tbuckley/cabot-search huggingface dataset:
Cutting Toenails at 82
Authors: Jason David Eubanks
Journal: JAMA (2002)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
The ED and the Uninsured
Authors: Tracy Hampton
Journal: JAMA (2004)

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
Outpatient parenteral antimicrobial therapy: consider bronchiectasis too.
Authors: Andrew R L Medford
Journal: BMJ (2013)

In addition to the conditions listed by Chapman, outpatient parenteral antimicrobial therapy (OPAT) has potential application for infective exacerbations of non-cystic fibrosis bronchiectasis, where effective oral antimicrobials are often lacking. A feasibility study showed the utility of single agent parenteral meropenem for ambulatory management of patients with infective flares of bronchiectasis. This has been incorporated into the ambulatory management of appropriately selected patients presenting to a respiratory “hot” clinic with non-cystic fibrosis bronchiectasis in an ambulatory care area. Atmost, 28% of all unselected “hot” patients require admission during the following month (with proportions much lower for non-cystic fibrosis bronchiectasis alone). One of the key design features is that both the administration of OPAT and review of its effectiveness occur in the same ambulatory care unit, allowing easy admission to secondary care if needed for escalated treatment. Another important design feature is that the effectiveness of OPAT is reviewed by a specialist in the particular condition.
Abstract 16553: Cardiovascular Effects of Dipeptidyl Peptidase-4 Inhibitors in Diabetic Patients: A Meta-Analysis of 95 Trials
Authors: Gianluigi Savarese, Pasquale Perrone-Filardi, Carmen D’Amore, Cristiana Vitale, Giovanni G Camici, Bruno Trimarco, Luca Pani, Giuseppe Rosano
Journal: Circulation (2014)

Introduction: Dipeptidyl peptidase-4 inhibitors (DPP-4) improve glucose control in patients with type 2 diabetes mellitus (DM), but their effects on cardiovascular (CV) events are debated. Hypothesis: The aim of this study was to evaluate the impact of DPP-4 treatment on CV morbidity and mortality. Methods: Randomized trials enrolling more than 200 patients, comparing DPP-4 inhibitors versus placebo or active treatments in patients with DM and reporting at least one adverse event among all-cause and CV mortality, stroke, myocardial infarction (MI) and new onset of heart failure (HF) were searched. Meta-analysis was performed to assess the influence of treatment on pre-specified outcomes in the short and long term (less and more than 30 weeks, respectively). The assumption of homogeneity between the treatment effects in different trials was tested by Q statistic and further quantified by I2 statistic. Macaskill’s test was performed to assess publication bias. Results: Ninety-five trials enrolling 85,394 pa...
198. Cell-Based Gene Therapy for Primary Pulmonary Hypertension Using a Non-Viral Gene Delivery System
Authors: Linda N. Liu, Linhong Li, Yidan Zhao, Qiuwang Zhang, Rama Shivakumar, Cornell Allen, Joseph C. Fratantoni, Duncan J. Stewart, David W. Courtman
Journal: Molecular Therapy (2004)

Primary pulmonary hypertension (PPH) is a progressive disease of unknown pathogenesis with a bleak prognosis for affected patients. The available treatment options utilize vasorelaxants such as continuously infused prostaglandin analogs or inhaled nitric oxide (NO). We are developing a cell-based gene therapy approach that administers NO in situ and utilizes a non-viral gene delivery system. We present here preclinical in vivo data on a model system that utilizes PH induced by a chemical agent, monocrotaline (MCT), in the rat and intravenous (IV) administration of fibroblasts transfected with endothelial nitric oxide synthase (eNOS).
447. Replication-Competent Oncolytic Adenovirus Vectors That Express TRAIL and Over-Express ADP
Authors: Baoling Ying, Peter Krajcsi, Ann E. Tollefson, Jacqueline F. Spencer, Konstantin Doronin, Drew L. Lichtenstein, William S. M. Wold
Journal: Molecular Therapy (2004)

Top of pageAbstract
The need for new anti-cancer treatments is evident from the fact that malignant neoplasms are the second leading cause of death in the United States and third leading cause of death world-wide. Oncolytic adenovirus (Ad) vectors, which kill cancer cells by harnessing the cytolytic nature of the virus life cycle, are a new class of anti-cancer agents that have been demonstrated to be safe in humans but that have thus far yielded disappointing clinical efficacy results, despite demonstrating efficacy in pre-clinical models. We have constructed several new oncolytic Ad vectors that contain features designed to enhance vector efficacy while maintaining safety. All of our vectors over-express ADP, the viral protein required late in infection for efficient cell lysis and release of progeny virions at the culmination of the infectious cycle. Because our vectors over-express ADP, infected cells are lysed rapidly and progeny virions are released efficiently, which translates into improved cell-to-cell dissemination of the vector. Our vectors are also engineered to express the cancer therapeutic protein tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), a member of the TNF family of cytokines that shows specificity for neoplastic cells. TRAIL expression and secretion provides a means of enhancing vector efficacy by providing a way to kill uninfected tumor cells. The TRAIL cDNA was inserted into our vectors such that it would be expressed similarly to ADP, that is, abundant expression late in the infectious cycle. We have shown in cultured cancer cells that our TRAIL-expressing vectors synthesize a large quantity of TRAIL late in the infection and are highly cytolytic to both infected and uninfected cells. TRAIL expression in infected cells leads to apoptosis in nearby uninfected cells and ADP expression results in efficient cytolysis of infected cells. As a safety feature, all of the vectors contain a deletion that eliminates expression of nearly all of the E3 proteins; these proteins function to protect infected cells from the immune system. As an additional safety feature, some vectors also contain deletions within the E1A gene that result in selective replication of the vector in cancer cells because the mutant E1A proteins are no longer able to bind to pRB family members or p300/CBP. The vectors were shown to reduce the growth of Hep3B liver cell tumor xenografts grown in nude mice.
A symptom-limited incremental step test determines maximal physiological responses in patients with COPD
Authors: Simone Dal Corso, Carla Malaguti, Anderson Alves de Camargo, Meyer Izbicki, Luiz Eduardo Nery
Journal: European Respiratory Journal (2012)

Background: Step tests (StTs) have been used to evaluate exercise tolerance and effort-related hypoxaemia in different diseases. StTs can be classified as paced (fixed rate) or self-paced cadence. However, an incremental step test (IStT) has never been tested in COPD patients. Aim: To compare maximal physiological responses between an IStT and symptom-limited incremental cycle ergometry (CE), and to test the reliability of the IStT in patients with COPD on different days. Material and methods: Twenty-two patients (VEF1 47±13 %) underwent two IStTs (IStT-1 and IStT-2, height of 20 cm) and a CE. For the IStT, the initial step rate was set at 10 steps/min and was increased by one step every 30 seconds. The stepping rate was dictated by an audio signal played on a CD. Results: Despite significant differences in peak VO2 (1.18±0.36 L for 1.26±0.41 L and 1.26±0.43 L, respectively), no differences were observed for VE, L/min (42.0±13.9, 42.5±14.6, 41.2±13.7, respectively) and for heart rate expressed as a percentage of the predicted rate (89±12, 90±13, 88±11, respectively). The desaturation was significantly lower for CE compared to IStT-1 or IStT-2 (-3.4 ± 3.4 %, -6.3 ± 4.9 %, -6.3 ± 4.0%, respectively). Both IStTs showed highly reproducible VO2 peaks (intraclasse correlation coefficient (ICC)=0.99) and number of steps (ICC=0.98). A strong correlation was found between the work performed on the IStT [step height (m) x number of steps x weight (kg) x 0.16357] and peak VO2 on CE (r=0.93). Conclusion: A symptom-limited incremental step test, externally paced, elicits maximal cardiopulmonary and metabolic responses, and is well tolerated and reproducible in patients with COPD.
Quality improvement report: Simple intervention to improve detection of child abuse in emergency departments
Authors: J. R Benger
Journal: BMJ (2002)

Child abuse is easily overlooked in a busy emergency department.Two stage audit of 1000 children before and after introduction of reminder flowchart.An emergency department in a suburban teaching hospital seeing about 4000 injured preschool children a year.Number of records in which intentional injury was adequately documented and considered and the number of children referred for further assessment before and after introduction of reminder flowchart into emergency department notes.Nurses were asked to insert a reminder flowchart for assessing intentional injury into the notes of all children aged 0-5 years attending the department with any injury and to record the results of checking the child protection register. EFFECT OF CHANGE: Documentation of all eight indicators that intentional injury had been considered had increased in the second audit. Records of compatibility of history with injury and consistency of history increased from less than 2% to more than 70% (P<0.0001). More children were referred for further assessment in the second audit than the first, although the difference was not significant (6 (0.6%) v 14 (1.4%), P=0.072). The general level of awareness and vigilance increased in the second audit, even for children whose records did not contain the flowchart.Inclusion of a simple reminder flowchart in the notes of injured preschool children attending the emergency department increases awareness, consideration, and documentation of intentional injury. Rates of referral for further assessment also increase.
Clinicopathological correlates of the gastric oncogenome
Authors: Siew Hong Leong, Meh Tan, Sun Young Rha, Hyun Cheol Chung, Amit Aggarwal, Patrick Tan, Oi Lian Kon
Journal: Cancer Research (2006)

4203   Aneuploidy is common in gastric cancer while little is known of structurally rearranged chromosomes that may drive carcinogenesis. Pan-genomic copy number profiles of gastric cancer currently lack utility. We studied (a) copy number aberrations as genomic classifiers and prognostic markers; (b) highly expressed genes of gastric cancer amplicons; and (c) gene expression changes in recurrent translocation breakpoint loci. Analysis of 203 primary gastric adenocarcinomas (Progenetix CGH database, July 2004) using a neural network (Self Organising Tree Algorithm, EBI) segregated 2 genomic subclasses of 89 and 114 tumors. Supervised class prediction (GeneCluster 2.0) was performed on training (203 gastric cancers) and test (44 gastric cancers and 18 human gastric cancer cell lines) datasets. Models were built from the training set using a S2N similarity metric, median values for class estimate and 10 4  random permutations. Genomic classifiers (17q and 20q) were evaluated on the test set by weighted voting and leave-one-out cross-validation with 73% accuracy (45/62 correctly assigned). Genomic subclasses correlated significantly with clinical stage (p=0.011, Fisher’s exact test). The cell lines were almost equally distributed between the genomic subclasses, indicating that they were true biological representations of primary gastric cancers. 16p copy number gains were more prevalent in stage 3 and 4 gastric cancers (p=0.047, Fisher’s test) than in stages 1 and 2. 16p gains were associated with shorter survival (p=0.01, log rank rest). Overexpression of a 16p gene, SLC9A3R2, in 56% of gastric cancers was however associated with longer survival (p=0.038, log rank test). Forty-eight recurrent translocation breakpoints e.g. 2p22 and 8q22, were identified from parallel CGH and spectral karyotyping of 18 gastric cancer cell lines (AGS, NCIN87, Hs746T, Kato III, SNU1, SNU5, SNU16, IM95, MKN7, FU97, YCC-1, YCC-2, YCC-3, YCC-6, YCC-9, YCC-10, YCC-11 and YCC-16). Copy number gains among 247 primary gastric cancers were more frequent in recurrent breakpoint regions than in cytobands unaffected by translocations (p≤0.001, Mann-Whitney test). We ascertained the expression status of breakpoint genes in 55 primary gastric cancers. Eighty-two breakpoint genes were overexpressed (> 2-fold) in 20-96% of gastric cancers, while 83 were underexpressed (
Application of FAST™ fragment-based lead discovery and structure-guided design to discovery of small molecule inhibitors of BCR-ABL tyrosine kinase active against the T315I imatinib-resistant mutant
Authors: Stephen K. Burley
Journal: Cancer Research (2006)

4851  The Philadelphia chromosome translocation creates a BCR-ABL fusion gene that encodes a constitutively active BCR-ABL tyrosine kinase, which gives rise to chronic myelogenous leukemia (CML). The clinical success of imatinib (Gleevec) demonstrated that BCR-ABL tyrosine kinase inhibitors can provide effective treatment for CML. However, some CML patients treated with imatinib develop resistance leading to disease progression. The majority of resistance is due to point mutations in BCR-ABL, which give rise to active mutant enzymes that are insensitive to imatinib. In all, ∼30 imatinib-resistant BCR-ABL mutants have been identified in clinical isolates. The T315I mutant represents ∼20% of clinically observed mutations, making it one of the most common causes of resistance. Second-generation BCR-ABL inhibitors, including AMN-107 and BMS-354825, inhibit many of the clinically relevant mutants but not T315I. Mutant T315I BCR-ABL is, therefore, an important and challenging target for discovery of CML therapeutics. We have applied a proprietary X-ray crystallographic fragment-based lead discovery platform (FAST™) and structure-guided lead optimization to identify potent inhibitors of wild-type BCR-ABL and the four most common mutants, including T315I. Our lead discovery efforts yielded five chemical series that inhibit both wild-type (WT) and T315I BCR-ABL. Compounds in our most advanced lead series potently inhibit proliferation of K562 cells and Ba/F3 cells with WT BCR-ABL and the vast majority of the clinically relevant BCR-ABL mutations, including M244V, G250E, Q252H, Y253F, Y253H, E255K, F311L, T315I, F317L, M351T, F359V, V279I, L387M, H396P, and H396R (see below). Further details describing in vitro and in vivo profiling and efficacy testing of these novel BCR-ABL T315I inhibitors will be presented.
ESCMID∗ guideline for the diagnosis and treatment of biofilm infections 2014
Authors: N. Høiby, T. Bjarnsholt, C. Moser, G.L. Bassi, T. Coenye, G. Donelli, L. Hall-Stoodley, V. Holá, C. Imbert, K. Kirketerp-Møller, D. Lebeaux, A. Oliver, A.J. Ullmann, C. Williams
Journal: Clinical Microbiology and Infection (2015)

Biofilms cause chronic infections in tissues or by developing on the surfaces of medical devices. Biofilm infections persist despite both antibiotic therapy and the innate and adaptive defence mechanisms of the patient. Biofilm infections are characterized by persisting and progressive pathology due primarily to the inflammatory response surrounding the biofilm. For this reason, many biofilm infections may be difficult to diagnose and treat efficiently. It is the purpose of the guideline to bring the current knowledge of biofilm diagnosis and therapy to the attention of clinical microbiologists and infectious disease specialists. Selected hallmark biofilm infections in tissues (e.g. cystic fibrosis with chronic lung infection, patients with chronic wound infections) or associated with devices (e.g. orthopaedic alloplastic devices, endotracheal tubes, intravenous catheters, indwelling urinary catheters, tissue fillers) are the main focus of the guideline, but experience gained from the biofilm infections included in the guideline may inspire similar work in other biofilm infections. The clinical and laboratory parameters for diagnosing biofilm infections are outlined based on the patient's history, signs and symptoms, microscopic findings, culture-based or culture-independent diagnostic techniques and specific immune responses to identify microorganisms known to cause biofilm infections. First, recommendations are given for the collection of appropriate clinical samples, for reliable methods to specifically detect biofilms, for the evaluation of antibody responses to biofilms, for antibiotic susceptibility testing and for improvement of laboratory reports of biofilm findings in the clinical microbiology laboratory. Second, recommendations are given for the prevention and treatment of biofilm infections and for monitoring treatment effectiveness. Finally, suggestions for future research are given to improve diagnosis and treatment of biofilm infections.
Aminoglycoside-Inactivating Enzymes in Clinical Isolates of Streptococcus Faecalis
Authors: Donald J. Krogstad, Thomas R. Korfhagen, Robert C. Moellering, Christine Wennersten, Morton N. Swartz, Stanislaw Perzynski, Julian Davies
Journal: Journal of Clinical Investigation (1978)

Clinical isolates of enterococci (Streptococcus faecalis) with high-level resistance to both streptomycin and kanamycin (minimal inhibitory concentration >2,000 μg/ml), and resistant to synergism with penicillin and streptomycin or kanamycin were examined for aminoglycoside-inactivating enzymes. All of the 10 strains studied had streptomycin adenylyltransferase and neomycin phosphotransferase activities; the latter enzyme phosphorylated amikacin as well as its normal substrates, such as kanamycin. Substrate profiles of the neomycin phosphotransferase activity suggested that phosphorylation occurred at the 3′-hydroxyl position, i.e., aminoglycoside 3′-phosphotransferase. A transconjugant strain, which acquired high-level aminoglycoside resistance and resistance to antibiotic synergism after mating with a resistant clinical isolate, also acquired both enzyme activities. Quantitative phosphorylation of amikacin in vitro by a sonicate of the transconjugant strain inactivated the antibiotic, as measured by bioassay, and the phosphorylated drug failed to produce synergism when combined with penicillin against a strain sensitive to penicillin-amikacin synergism.
REMARKS ON THE DIAGNOSIS OF CORONARY OCCLUSION
Authors: Louis Hamman
Journal: Annals of Internal Medicine (1934)

Article1 October 1934REMARKS ON THE DIAGNOSIS OF CORONARY OCCLUSIONLOUIS HAMMAN, M.D., F.A.C.P.LOUIS HAMMAN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-8-4-417 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAbout eight or ten years ago, at a time when I was much interested in the clinical manifestations of coronary occlusion, I was often asked to see patients with symptoms of collapse following a severe attack of pain in the chest and under these circumstances had the satisfaction of pointing out how clearly and simply the diagnosis of coronary occlusion could be made. However, these opportunities have come very, very rarely during the past few years. At the present day the humblest practitioner of medicine and the most recent graduate are so thoroughly familiar with the clinical picture of this... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Baltimore, Maryland*Read at the Chicago meeting of the American College of Physicians, April 18, 1934. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMediastinal emphysema complicating a zygomatic fracture: A case report and review of the literatureClinical Features of Ischemic Heart DiseaseClinical presentation of myocardial infarction in the elderly.The accuracy of diagnosis of myocardial infarctionACUTE SPONTANEOUS MEDIASTINAL EMPHYSEMAPAINLESS CARDIAC INFARCTIONMediastinal Emphysema and Its Occurrence in Artificial PneumoperitoneumMediastinal Emphysema Complicating Myocardial InfarctionMEDIASTINAL EMPHYSEMA OCCURRING WITH THERAPEUTIC PNEUMOPERITONEUM: REPORT OF TEN CASES*MILTON N. TOWBIN, M.D.Acute Mediastinal Emphysema Complicating EclampsiaMediastinal EmphysemaRecurrent spontaneous mediastinal emphysema simulating myocardial infarctionSpontaneous interstitial emphysema of the lung simulating organic heart diseaseSpontaneous mediastinal emphysema with acute right ventricular strainSpontaneous mediastinal emphysemaSpinal cord ischemia in dissecting aortic aneurysmÜber die Entstehung des HerzinfarktsDie Klinik der Coronarerkrankungen 1 October 1934Volume 8, Issue 4Page: 417-431KeywordsGraduate medical educationThorax Issue Published: 1 October 1934 PDF downloadLoading ...