tbuckley/cabot-search huggingface dataset:
A longitudinal study of the association between infrapatellar fat pad maximal area and changes in knee symptoms and structure in older adults
Authors: Faming Pan, Weiyu Han, Xia Wang, Zhenhua Liu, Xingzhong Jin, Benny Antony, Flavia Cicuttini, Graeme Jones, Changhai Ding
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The infrapatellar fat pad (IPFP) is of uncertain significance for knee osteoarthritis. The aim of this study was to describe the longitudinal associations between baseline IPFP maximal area and changes in knee pain, knee cartilage volume and cartilage defects in older adults. <h3>Methods</h3> 356 community-dwelling male and female adults aged 50–80 years were measured at baseline and approximately 2.6 years later. T1-weighted or T2-weighted fat-suppressed MRI was used to assess maximal IPFP area, cartilage volume and cartilage defects at baseline and/or follow-up. Knee pain was assessed by the self-administered Western Ontario McMaster Osteoarthritis Index questionnaire. <h3>Results</h3> After adjustment for confounders, IPFP maximal area in women was significantly and negatively associated with changes in knee pain (β: −0.18 to −0.86 for total knee pain, pain at night while in bed, pain when sitting/lying and pain when standing upright, all p&lt;0.05) but not with other knee pain subscales. IPFP maximal area in women was beneficially associated with change in tibial cartilage volume per annum (β: +1.56% per cm<sup>2</sup> at medial site; +0.86% per cm<sup>2</sup> at lateral site, both p&lt;0.05), but not with change in patellar cartilage volume. Further, it was significantly associated with reduced risks of increases in medial cartilage defects (relative risk: 0·46 at tibial site, relative risk: 0.59 at femoral site; both p&lt;0.05) but not with increases at other sites in women. No significant associations were found in men. <h3>Conclusions</h3> While the associations are not fully consistent, IPFP maximal area appears to have a protective role for knee symptoms and cartilage damage in older female adults.
Phase II Trial of Irinotecan in Patients With Metastatic Epithelial Ovarian Cancer or Peritoneal Cancer
Authors: Diane C. Bodurka, Charles Levenback, Judith K. Wolf, Jacalyn Gano, J. Taylor Wharton, John J. Kavanagh, David M. Gershenson
Journal: Journal of Clinical Oncology (2003)

To evaluate the efficacy and toxicity of irinotecan in patients with metastatic platinum-resistant or platinum-refractory epithelial ovarian cancer or primary peritoneal cancer.Thirty-one patients with measurable disease were enrolled in our study at The University of Texas M.D. Anderson Cancer Center. Twenty-five of these patients were treated with irinotecan at a dose of 300 mg/m2 intravenously for 90 minutes every 3 weeks; the remaining six patients were treated with 250 mg/m2 because their age was greater than 65 years. Median age was 57 years (range, 38 to 74 years). The majority (84%) had a Zubrod performance status of 0. All patients were evaluated for irinotecan toxicity, and 29 (94%) were evaluable for response.The overall response rate was 17.2%. One patient (3%) had a complete response, four (14%) had partial responses, 14 (48%) had stable disease, and 10 had (35%) disease progression. Median progression-free survival was 2.8 months (range, 1.1 to 16 months), median duration of response was 1.4 months (range, 0.7 to 10.1 months); median survival from primary diagnosis was 24.3 months (range, 6.5 to 85.7 months); and median survival from initiation of irinotecan was 10.1 months (range, 2.3 to 34 months). Major toxicities included fatigue (16 patients), neutropenia (11 patients), diarrhea (nine patients), nausea (10 patients), and anorexia (seven patients). Eleven patients required dose reductions because of these toxicities. No treatment-related deaths occurred.Irinotecan has moderate efficacy and substantial toxicity in patients with metastatic platinum-resistant or platinum-refractory epithelial ovarian or primary peritoneal cancer.
Study Ignites Debate on New Anticoagulant
Authors: Mike Mitka
Journal: JAMA (2013)

San Francisco� Researchers claim that an experimental anticlotting drug that failed to demonstrate benefit in 2 previous studies showed positive results in a new study. They said the experimental drug, cangrelor, may offer another option for reducing periprocedural complications from percutaneous coronary intervention (PCI). But others are not so sure.
Contribution of prostaglandins to the renal circulation in conscious, anesthetized, and laparotomized dogs.
Authors: N A Terragno, D A Terragno, J C McGiff
Journal: Circulation Research (1977)

The effects of an inhibitor of prostaglandin (PG) synthetase, indomethacin, were studied on renal blood flow (RBF) and mean aortic blood pressure (MABP) and related to changes in concentrations of PGs in renal venous blood under widely different experimental conditions. Although levels of PGE-like material ("PGE") in renal venous blood of the chloralose-anesthetized-laparotomized dog were 8-fold greater than in conscious dogs, viz., 0.39 vs. 0.05 ng/ml of blood, respectively, RBF and MABP were similar for each group. Indomethacin in doses as high as 10 mg/kg, iv, affected neither RBF, MABP, nor PG levels either in the conscious dog or in the anesthetized dog. However, in the anesthetized-laparotomized dog, smaller doses of indomethacin (2 mg/kg, iv) decreased RBF by more than 40% and increased MABP by 15%. This was associated with a decline in concentration of renal venous PGs to those levels observed in conscious dogs. The principal renal PG varied according to the experimental conditions. The venous levels of "PGF" were greater than "PGE" in conscious dogs, whereas in acutely stressed dogs the renal venous concentrations of "PGE" were more than 2-fold those of "PGF". Plasma renin activity was highly correlated with "PGE" levels in renal venous blood, but not with "PGF" levels. Thus, in the acutely stressed dog, the renal circulation is supported by a major PG component, withdrawal of which results in a decline in RBF. In contrast, in the conscious dog at rest, renal PGs do not appear to contribute significantly to RBF. The significance of the small basal release of PGs into the renal venous effluent of the conscious dog, which is not affected by indomethacin, remains to be determined.
Heart Failure Care in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
Authors: Thomas Callender, Mark Woodward, Gregory Roth, Farshad Farzadfar, Jean-Christophe Lemarie, Stéphanie Gicquel, John Atherton, Shadi Rahimzadeh, Mehdi Ghaziani, Maaz Shaikh, Derrick Bennett, Anushka Patel, Carolyn S. P. Lam, Karen Sliwa, Antonio Barretto, Bambang Budi Siswanto, Alejandro Diaz, Daniel Herpin, Henry Krum, Thomas Eliasz, Anna Forbes, Alastair Kiszely, Rajit Khosla, Tatjana Petrinic, Devarsetty Praveen, Roohi Shrivastava, Du Xin, Stephen MacMahon, John McMurray, Kazem Rahimi
Journal: PLoS Medicine (2014)

Background Heart failure places a significant burden on patients and health systems in high-income countries. However, information about its burden in low- and middle-income countries (LMICs) is scant. We thus set out to review both published and unpublished information on the presentation, causes, management, and outcomes of heart failure in LMICs. Methods and Findings Medline, Embase, Global Health Database, and World Health Organization regional databases were searched for studies from LMICs published between 1 January 1995 and 30 March 2014. Additional unpublished data were requested from investigators and international heart failure experts. We identified 42 studies that provided relevant information on acute hospital care (25 LMICs; 232,550 patients) and 11 studies on the management of chronic heart failure in primary care or outpatient settings (14 LMICs; 5,358 patients). The mean age of patients studied ranged from 42 y in Cameroon and Ghana to 75 y in Argentina, and mean age in studies largely correlated with the human development index of the country in which they were conducted (r = 0.71, p<0.001). Overall, ischaemic heart disease was the main reported cause of heart failure in all regions except Africa and the Americas, where hypertension was predominant. Taking both those managed acutely in hospital and those in non-acute outpatient or community settings together, 57% (95% confidence interval [CI]: 49%–64%) of patients were treated with angiotensin-converting enzyme inhibitors, 34% (95% CI: 28%–41%) with beta-blockers, and 32% (95% CI: 25%–39%) with mineralocorticoid receptor antagonists. Mean inpatient stay was 10 d, ranging from 3 d in India to 23 d in China. Acute heart failure accounted for 2.2% (range: 0.3%–7.7%) of total hospital admissions, and mean in-hospital mortality was 8% (95% CI: 6%–10%). There was substantial variation between studies (p<0.001 across all variables), and most data were from urban tertiary referral centres. Only one population-based study assessing incidence and/or prevalence of heart failure was identified. Conclusions The presentation, underlying causes, management, and outcomes of heart failure vary substantially across LMICs. On average, the use of evidence-based medications tends to be suboptimal. Better strategies for heart failure surveillance and management in LMICs are needed. Please see later in the article for the Editors' Summary
How many eggs?
Authors: Marc J N C Keirse, Frans M Helmerhorst
Journal: BMJ (2004)

worked hard to help trusts comply, 5 a recent survey of 490 junior doctors shows that only a third thought that their place of work had implemented changes in order to be complaint with the directive. 6 A survey conducted by the Guardian showed that about half of 75 trusts expected difficulties complying. 7 The health and safety executive may impose up to £5000 for every breach and has the right to prosecute.However, it does not seem to have enough inspectors or time to enforce the legislation for the groups included since 1998.This does not bode well for doctors in training.Where does this leave the rights of individual doctors?The BMA's junior doctors committee has produced guidelines which outline individual rights, provide samples of appropriate forms, and list the steps to take if doctors in training wish to challenge any breach of the limit on working hours. 8 Doctors might also learn the lesson on the importance of collective injunctions from coal miners.In 1999 a group of coal miners took out an injunction against their employers for making them work more than 48 hours a week in order to keep mines open.On the advice of their union, they refused to sign an opt out agreement.The high court ruled in their favour and "granted a declaration that the plaintiffs [claimants] need not work until such time as their average hours fell within the statutory limits." 9 Unfortunately, the most likely outcome is that those who are already exploited will be further abused.Richer countries will continue to recruit from poorer ones as a quick fix to their staffing shortages, worsened by the directive. 10And as doctors in training go home to a good night's sleep or attend a training course, their (usually overseas) non-standard grade colleagues-a vulnerable group unlikely to protest against breaches of the directive, because of fears about their future job prospectswill be left holding the bleep.
Talking About Incontinence
Authors: Todd H. Wagner, Leslee L. Subak
Journal: JAMA (2010)

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
Chronic ethanol consumption selectively stimulates rectal cell proliferation in the rat.
Authors: U A Simanowski, H K Seitz, B Baier, B Kommerell, H Schmidt-Gayk, N A Wright
Journal: Gut (1986)

Cell proliferation was examined in the gastrointestinal tract of 30 pair fed rats having received an isocaloric liquid diet containing 36% of total calories either as ethanol or carbohydrates for four weeks. Utilising the metaphase arrest technique with vincristine, cell proliferation was measured as crypt cell production rate. This was selectively increased in the rectal mucosa of ethanol fed rats (19.1 +/- 2.0 vs 9.1 +/- 1.8 cells/crypt/h; p less than 0.005). There was a concomitant increase in proliferative compartment size (48.1 +/- 5.6% vs 30.1 +/- 8.5% of crypt population size; p less than 0.001). Serum gastrin concentrations were also found to be significantly increased after ethanol feeding (172 +/- 51 vs 106 +/- 27 pmol/l; p less than 0.01). The ethanol dependent proliferative changes in the rectal mucosa are predictive of higher susceptibility of this site to carcinogenesis, supporting experimental and epidemiological data. Increased gastrin concentrations may partly explain the observed rectal hyperproliferation. Other possible causes cannot, however, be excluded.
Experts Focus on Infective Agents of Bioterrorism
Authors: Joan Stephenson
Journal: JAMA (2002)

Chicago—Bioterrorism is on the minds of infectious disease specialists these days. And as many gathered here at the Interscience Conference on Antimicrobial Agents and Chemotherapy, the topic took on a new urgency in the wake of recent deaths and illness caused by anthrax-laced mail.
Effect of hypertonicity on contractility of isolated working rat left ventricle
Authors: S. A Ben-Haim, G. Hayam, Y. Edoute, O. S Better
Journal: Cardiovascular Research (1992)

The aim was to evaluate the effect of hypertonic perfusate on isolated left ventricular mechanical and energetic characteristics.An isolated working rat heart model was perfused with a hyponatraemic Krebs-Heinseleit bicarbonate buffer (240 mOsmol.litre-1). To this buffer was added increasing amounts of mannitol to achieve 280, 320, and 360 mOsmol.litre-1 perfusates.Left ventricular peak pressure, maximum time derivative of left ventricular pressure (dP/dtmax), and end systolic pressure were all increased to a maximum value at 280 or 320 mOsmol.litre-1 perfusate tonicity. A similar response was evident with cardiac output, which changed from 33.7(SEM 0.6) to 43.5(0.8) ml.min-1 following changing the perfusate tonicity from 240 to 280 mOsmol.litre-1 (p less than or equal to 0.003). However, increasing perfusate tonicity further decreased cardiac output to 36.5(1.3) ml.min-1 at 360 mOsmol.litre-1. Maximal left ventricular elastance remained unchanged during perfusion with increasing perfusate tonicities.Changing perfusate osmolality using mannitol has a positive inotropic effect at low osmolalities and a negative inotropic effect at perfusate osmolality greater than 320 mOsm.litre-1.
Can a Selective PPARγ Modulator Improve Glycemic Control in Patients With Type 2 Diabetes With Fewer Side Effects Compared With Pioglitazone?
Authors: Alex M. DePaoli, Linda S. Higgins, Robert R. Henry, Christos Mantzoros, Fredrick L. Dunn
Journal: Diabetes Care (2014)

INT131 besylate is a potent, nonthiazolidinedione, selective peroxisome proliferator-activated receptor γ (PPARγ) modulator (SPPARM) designed to improve glucose metabolism while minimizing the side effects of full PPARγ agonists. This placebo-controlled study compared the efficacy and side effects of INT131 besylate versus 45 mg pioglitazone HCl in subjects with type 2 diabetes (T2D).This was a 24-week randomized, double-blind, placebo- and active-controlled study of 0.5-3.0 mg INT131 versus 45 mg pioglitazone or placebo daily in 367 subjects with T2D on sulfonylurea or sulfonylurea plus metformin. The primary efficacy analysis was the comparison of change from baseline to week 24 in hemoglobin A1c (HbA1c) across treatment groups. Fluid status was assessed with a prospective scoring system for lower-extremity pitting edema.INT131 had a steep dose response for efficacy as measured by changes in HbA1c. After 24 weeks' treatment, the 0.5-mg dose demonstrated minimal efficacy (HbA1c -0.3 ± 0.12%) and the 2-mg dose demonstrated near-maximal efficacy (HbA1c -1.1 ± 0.12%), which was not statistically different from the efficacy of 45 mg pioglitazone (HbA1c -0.9 ± 0.12%; P < 0.01 for noninferiority). With the 1-mg dose, INT131 provided significant improvements in glycemic control (HbA1c 0.8 ± 0.12; P < 0.001 vs. placebo) but with less edema, weight gain, and hemodilution than observed with 45 mg pioglitazone.INT131 demonstrated dose-dependent reductions in HbA1c, equivalent to 45 mg pioglitazone, but with less fluid accumulation and weight gain, consistent with its SPPARM design.
Lack of Mucosal Immune Reconstitution during Prolonged Treatment of Acute and Early HIV-1 Infection
Authors: Saurabh Mehandru, Michael A Poles, Klara Tenner-Racz, Patrick Jean-Pierre, Victoria Manuelli, Peter Lopez, Anita Shet, Andrea Low, Hiroshi Mohri, Daniel Boden, Paul Racz, Martin Markowitz
Journal: PLoS Medicine (2006)

Background During acute and early HIV-1 infection (AEI), up to 60% of CD4+ T cells in the lamina propria of the lower gastrointestinal (GI) tract are lost as early as 2–4 wk after infection. Reconstitution in the peripheral blood during therapy with highly active antiretroviral therapy (HAART) is well established. However, the extent of immune reconstitution in the GI tract is unknown. Methods and Findings Fifty-four AEI patients and 18 uninfected control participants underwent colonic biopsy. Forty of the 54 AEI patients were followed after initiation of antiretroviral therapy (18 were studied longitudinally with sequential biopsies over a 3-y period after beginning HAART, and 22 were studied cross sectionally after 1–7 y of uninterrupted therapy). Lymphocyte subsets, markers of immune activation and memory in the peripheral blood and GI tract were determined by flow cytometry and immunohistochemistry. In situ hybridization was performed in order to identify persistent HIV-1 RNA expression. Of the patients studied, 70% maintained, on average, a 50%–60% depletion of lamina propria lymphocytes despite 1–7 y of HAART. Lymphocytes expressing CCR5 and both CCR5 and CXCR4 were persistently and preferentially depleted. Levels of immune activation in the memory cell population, CD45RO+ HLA-DR+, returned to levels seen in the uninfected control participants in the peripheral blood, but were elevated in the GI tract of patients with persistent CD4+ T cell depletion despite therapy. Rare HIV-1 RNA–expressing cells were detected by in situ hybridization. Conclusions Apparently suppressive treatment with HAART during acute and early infection does not lead to complete immune reconstitution in the GI mucosa in the majority of patients studied, despite immune reconstitution in the peripheral blood. Though the mechanism remains obscure, the data suggest that there is either viral or immune-mediated accelerated T cell destruction or, possibly, alterations in T cell homing to the GI tract. Although clinically silent over the short term, the long-term consequences of the persistence of this lesion may emerge as the HIV-1–infected population survives longer owing to the benefits of HAART.
MULTIPLE-BALLOON-KYMOGRAPH RECORDING OF INTESTINAL MOTILITY IN MAN WITH OBSERVATIONS ON THE CORRELATION OF THE TRACING PATTERNS WITH BARIUM MOVEMENTS 1
Authors: William P. Chapman, William L. Palazzo, Audrey Taylor, Warren Proudfoot
Journal: Journal of Clinical Investigation (1949)

The balloon water manometer system has long been employed in animals and in man as a means of recording graphically the motility of the alimentary tract (1, 2).As others have done, we have used this method to study the behavior of adjacent segments of the small intestine in man under control conditions and in response to drugs and placebos (3,4).The purpose of this com- munication is to describe the recording procedure and the evaluation of the tracing patterns.The results of the drug and placebo studies are to be reported elsewhere.Certain drawbacks to the use of the balloon wa- ter manometer system have been presented by Quigley (5).He has pointed out that this method necessitates using a large volume/pressure coefficient which does not maintain a linear relationship.The pressure, moreover, registered by the balloon varies depending on its changing shape and on the degree of patency of the intestinal lumen.These objections did not primarily concern us as we were interested in qualitative and relative quantitative changes in motility rather than in absolute measurements of intraluminal pressures.Various workers have described graphic rec- ords of motility in terms of their non-propulsive and propulsive character (6-9).Adler, Atkin- son and Ivy (6) observed that in the colon of pa- tients with colostomies low, relatively rapid wave patterns were non-propulsive while high, sustained contractions were associated with the forward movement of the intestinal contents provided ade- quate coordination existed between bowel seg- ments.Abbott and Pendergrass (7) felt that a
Screening coagulation testing using the APTT: Which reagent to choose?
Authors: Francine R. Dembitzer, Yvelisse Suarez, Louis M. Aledort, Ellinor I.B. Peerschke
Journal: American Journal of Hematology (2010)

APTT testing is integral to hemostasis testing. A prolonged result, however, can be difficult to interpret, depending on the APTT reagent's sensitivity to the lupus anticoagulant. This often generates additional laboratory testing for both factor deficiencies and the presence of a lupus anticoagulant, and in so doing, delays patient management. We have found it useful to provide APTT testing with both a lupus anticoagulant sensitive and insensitive reagent, to facilitate the rapid exclusion of significant factor deficiencies. The following case report illustrates the utility of this approach and provides a backdrop for necessary discussions between laboratories and clinicians regarding which APTT reagent best meets their clinical need for screening hemostasis testing.
Hematopoietic Stem Cell Gene Therapy for Adenosine Deaminase–Deficient Severe Combined Immunodeficiency Leads to Long-Term Immunological Recovery and Metabolic Correction
Authors: H. Bobby Gaspar, Samantha Cooray, Kimberly C. Gilmour, Kathryn L. Parsley, Fang Zhang, Stuart Adams, Emma Bjorkegren, Jinhua Bayford, Lucinda Brown, E. Graham Davies, Paul Veys, Lynette Fairbanks, Victoria Bordon, Theoni Petropoulou, Christine Kinnon, Adrian J. Thrasher
Journal: Science Translational Medicine (2011)

Gene therapy can restore immune and metabolic function in patients with adenosine deaminase immunodeficiency.
Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore
Authors: Charles D. Gomersall, Dessmon Y. H. Tai, Shi Loo, James L. Derrick, Mia Siang Goh, Thomas A. Buckley, Catherine Chua, Ka Man Ho, Geeta P. Raghavan, Oi Man Ho, Lay Beng Lee, Gavin M. Joynt
Journal: Intensive Care Medicine (2006)