tbuckley/cabot-search huggingface dataset:
Segmental chloride and fluid handling during correction of chloride-depletion alkalosis without volume expansion in the rat.
Authors: J H Galla, D N Bonduris, S L Dumbauld, R G Luke
Journal: Journal of Clinical Investigation (1984)

To determine whether chloride-depletion metabolic alkalosis (CDA) can be corrected by provision of chloride without volume expansion or intranephronal redistribution of fluid reabsorption, CDA was produced in Sprague-Dawley rats by peritoneal dialysis against 0.15 M NaHCO3; controls (CON) were dialyzed against Ringer's bicarbonate. Animals were infused with isotonic solutions containing the same Cl and total CO2 (tCO2) concentrations as in postdialysis plasma at rates shown to be associated with slight but stable volume contraction. During the subsequent 6 h, serum Cl and tCO2 concentrations remained stable and normal in CON and corrected towards normal in CDA; urinary chloride excretion was less and bicarbonate excretion greater than those in CON during this period. Micropuncture and microinjection studies were performed in the 3rd h after dialysis. Plasma volumes determined by 125I-albumin were not different. Inulin clearance and fractional chloride excretion were lower (P less than 0.05) in CDA. Superficial nephron glomerular filtration rate determined from distal puncture sites was lower (P less than 0.02) in CDA (27.9 +/- 2.3 nl/min) compared with that in CON (37.9 +/- 2.6). Fractional fluid and chloride reabsorption in the proximal convoluted tubule and within the loop segment did not differ. Fractional chloride delivery to the early distal convolution did not differ but that out of this segment was less (P less than 0.01) in group CDA. Urinary recovery of 36Cl injected into the collecting duct segment was lower (P less than 0.01) in CDA (CON 74 +/- 3; CDA 34 +/- 4%). These data show that CDA can be corrected by the provision of chloride without volume expansion or alterations in the intranephronal distribution of fluid reabsorption. Enhanced chloride reabsorption in the collecting duct segment, and possibly in the distal convoluted tubule, contributes importantly to this correction.
Aorto-Inferior Vena Caval Fistula of Neoplastic Origin Hemodynamic and Coronary Blood Flow Studies
Authors: E. STANLEY CRAWFORD, DAVID J. TURELL, JAMES K. ALEXANDER
Journal: Circulation (1963)

A case report of a 51-year-old man is presented, who spontaneously developed an aorto-vena caval fistula in the region of a mesenchymal tumor involving both the abdominal aorta and vena cava. The disease was manifested clinically by rapidly progressive and massive leg swelling, prominent abdominal and leg veins, a machinery murmur over the abdomen and in the flanks, and a pulsatile abdominal mass, with signs of cardiac enlargement and a high output state. The fistula was demonstrated preoperatively by translunmbar aortography and closed surgically by resection of the tumor en masse, with a part of the vena caval wall and the distal aorta and proximal common iliac arteries. Vascular continuity was restored by lateral suture of the vena cava and by insertion of a bifurcation graft bridging the defect in the aorta and iliac arteries. The patient has been relieved of all clinical manifestations of the fistula to date, 1 year after operation. Preoperative hemodynamic studies revealed certain alterations characteristic of systemic arteriovenous fistula, including increased pulse pressure, high cardiac output and stroke volume, reduced systemic vascular resistance and arteriovenons oxygen difference, and increased plasnma and circulating blood volumes. Some degree of cardiac failure appeared to be present. Coronary arteriovenous oxygen difference was normal, indicating that the observed increase in coronary blood flow closely paralleled the augmented energy requirement of the heart as reflected by the ventricular oxygen uptake. Reversion to normal of the observed changes in systemic hemodynamics, coronary blood flow, and myocardial metabolism was demonstrated 2 weeks postoperatively.
Experts Say AIDS Pain 'Dramatically Undertreated'
Authors: Joan Stephenson
Journal: JAMA (1996)

DESPITE ever more sophisticated strategies for treating human immunodeficiency virus (HIV) disease, researchers are finding that many patients suffer needlessly because physicians fail to recognize and alleviate AIDS-related pain. Studies show that although people with HIV infection and AIDS suffer pain comparable to that experienced by cancer patients, their pain is "dramatically undertreated, even in academic centers with a focus on HIV care," said William Breitbart, MD, at a recent international congress on pain held in Vancouver, British Columbia. "The story of pain in AIDS has been a story of neglect," noted Breitbart, of Memorial Sloan-Kettering Cancer Center, New York, NY. And the problem may be exacerbated by pressures of managed care that result in greater numbers of people with HIV and AIDS being cared for by primary care physicians, many of whom have little training or experience in managing chronic pain. "Most physicians haven't been trained in
Jejunoileal Bypass for Morbid Obesity
Authors: Michael P. Hocking, Margaret C. Duerson, J. Patrick O'Leary, Edward R. Woodward
Journal: New England Journal of Medicine (1983)

To evaluate the results of jejunoileal bypass for morbid obesity, we studied 100 patients with intact bypasses an average of more than five years after surgery. Mean weight loss at five years was 102.7 lb (46.6 kg) (33 per cent). Although nearly half the patients regained some weight between one and five years after surgery, only 17 per cent regained 20 lb (9 kg) or more. Medical benefits (such as improved glucose tolerance and lowered blood pressure) were maintained at five years, but side effects and complications continued to occur in the late postoperative period. Diarrhea (more than three stools per day) persisted in 58 per cent of the patients, and electrolyte disturbances occurred in over a third. Diminished levels of B12 or folate or both were present in 88 per cent. Twenty-one per cent of the patients had nephrolithiasis, and 20 per cent of those who were at risk required cholecystectomy. Progressive hepatic structural abnormalities occurred in 29 per cent of the patients, and there was a 7 per cent incidence of cirrhosis. Although 81 per cent of the patients had satisfactory results at five years, side effects and complications continued to occur, mandating careful follow-up indefinitely. The risk-to-benefit ratio at five years after surgery seems acceptable, but the continued untoward effects of the bypass in the late postoperative period have led us to abandon this procedure in favor of gastric bypass. Only continued longitudinal follow-up will determine whether on balance jejunoileal bypass represents such a serious long-term health hazard that prophylactic restoration of intestinal continuity is indicated. (N Engl J Med 1983; 308:995–9.)
Endotherapy of high grade dysplasia and early cancer in Barrett's oesophagus: results from a large UK series comparing outcomes of two radically different approaches
Authors: J.-E. Abela, P. Bhandari, J. Morris, P. Basford, C. K. Mackay, J. J. Going, D. MacArthur, D. Poller, D. Cowlishaw, P. Glen, G. M. Fullarton
Journal: Gut (2011)

<h3>Introduction</h3> Endoscopic therapy of Barrett9s Oesophagus (BE) with high grade dysplasia (HGD) and/or intramucosal cancer (IMC) by endoscopic mucosal resection (EMR) or radiofrequency ablation (RFA) is a recognised alternative to surgical resection. The aim of this study is to compare the outcomes of two radically different endotherapy approaches of focal EMR of neoplastic foci followed by RFA versus focal EMR followed by more radical EMR as necessary. <h3>Methods</h3> Patients referred with Barrett9s HGD and/or IMC where treated with either focal EMR to visibly elevated lesions with subsequent intensive RFA of residual BE (Group A) or by a protocol of focal EMR to eradicate neoplasia (Group B). There were 37 patients (83% males) in Group A with a mean age of 66 years and a mean Barrett9s segment length was 6.9 cms (1–14). In Group B we had 44 patients (90% males) with a mean age of 68 years and mean segment length of 5.0 cms (2–15). All patients were followed up in a rigorous endoscopic programme. The mean duration of follow-up was 23 months in Group A and 32 months in Group B. <h3>Results</h3> In Group A total of 23 EMR procedures were performed with a mean of 0.6 sessions per patient. Treatment then proceeded with a RFA-intensive protocol such that a total of 79 ablations were administered with a mean of 2 sessions per patient. Thereafter, Nd:YAG laser was applied to residual islands less than 0.5 cm in length. In Group B a total of 72 EMR procedures were performed with a mean of 1.6 sessions per patient. In this group RFA was employed in 6 patients only. No significant post-procedural complications were identified in these patients. Eradication of neoplasia (HGD and IMC) was achieved in 35/37 patients (95%) in Group A and 41/41 (100%) in Group B. Furthermore, during this relatively short follow-up period eradication of Barrett9s oesophagus was achieved in 31/37 of patients (84%) in Group A. <h3>Conclusion</h3> This is the largest reported series demonstrating similarly excellent outcomes for two radically different endoscopic approaches for the ablation of Barrett9s neoplasia. In addition, the RFA-intensive strategy has proved effective in eradicating residual Barrett9s oesophagus. These observations call for a randomised controlled trial comparing these two strategies in order to identify the most cost-effective option.
C-TERMINAL PROVASOPRESSIN (COPEPTIN), MID-REGION PRO-ADRENOMEDULLIN (MR-PROADM) AND MID-REGION PRO-ATRIAL NATRIURETIC PEPTIDE (MR-PROANP) AS NOVEL PROGNOSTIC BIOMARKERS AFTER NON-ST ELEVATION ACUTE CORONARY SYNDROME: ANALYSIS FROM MERLIN TIMI-36
Authors: Ryan G. O'Malley, Marc P. Bonaca, Marc S. Sabatine, Benjamin M. Scirica, Sabina A. Murphy, Petr Jarolim, Eugene Braunwald, David A. Morrow
Journal: Journal of the American College of Cardiology (2011)
Woman gives birth to two babies in separate pregnancies after ovarian transplant
Authors: S. Mayor
Journal: BMJ (2010)

We investigated genetic polymorphisms in the pregnane X receptor (<i>NR1I2</i>) in Korean individuals (<i>n</i> = 83) and the effects of <i>NR1I2</i> genotypes on rifampin-mediated induction of bupropion hydroxylation. The pharmacokinetics of bupropion and hydroxybupropion were evaluated after an oral dose of bupropion (150 mg) administered before and after rifampin treatment for 7 days in 35 healthy subjects. The area under the time-concentration curve (AUC) ratio of hydroxybupropion to bupropion in <i>CYP2B6</i>*<i>6</i> carriers was significantly lower than that in <i>CYP2B6</i>*<i>6</i> noncarriers in both the basal and rifampin-induced states (<i>p</i> = 0.012). Among the <i>CYP2B6</i>*<i>6</i> carriers (<i>n</i> = 13), the <i>NR1I2</i> TGT (−25385T + g.7635G + g.8055T) carriers exhibited a significantly lower AUC ratio, representing the CYP2B6 hydroxylation activity, compared with the TGT noncarriers, in the induced state (11.9 versus 20.3, <i>p</i> = 0.045). The percent difference in the AUC ratio between the basal and induced states was also significantly different (212% versus 58.8%, <i>p</i> = 0.006). However, no significant difference was observed among the <i>NR1I2</i> TGT genotypes for the <i>CYP2B6</i>*6 noncarriers (<i>n</i> = 22). In conclusion, it is suggested the <i>NR1I2</i> TGT genotype decreases the bupropion hydroxylation induced by treatment with rifampin, particularly in <i>CYP2B6</i>*<i>6</i> carriers.
Decreased vulnerability to ventricular fibrillation by vasodilator-induced baroreceptor sensitisation
Authors: P. R KOWEY, R. L VERRIER, B. LOWN
Journal: Cardiovascular Research (1983)

Vulnerability to ventricular fibrillation (VF) is affected by changes in systemic arterial blood pressure which are mediated through the sympathetic nervous system. We determined that small doses of a vasodilator drug can abolish the enhanced ventricular vulnerability induced by norepinephrine infusion. Noradrenaline (0.5 μg·kg−l·min−1) caused a fall in ventricular fibrillation threshold from 30 to 20 mA (P<0.001). Pretreatment with prostaglandin E1, I2 or nitroglycerin at doses which reduced mean arterial blood pressure by 0.7 to 1.3 kPa (5 to 10 mmHg) abolished the enhanced vulnerability produced by noradrenaline. Following baroreceptor denervation, these agents no longer afforded protection against the profibrillatory action of noradrenaline. We conclude that small doses of vasodilator agents can augment ventricular electrical stability. The mechanism for this protective action appears to be a decrease in cardiac sympathetic tone resulting from vasodilatation of baroreceptor areas.
Polycyclic aromatic hydrocarbons and cancer in man.
Authors: G Mastrangelo, E Fadda, V Marzia
Journal: Environmental Health Perspectives (1996)

Various substances and industrial processes, surrogates of exposure to polycyclic aromatic hydrocarbons (PAHs), are currently classified as human carcinogens. This paper reviews recent epidemiological studies reporting direct evidence of the carcinogenic effects of PAHs in occupationally exposed subjects. Risks of lung and bladder cancer were dose dependent when PAHs were measured quantitatively and truly nonexposed groups were chosen for comparison. These new findings suggest that the current threshold limit value of 0.2 mg/m3 of benzene soluble matter (which indicates PAH exposure) is unacceptable because, after 40 years of exposure, it involves a relative risk of 1.2-1.4 for lung cancer and 2.2 for bladder cancer.
Cost-effectiveness of hepatitis C virus antiviral treatment for injection drug user populations
Authors: Natasha K. Martin, Peter Vickerman, Alec Miners, Graham R. Foster, Sharon J. Hutchinson, David J. Goldberg, Matthew Hickman
Journal: Hepatology (2011)

Injecting drug use is the main risk of hepatitis C virus (HCV) transmission in most developed countries. HCV antiviral treatment (peginterferon-α + ribavirin) has been shown to be cost-effective for patients with no reinfection risk. We examined the cost-effectiveness of providing antiviral treatment for injecting drug users (IDUs) as compared with treating ex/non-IDUs or no treatment. A dynamic model of HCV transmission and disease progression was developed, incorporating: a fixed number of antiviral treatments allocated at the mild HCV stage over 10 years, no retreatment after treatment failure, potential reinfection, and three baseline IDU HCV chronic prevalence scenarios (20%, 40%, and 60%). We performed a probabilistic cost-utility analysis estimating long-term costs and outcomes measured in quality adjusted life years (QALYs) and calculating the incremental cost-effectiveness ratio (ICER) comparing treating IDUs, ex/non-IDUs, or no treatment. Antiviral treatment for IDUs is the most cost-effective option in the 20% and 40% baseline chronic prevalence settings, with ICERs compared with no treatment of £ 521 and £ 2,539 per QALY saved, respectively. Treatment of ex/non-IDUs is dominated in these scenarios. At 60% baseline prevalence, treating ex/non-IDUs is slightly more likely to be the more cost-effective option (with an ICER compared with no treatment of £ 6,803), and treating IDUs dominated due to high reinfection. A sensitivity analysis indicates these rankings hold even when IDU sustained viral response rates as compared with ex/non-IDUs are halved.Despite the possibility of reinfection, the model suggests providing antiviral treatment to IDUs is the most cost-effective policy option in chronic prevalence scenarios less than 60%. Further research on how HCV treatment for injectors can be scaled up and its impact on prevalence is warranted.
End Run around Epo
Authors: H. Franklin Bunn
Journal: New England Journal of Medicine (2009)

Recombinant human erythropoietin is arguably the most successful therapeutic application of recombinant DNA technology to date. Since the initial reports — which appeared 22 and 23 years ago1,2 — documented a cure of the anemia of chronic kidney disease with recombinant human erythropoietin, well over a million patients have been treated with it effectively and with minimal drug-related toxicity. Moreover, recombinant human erythropoietin has also been effective in the treatment of patients with cancer, particularly when anemia has been aggravated by chemotherapy.Although recombinant human erythropoietin merits high marks for efficacy and safety, concerns have arisen about two distinct . . .
The Smith-Petersen Nail
Authors: Robert G. Thompson
Journal: JAMA (1967)

<h3>To the Editor:—</h3> In reviewing the article, "Slipped Capital Femoral Epiphysis," by Drs. Aufranc, Jones, and Turner (<b>198</b>:546, 1966), which was the FRACTURE OF THE MONTH, I was struck by the fact that apparently there are a few surgeons in this country who are still using Smith-Petersen nails to fix a slipped capital femoral epiphysis internally. The ensuing complication, distraction of the epiphyseal head by the nail, happens all too frequently with this type of internal fixation. I was also surprised at Dr. Aufranc's comment, "I think the choice of fixation device is less important than the skill with which the device is employed." It is quite obvious to me and others who have had any experience with the treatment of slipped capital femoral epiphysis, that any type of nail such as the Smith-Petersen, which has to be pounded into a small, hard femoral neck, risks lifting the femoral
Letter: The killer worm.
Authors: F D Dastur, G H Kashyap, K G Nair
Journal: BMJ (1974)

rates might have been expected on the basis of the distribution of maternal age, parity, and ethnic group in mothers of different blood groups in the Jerusalem population.TABLE I-Recorded Frequency of Toxaemia by Blood Groups Blood No. of Pre-eclampsia Group Births (%) Rh+ A 3,696 1-70 B 2,
Literature and Medicine
Authors: Larry R. Churchill
Journal: JAMA (1989)

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
Cardiorespiratory Fitness, Adiposity, and Mortality
Authors: Norbert Stefan
Journal: JAMA (2008)

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
ABORTION IN THE UNITED STATES
Authors: Cynthia C. Harper, Jillian T. Henderson, Philip D. Darney
Journal: Annual Review of Public Health (2004)

▪ Abstract Abortion is an extremely safe and common medical procedure. In the United States, over one million women had an abortion in the year 2000. Advances in early abortion techniques have helped to increase the proportion of early procedures, the safest type. Abortion rates have been declining since the early nineties among adults and adolescents, but rates among poor, minority women remain high. State restrictions to abortion have a larger impact on poor women and young women. Restrictions and regulations have also resulted in the concentration of abortion services in specialized clinics. These clinics are subject to harassment. The expansion of abortion services to more types of providers could increase access, as well as integrate abortion into women's health care.
Diagnosis of Treatable Wilson's Disease
Authors: George E. Cartwright
Journal: New England Journal of Medicine (1978)

IT is a tragedy for patients, their families and their physicians when the physician fails to make the diagnosis of a progressive and fatal disorder that is treatable.Wilson's disease is such a disorder.1 All the clinical manifestations can be prevented if the disease is diagnosed before functional impairment occurs. The disease is reversible even after severe functional impairment develops. It is not treatable after irreversible damage is inflicted on the brain or liver.Unfortunately, but understandably, these tragedies occur too frequently in the diagnosis of Wilson's disease. It is unfortunate for the patients who suffer severe physical and emotional . . .
Leptospirosis Caused by Serotype<i>fort-Bragg</i>
Authors: DAVID W. FRASER
Journal: Annals of Internal Medicine (1973)

Seven serologically proved cases of leptospirosis occurred in five families in a Portland, Oregon, suburb in the first 3 months of 1972. Leptospires of serotype fort-bragg of the Autumnalis serogroup were isolated from the urine of two patients. All 7 patients showed serologic evidence of Autumnalis infection. Symptoms included headache, fever, and myalgia. Three patients had rash and two, jaundice. A pet dog owned by the family in which three of the cases occurred died of leptospirosis in March 1972 after a 4-month illness. Two of five veterinary workers who handled the dog had demonstrable titers against antigens of the Autumnalis serogroup. Whether this dog introduced fort-bragg leptospires into the community or whether he was locally infected from another source could not be determined.
Textbook of pathology with clinical application.
Authors: Lester S. King
Journal: JAMA (1963)

In any new edition of a successful textbook the author must make many far-reaching decisions. How much new material should he add? How much may the size of the book increase? How well can he preserve the original spirit (for any successful text must have an indefinite quality which we can only call "spirit")? In the present edition Dr. Robbins has made certain successful compromises. The new edition, although it has about 160 fewer pages, has a larger format. The new volume is approximately half a pound heavier than the original, but the paper seems to be of better quality. Perhaps because of this the illustrations frequently seem to have more "snap" and clarity than in the original printing. The text has undergone a thorough and conscientious revision while retaining the same general pattern and arrangement. If we make a page-by-page comparison of the two editions we can appreciate the