tbuckley/cabot-search huggingface dataset:
Double-Outlet Right Ventricle with Transposed Great Arteries and Subpulmonary Ventricular Septal Defect
Authors: BILLY M. HIGHTOWER, ALBERTO BARCIA, LIONEL M. BARGERON, JOHN W. KIRKLIN
Journal: Circulation (1969)

The angiocardiographic findings and successful surgical treatment of three patients with double-outlet right ventricle, bilateral conus, transposition of the great arteries, subpulmonary ventricular septal defect, and pulmonary-mitral valve discontinuity are reported. The atria, viscera, and ventricles were normally located, and the aorta originated to the right and anterior to the pulmonary artery. Surgical repair was accomplished by closure of the ventricular septal defect in such a way that left ventricular outflow was routed via a prosthetic tunnel to the pulmonary artery. Then systemic venous return was transposed intra-atrially by the Mustard technique. All patients survived complete repair and have continued to improve over a period ranging from several months to 1 year after operation. In one patient complete heart block developed postoperatively, necessitating the insertion of a permanent electronic pacemaker. Details of the method of repair and preoperative studies are presented.
The Dynamic Formulation—A Critique of a Psychiatric Ritual
Authors: STEPHEN R. GOLDSMITH, ARNOLD J. MANDELL
Journal: American Journal of Psychiatry (1969)

The authors, studying predictions of psychological state formed solely from dynamic formulations, found no correlation between correct predictions and length of professional psychiatric experience. They question the misuse of deductive reasoning and selection of statements in the formulations used in formal psychiatric examinations and suggest that the dynamic formulation may not be a useful predictor of diagnostic entities.
Clearance and early hydrolysis of atrial natriuretic factor in vivo. Structural analysis of cleavage sites and design of an analogue that inhibits hormone cleavage.
Authors: C L Condra, E A Leidy, P Bunting, C D Colton, R F Nutt, M Rosenblatt, J W Jacobs
Journal: Journal of Clinical Investigation (1988)

This study examines the clearance and early hydrolysis of atrial natriuretic factor (ANF) in vivo. Radiolabeled ANF was cleared from the circulation of the rat with biphasic kinetics; the majority (90%) of ANF cleared with a t1/2 of 15 s, the remaining peptide was cleared with a t1/2 of 5 min. Microsequence analysis of ANF peptides recovered from the circulation of rats revealed five major degradation products of the intact hormone. The first cleavage occurred between amino acids 12 and 13 of the hormone and would inactivate ANF. Over time, additional fragments of the hormone were generated, including fragments of 6, 7, 21, and 24 amino acids in length. Whole body radioautography of rats injected with [123I]-ANF revealed the kidney as a predominant organ involved in clearance of ANF. Subsequent amino acid sequence analyses of radiolabeled ANF exposed to the kidney in vivo indicated that this organ generated four of the five major hydrolysis products observed in circulation, namely, the 6, 7, 16, and 21 amino acid fragments of the hormone. In an attempt to stabilize ANF in vivo, a synthetic analogue of the hormone was prepared that contained the amino acid analogue, aminoisobutyric acid, substituted at position 13. This analogue completely abolished the in vivo cleavage of ANF at this site. These studies demonstrate the usefulness of a protein chemistry approach in characterizing hormone metabolism in vivo and designing analogues with enhanced in vivo stability to cleavage.
No Special Treatment
Authors: Rebecca Voelker
Journal: JAMA (1995)

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
Flexible Versus Nonflexible Mitral Valve Rings for Congestive Heart Failure
Authors: Martinus T. Spoor, Amy Geltz, Steven F. Bolling
Journal: Circulation (2006)

Background— Surgical intervention is playing an increasingly important therapeutic role in congestive heart failure (CHF) patients with ischemia and dilated cardiomyopathy. Their mitral regurgitation (MR) is a result of left ventricular (LV) geometrical distortion. The optimal type of ring for CHF patients with geometric ventricular-based MR is unknown. This study reviewed the results of flexible versus nonflexible complete mitral valve rings in CHF patients with geometric mitral regurgitation. Methods and Results— Using a prospectively maintained database, patients undergoing mitral valve reconstruction (MVR) with either a flexible or nonflexible complete ring were identified on the basis of preoperative ejection fraction (EF) ≤30% and no primary mitral pathology. These 2 groups of CHF patients with severe geometric MR were then compared in terms of recurrent MR requiring reoperation. Between 1992 and 2004, 289 patients with EF ≤30%, received an undersized complete mitral annuloplasty ring as their MVR procedure. Of these, 170 patients had a flexible complete ring. In follow-up, 16 “flexible” patients (9.4%) required a repeat procedure for significant recurrent geometric MR and CHF (10 replacements, 3 re-repairs, 3 transplants). The average time to reoperation was 2.4 years. In contrast, 119 patients with an EF ≤30% received a MVR using an undersized nonflexible complete ring. Only 3 “non-flexible” patients required a repeat operation, MVR (1), and 2 patients required a transplant. The time to reoperation was 4.0 years. A significant difference in reoperation rates, for recurrent MR, between the 2 groups ( P =0.012). There were no differences between groups, in terms of age, ring size used, preoperative EF, LV size, MR grade, or New York Heart Association class. Conclusions— Patients with CHF having a flexible ring have a higher likelihood of developing recurrent MR requiring reoperation. The use of a nonflexible ring appears to significantly reduce the need for repeat surgical procedures. Further refinement and development of nonflexible ring systems, aimed at LV restoration, deserve ongoing investigation.
Possibilities and Limits of Training in Medical Psychotherapy within an Interdisciplinary Cooperation
Authors: W. Saameli
Journal: Psychotherapy and Psychosomatics (1990)

In Switzerland as a rule a first main accent of the training as a psychotherapist with medical background takes place during the years between qualifying as an MD and obtaining the specialization certificate as a psychiatrist. These years are usually spent in institutions in which the obligation to serve the population ranks higher than to provide a training for psychotherapists. With the increasing number of doctors in free practice, including medical psychotherapists, the patients treated in institutions are those who need guidance provided by a pluridisciplinary team of professionals with different backgrounds. This is not only the case for inpatient units specialized in psychotherapy but also for psychiatric wards in general. More and more psychiatric services are being established in the field between the psychiatric clinic and the private practice of psychotherapists, in the form of day-care units or teams working in the community or in liaison psychiatry within the units of the somatic disciplines. The everyday situation of a resident on the way to becoming a psychotherapist consists in trying to treat patients by psychological means and methods together with other doctors, psychologists, social workers and nurse therapists who understand at least their attitude as a psychotherapeutic one. In my view this way of working is practised more and more. Can it be taken as a part of the training of psychotherapists or not? I think yes, because many abilities which are part of basic psychotherapy can continually be trained in such a setting in which the critical attitudes of representatives of other disciplines have stimulating effects. The psychotherapeutical support given to other members of helping professions can be designated as the method of cooperation which will have to be added to the classical psychotherapeutic schools.
Health department chooses 14 projects as exemplars of integration of health and social care
Authors: N. Hawkes
Journal: BMJ (2013)

Fourteen projects across England have been chosen by the Department of Health as exemplars of integrated care. They were selected from 115 responses to a call that the department issued in May for applications to take part in a programme to demonstrate excellence in bringing together health and social care services.

Their selection will not mean they get any additional funding, the department said, but will enable them to get feedback and evaluation from an advisory group that is chaired by Jennifer Dixon, chief executive of the Health Foundation. The group includes a representative of Kaiser Permanente, the California based health provider seen as a leader in integrated care, and a leading Swedish expert.

Norman Lamb, the care and support minister, said …
Enhancing Exposure of HIV-1 Neutralization Epitopes through Mutations in gp41
Authors: Catherine A Blish, Minh-An Nguyen, Julie Overbaugh
Journal: PLoS Medicine (2007)

The generation of broadly neutralizing antibodies is a priority in the design of vaccines against HIV-1. Unfortunately, most antibodies to HIV-1 are narrow in their specificity, and a basic understanding of how to develop antibodies with broad neutralizing activity is needed. Designing methods to target antibodies to conserved HIV-1 epitopes may allow for the generation of broadly neutralizing antibodies and aid the global fight against AIDS by providing new approaches to block HIV-1 infection. Using a naturally occurring HIV-1 Envelope (Env) variant as a template, we sought to identify features of Env that would enhance exposure of conserved HIV-1 epitopes.Within a cohort study of high-risk women in Mombasa, Kenya, we previously identified a subtype A HIV-1 Env variant in one participant that was unusually sensitive to neutralization. Using site-directed mutagenesis, the unusual neutralization sensitivity of this variant was mapped to two amino acid mutations within conserved sites in the transmembrane subunit (gp41) of the HIV-1 Env protein. These two mutations, when introduced into a neutralization-resistant variant from the same participant, resulted in 3- to >360-fold enhanced neutralization by monoclonal antibodies specific for conserved regions of both gp41 and the Env surface subunit, gp120, >780-fold enhanced neutralization by soluble CD4, and >35-fold enhanced neutralization by the antibodies found within a pool of plasmas from unrelated individuals. Enhanced neutralization sensitivity was not explained by differences in Env infectivity, Env concentration, Env shedding, or apparent differences in fusion kinetics. Furthermore, introduction of these mutations into unrelated viral Env sequences, including those from both another subtype A variant and a subtype B variant, resulted in enhanced neutralization susceptibility to gp41- and gp120-specific antibodies, and to plasma antibodies. This enhanced neutralization sensitivity exceeded 1,000-fold in several cases.Two amino acid mutations within gp41 were identified that expose multiple discontinuous neutralization epitopes on diverse HIV-1 Env proteins. These exposed epitopes were shielded on the unmodified viral Env proteins, and several of the exposed epitopes encompass desired target regions for protective antibodies. Env proteins containing these modifications could act as a scaffold for presentation of such conserved domains, and may aid in developing methods to target antibodies to such regions.
Activation of synovial fibroblasts in rheumatoid arthritis.
Authors: R W Kinne, E Palombo-Kinne, F Emmrich
Journal: Annals of the Rheumatic Diseases (1995)

Correspondence to: Raimund W Kinne, Max-Planck-Society, Clinical Research Unit for Rheumatology/Immunology, Schwabachanlage 10, D-91054 Erlangen, Germany. Several reports have proposed the hypothesis that synovial fibroblasts play a major role in the crippling destruction of cartilage and bone in the inflamed joints of patients with rheumatoid arthritis (RA),la either autonomouslyl or in concert with T cells and macrophages. 1-3 4a 5 RA synovial fibroblasts are a major component of the invasive pannus,3 a vascular and fibrous granulation tissue arising from the joint recessus and extending onto the surface of the cartilage.6 A number of studies indicate that these fibroblasts are morphologically altered'-4 7 and, in addition, highly activated' 2 4a 8 9-phenotypic features that have been interpreted either as signs of irreversible cellular transformationl-4 7 or as the result of strong, but reversible stimulation originating from the surrounding inflammatory microenvironment.2 4a 5 Activation of fibroblasts in vitro is known to generate several functional responses, such as production of matrix components,'0 soluble mediators,1 or enzymes' 2 4 8 11 that could contribute significantly to joint pathology in chronic RA in vivo. 1-4 811-15
Long-term Survival of Adult Trauma Patients
Authors: Giana H. Davidson, Christian A. Hamlat, Frederick P. Rivara, Thomas D. Koepsell, Gregory J. Jurkovich, Saman Arbabi
Journal: JAMA (2011)

ContextInpatient trauma case fatality rates may provide an incomplete assessment for overall trauma care effectiveness.To date, there have been few large studies evaluating long-term mortality in trauma patients and identifying predictors that increase risk for death following hospital discharge.Objectives To determine the long-term mortality of patients following trauma admission and to evaluate survivorship in relationship with discharge disposition.Design, Setting, and Patients Retrospective cohort study of 124 421 injured adult patients during January 1995 to December 2008 using the Washington State Trauma Registry linked to death certificate data.Main Outcome Measures Kaplan-Meier and Cox proportional hazards models were used to evaluate long-term mortality following hospital admission for trauma. ResultsOf the 124 421 trauma patients, 7243 died before hospital discharge and 21 045 died following hospital discharge.Cumulative mortality at 3 years postinjury was 16% (95% confidence interval [CI], 15.8%-16.2%)compared with the expected population cumulative mortality of 5.9% (95% CI, 5.9%-5.9%).In-hospital mortality improved during the 14-year study period from 8% (n = 362) to 4.9% (n = 600), whereas long-term cumulative mortality increased from 4.7% (95% CI, 4.1%-5.4%)to 7.4% (95% CI, 6.8%-8.1%).After adjustments for confounders, patients who were older and those who were discharged to a skilled nursing facility had the highest risk of death.The adjusted hazard ratios (HRs) for death after discharge to a skilled nursing facility compared with that after discharge home were 1.41 (95% CI, 0.72-2.76)for patients aged 18 to 30 years, 1.92 (95% CI, 1.36-2.73)for patients aged 31 to 45 years, 2.02 (95% CI, 1.39-2.93)for patients aged 46 to 55 years, 1.93 (95% CI, 1.40-2.64)for patients aged 56 to 65 years, 1.49 (95% CI, 1.14-1.94)for patients aged 66 to 75 years, 1.54 (95% CI, 1.27-1.87)for patients aged 76 to 80 years, and 1.38 (95% CI, 1.09-1.74)for patients older than 80 years.Other significant predictors of mortality after discharge included maximum head injury score on Abbreviated Injury Score scale (HR, 1.20; 95% CI, 1.13-1.26),Injury Severity Score (HR, 0.98; 95% CI, 0.97-0.98),Functional Independence Measure (HR, 0.89; 95% CI, 0.88-0.91),mechanism of injury being a fall (HR, 1.43; 95% CI, 1.30-1.58),and having Medicare (HR, 1.28; 95% CI, 1.15-1.43)or other government insurance (HR, 1.65; 95% CI, 1.47-1.85).Conclusions Among adults admitted for trauma in Washington State, 3-year cumulative mortality was 16% despite a decline in in-hospital deaths.Discharge to a skilled nursing facility at any age following trauma admission was associated with a higher risk of subsequent mortality.
Campaign against AIDS in Switzerland: evaluation of a nationwide educational programme.
Authors: P Lehmann, D Hausser, B Somaini, F Gutzwiller
Journal: BMJ (1987)

The campaign against the spread of the acquired immune deficiency syndrome (AIDS) in Switzerland includes a nationwide educational programme. A booklet about AIDS was mailed to every Swiss household in March 1986, and in 1987 there has been a mass media campaign promoting the use of condoms. We evaluated the results of the first phase--the distribution of the booklet--using a separate sample pretest and post-test design. The pretest was carried out 15 days before the booklet was mailed (sample n = 1056) and the post-test two months after the booklet was mailed (n = 1278). Of the population aged 20-69, to whom the book was sent, 56% read the booklet. For those who read the booklet compared with those who did not the results showed an improvement in knowledge and a better understanding of the risks of specific behaviours and of exposed groups and thus less fear of becoming infected through daily activities. The mean indices of knowledge and beliefs were significantly different when tested by the Kruskal-Wallis method. Having better information does not imply that people will change their behaviour, but both the high reading rate and the increase in knowledge suggest that the Swiss educational programme reached its objectives. Moreover, the success of this campaign helps to support other campaigns that are being developed to promote the use of condoms.
Accelerated Thromboplastin Generation in Patients with Acute Peripheral Arterial Occlusion Complicating Arteriosclerosis Obliterans.
Authors: J. A. Spittel
Journal: Annals of Internal Medicine (1961)

s1 May 1961Accelerated Thromboplastin Generation in Patients with Acute Peripheral Arterial Occlusion Complicating Arteriosclerosis Obliterans.J. A. Spittel Jr., M.D., (Assoc.), C. A. Pascuzzi, M.D., J. H. Thompson Jr., M.D., C. A. Owen Jr., M.D.J. A. Spittel Jr., M.D., (Assoc.)Search for more papers by this author, C. A. Pascuzzi, M.D.Search for more papers by this author, J. H. Thompson Jr., M.D.Search for more papers by this author, C. A. Owen Jr., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-5-1040_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSome patients with arteriosclerosis obliterans experience a chronic course; others have acute arterial occlusion. Previous investigators have suspected hypercoagulability of the blood as the cause of the acute thrombotic arterial occlusion, but methods consistently effective in demonstrating hypercoagulability have not emerged.During normal blood coagulation, the generation of thromboplastin requires more time than all other phases of clotting combined. Accordingly, the thromboplastin generation test (TGT), designed to measure the rate of formation of thromboplastin and the amount formed under standardized conditions, was utilized in this study of patients with arteriosclerosis obliterans. To increase the likelihood of detecting any acceleration of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1961Volume 54, Issue 5Page: 1040-1040KeywordsBloodBlood coagulation ePublished: 1 December 2008 Issue Published: 1 May 1961 PDF downloadLoading ...
SYPHILIS AS A DISEASE INNOCENTLY ACQUIRED.
Authors: L. DUNCAN BULKLEY
Journal: JAMA (1905)

Syphilis is not necessarily a venereal disease. Syphilis is one of the great diseases affecting the human race, and if its entire clinical history could be perfectly known, for ages past, it would be recognized that this one poison had caused greater damage and misery and more decided race degeneration than any other one malady, except tuberculosis. And yet, thus far, except in a few isolated localities, there has been no general and intelligent attempt to restrict its ravages. The common occurrence of syphilis as a result of unlawful sexual intercourse, and its inclusion among venereal diseases in so many text-books of late years, are undoubtedly the cause of much of the feeling existing in regard to it as a disease not to be mentioned in good society, and one whose recognition should be tabooed. It has been ignored through ignorance and neglected through negligence. In studying the older
Sudden Death and Coronary Heart Disease
Authors: James C. Broadbent
Journal: JAMA (1975)

Sudden death is an extraordinary problem, as is so well outlined in this interesting, concise book. It is, in effect, the "tip of the iceberg" in coronary heart disease because it identifies, too late, the presence of sclerotic, narrowed coronary arteries and ischemic myocardium. In<i>Sudden Death and Coronary Heart Disease</i>, the author emphasizes the major problems in the identification of the potential victim of sudden death, in the definition of the predictors of sudden death, and in the limitations of the currently available measures for preventing and treating sudden death. We are, it seems, at an impasse in these matters, and the direction of future efforts is in doubt. In the preface, M. F. Oliver proposes that a major research effort be made to define the relationship between myocardial ischemia and ventricular fibrillation. The author sees hope in a better definition of the likely victim of sudden death, in
Continued use of hormonal pregnancy test.
Authors: C Brewer
Journal: BMJ (1978)

In both 1975 and 1977, the Committee on Safety of Medicines reported an association between hormonal pregnancy tests (HPTs) and subsequent congenital abnormalities and stated that such tests should no longer be used. Despite these findings, the Secretary of State declined to ban the proprietary drug involved (Primodos). Following the 1977 warning, 600 consecutive abortion patients at 6 branches of the British Pregnancy Advisory Service (BPAS) were asked whether they had been given HPTs. 12 patients (2%) indicated they had received such tests. Since most women had not consulted a general practitioner before coming to BPAS, this figure is probably an underestimate of actual use. Although a few doctors may have prescribed an HPT in the belief that the pregnancy would be terminated anyway, some HPTs were administered by doctors who subsequently refused to refer the patient for an abortion. If banning Primodos is considered an unacceptable infringement of professional freedom, the Department of Health and Social Security should consider making it a controlled drug, with the requirement that physicians ascertain through an immunological test that the recipient is not pregnant.