercier, of London, in his discussion of a paper by Dr. Batty Tuke. Dr. Mercier expresses his gratification at Dr. Tuke's complete acceptance of the doctrine, which,