tbuckley/cabot-search huggingface dataset:
Global tuberculosis levels plateau while extensively drug resistant strains increase
Authors: Anne Glusker
Journal: BMJ (2007)

The World Health Organization has issued a report announcing that levels of global tuberculosis have reached a plateau, while at the same time warning that extensively drug resistant tuberculosis and the confluence of HIV and tuberculosis remain urgent public health concerns.

“There is both good news and bad news, and they are connected,” says Mario Raviglione, the director of WHO's Stop TB campaign. “The positive is that the incidence, per capita, is declining. The disease may have reached its peak. But the bad news is that the decline is slow, too slow.”

WHO has been striving to meet two …
An oblique passion
Authors: Kevin Barraclough
Journal: BMJ (2005)

Throughout my life I have had a persistent, rather dilettante interest in mathematics. I dabble a little, drift away with pressures of work and family, but always seem to return.

It is, I think, the calm that draws me back. It is detached from the grit and noise of the medical world—a place of clean lines and perfect spheres, of abstract objects that glisten in the imagination in a sharp, multidimensional light. Sometimes I see them as solid …
Cardiac Autonomic Neuropathy in Diabetes
Authors: Rodica Pop-Busui
Journal: Diabetes Care (2010)

This review covers the epidemiology, pathophysiology, clinical presentation, and diagnosis of cardiac autonomic neuropathy (CAN) in diabetes and discusses current evidence on approaches to prevention and treatment of CAN.

A 26-year-old woman with “brittle” type 1 diabetes and severe CAN experienced sudden cardiac death. She had a 16-year history of poor diabetes control presenting with wide blood glucose fluctuations, recurrent episodes of severe hypoglycemia, and hypoglycemia unawareness. Over time she developed persistent orthostatic hypotension with daily falls in systolic blood pressure ranging from 30–60 mmHg. These episodes had significant impact on her daily activities and required intermittent therapy with the α-1 agonist midodrine. Other complications included severe gastroparesis, refractory diarrhea, and painful diabetic peripheral neuropathy. Her last clinical examination revealed resting tachycardia with a fixed rate of 115 bpm, supine blood pressure of 110/78 mmHg, which dropped to 70/48 mmHg while standing, symmetrical absent pinprick and temperature discrimination in stocking distribution, and left Charcot joint. Her last pertinent laboratory findings were A1C 8.7%, creatinine 1.9 mg/dl, microalbumin/creatinine 496 mg/g, and hemoglobin 10.8 g/dl.

CAN represents a significant cause of morbidity and mortality in diabetic patients and is associated with a high risk of cardiac arrhythmias and sudden death, possibly related to silent myocardial ischemia. Therefore, it has important clinical and prognostic relevance. Recent reports of major clinical trials undermine established thinking concerning glycemic control and cardiac risk. Thus, a review of this topic is both timely and important for physicians to better understand how to assess the complexity of conditions present in patients with diabetes in order to establish safe treatment targets.

Diabetes affects more than 23 million people in the U.S. (www.diabetes.org) and an estimated 250 million worldwide (www.who.int/diabetes). Diabetic neuropathies, including CAN, are a common chronic complication of type 1 and type 2 diabetes and confer high morbidity …
Concentration of folate in colorectal tissue biopsies predicts prevalence of adenomatous polyps
Authors: A. Flood, J. B. Mason, Z. Liu, B. D. Cash, A. Schatzkin, P. S. Schoenfeld, A. J. Cross
Journal: Gut (2010)

<h3>Background and aims</h3> Folate has been implicated as a potential aetiological factor for colorectal cancer. Previous research has not adequately exploited concentrations of folate in normal colonic mucosal biopsies to examine the issue. <h3>Methods</h3> Logistic regression models were used to estimate ORs and 95% CIs of adenoma according to the tissue concentration of folate using asymptomatic average-risk women (40–70 years) in a colorectal cancer screening study. Of the 1593 eligible women who were offered enrolment, 1483 (93%) participated. Colonoscopy was complete to the caecum in 98.7% (1463/1483) of the subjects, and normal colonic tissue biopsies were obtained from 813 (56%) of these, of whom 170 had at least one adenoma. <h3>Results</h3> A marginal reduction in risk for proximal adenomas (OR 0.56, 95% CI 0.29 to 1.09) but not distal adenomas (OR 1.01, 95% CI 0.43 to 2.37) was observed among women in the highest quintile of tissue folate concentration. A significant reduction in risk for advanced adenoma was observed for women in the highest quintile of tissue folate concentration (OR 0.24, 95% CI 0.06 to 0.93). Defining the outcome as proximal adenomatous and/or hyperplastic polyps, statistically significant inverse associations with tissue concentrations of folate were also observed (OR 0.54, 95% CI 0.31 to 0.95 for quintile 5 vs quintile 1). <h3>Conclusions</h3> These findings are consistent with the hypothesis that folate status of colonic mucosa is an exposure that is aetiologically important in determining the risk of particular molecular subtypes of colorectal cancer.
Myocardial Infarction, Presumably Embolic
Authors: Berton L. London
Journal: JAMA (1967)

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
Young woman with recurrent vomiting associated with weight loss
Authors: Ray Boyapati, Mayur Garg, Peter Crowley, Nathan Connelly
Journal: Gut (2012)

A 39-year-old woman presented with an 18-month history of episodic severe nausea, vomiting, diarrhoea and 30 kg weight loss requiring multiple hospital admissions. Her past medical history included hypothyroidism, migraines and lower back pain for which she used paracetamol, codeine and intermittent diclofenac up to 150 mg per day for up to a week during exacerbations.

C reactive protein and erythrocyte sedimentation rate were raised up to 89 mg/l and 80 mm/h respectively during some of these admissions. She was iron, vitamin B12 and …
Getting Rid of Gallstones Without Surgery
Authors: William S. Haubrich
Journal: JAMA (1975)

"ISN'T there a new way to just dissolve these gallstones?" With an estimated 15 million Americans harboring gallstones, it is likely this question is asked thousands of times every day in doctors' offices and hospitals across the land. In a word, the answer to the question is<i>yes</i>. But a single word is not enough; a proper answer requires an explanation, and for most patients the conclusion may appear to contradict the answer. Gallstones have been with us for centuries. In recent years, there has been a resurgence of interest in this ancient disease, stimulated by newer biochemical knowledge of how gallstones come to be. In the past, the gallbladder was thought to be at fault because that's where the stones accumulate and because the wall of the stone-laden gallbladder is often acutely or chronically inflamed and sometimes deeply scarred. Now we think the blame must be laid elsewhere, at
Preoperative Exercise Vo2 Measurement for Lung Resection Candidates: Results of Cancer and Leukemia Group B Protocol 9238
Authors: Gregory M. Loewen, Dorothy Watson, Leslie Kohman, James E. Herndon, Hani Shennib, Kemp Kernstine, Jemi Olak, M Jeffery Mador, David Harpole, David Sugarbaker, Mark Green
Journal: Journal of Thoracic Oncology (2007)
Infarct limitation of the second window of protection in a conscious rabbit model
Authors: X YANG, G BAXTER, R HEADS, D YELLON, J DOWNEY, M COHEN
Journal: Cardiovascular Research (1996)

Myocardial protection associated with ischemic preconditioning (PC) wanes within an hour or two. It has recently been observed, however, that a delayed phase of protection appears about 24 h after ischemic PC in anesthetized rabbits and dogs which might be related to synthesis of cytoprotective proteins. We tested whether a second window of protection could be induced in conscious rabbits.Rabbits chronically instrumented with a coronary artery occluder and ECG electrodes experienced a 30-min coronary occlusion followed by 3 h reperfusion. Infarct size was measured with triphenyltetrazolium chloride.35.7 +/- 2.3% of the risk zone infarcted in control animals. PC with 4 cycles of 5-min coronary occlusion/10-min reperfusion 24 h prior to the 30-min ischemia decreased infarction to 24.1 +/- 1.4% of the risk zone (P < 0.01). During the 30-min occlusion 3 of 7 non-PC rabbits developed ventricular fibrillation, while this arrhythmia did not occur in the 7 PC animals (P < 0.1). Myocardial hsp70 content in PC rabbits was twice that in controls. Collateral blood flow was not different in the two groups.A second window of protection exists in conscious rabbits which minimizes both infarction and arrhythmias, and cytoprotective protein content is increased in the myocardium of protected animals.
Study of relationship between the ECG components and some anthropometric measurements
Authors: Parminderjit Kaur, Anuradha Lehri, Satish Kumar Verma
Journal: British Journal of Sports Medicine (2010)

The study was conducted on 51 healthy male volunteer students in March 2008. The volunteers were taken from the various departments of Punjabi University, Patiala. All volunteers were adults within the age range of 18–23 years with no vascular abnormalities. All the anthropometric and ECG measurements were carried out under controlled conditions in quiet air-conditioned room with temperature and humidity levels controlled at 23 ± 2°C and 55% ± 5%, respectively, using standard equipments and techniques. It was concluded that body weight is positively correlated to QRS duration (r= 0.284, significant at 5%), it means that over weight were more prone to develop aberration in the ventricular depolarisation and blocks in the ventricular conduction system. It is also examined that greater BMI has shifted the electrical activity of repolarisation of the ventricles to the left (BMI is negatively correlated to the direction of ventricular repolarisation). It was also observed that weight has shown correlation with QRS duration. Maximum heart rate has shown positive correlation with P-axis (0.332), T-axis (0.299) and QTC interval (0.41) and negatively correlated with QT interval (0.632).
Abstract 3791: MAPK p38 is the link between autophagy and lipid metabolism in colorectal cancer cells
Authors: Paillas Salomé
Journal: Cancer Research (2011)

Abstract Autophagy is an intracellular degradation system that delivers cytoplasmic constituents to the lysosome. Recent progress has demonstrated that autophagy plays a wide variety of physiological and pathophysiological roles, notably in cancer. We have showed previously, that the p38 pathway was involved in Irinotecan sensitivity of colon cancer cells p53WT. p38 being involved in the induction of autophagy we wanted to determine its role in the processes of autophagy in presence and in absence of p53 in colorectal cancer cells. Our results show that the overexpression of the constitutively active p38alpha isoform in HCT116 p53KO cells leads to a massive autophagy, accompanied with a block in G2 / M. The induction of autophagy in this context doesn't leads to the cellular death but rather to survival. The autophagy induction by p38 overexpression in HCT116 was weaker, indicating that the lack of p53 increase p38 role in autophagy induction. Furthermore, we have shown that autophagy induced by p38 comes along with an increase of the lipid metabolism by activating a key enzyme of the synthesis of fatty acids. We demonstrate here, that the role of p38 in the induction of autophagy depends on the presence of p53 and that p38 would be the link between the increase of the lipid metabolism and the induction of autophagy that lead to survival. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3791. doi:10.1158/1538-7445.AM2011-3791
A Critique of the Use of Generic Screening in Quality Assessment
Authors: Paul J. Sanazaro
Journal: JAMA (1991)

This article summarizes available information on the efficiency and effectiveness of generic occurrence screening when used in quality assessment. Generic screening is relatively inefficient because of its multitiered review system and high rates of errors and false positives. Overall sensitivity may approach 70% to 80%, but specificity is estimated to range from about 22% to 73%. Effectiveness of generic screening in identifying problems in quality is limited by variability in peer review. Other limitations of generic screens include their lack of inherent relationship to the quality of patient care and their inability to provide direct performance measures for use in the periodic reappraisal of clinical privileges of medical staff members. We propose the monitoring of specific adverse surgical and medical clinical outcomes and related risk factors to increase efficiency in quality assessment and provide a more adequate database for the continual improvement of patient care and clinical performance.
THE PRESENT STATUS OF OUR KNOWLEDGE CONCERNING THE BACTERIOLOGY AND SERUM TREATMENT OF DIPHTHERIA.
Authors: SAMUEL E. ALLEN
Journal: JAMA (1900)

Although we may not consider this subject as exactly fitting for the deliberations of this Section, still diphtheria is to a certain extent a throat affection, and as such its discussion has a place here. The subject offers something a little different from the ordinary run of topics which engage our attention, and for that reason, on the advice of our Chairman, I take the liberty of introducing it here. It is not my intention to treat the subject from a practical standpoint, but rather to touch on the scientific advances which have been made by the bacteriologists and those engaged in working out the problems connected with serumtherapy. An enormous amount of work has been done and is being done along these lines, and an account of the latest theories advanced, even as imperfectly as given here, can not fail to be of some profit to us. The subject
Management of infertility
Authors: D J Cahill
Journal: BMJ (2002)

Delay in childbearing and the adverse effect of increasing age on women's fertility have increased referrals for fertility investigations and treatment. In the past 25 years the percentage of births to women age 30 and over in England and Wales has doubled (see fig A on bmj.com). 1 2 One in six couples require referral for investigation or treatment for subfertility.3 Couples are more aware of what can be done from media attention. Unfortunately, this often leads to falsely high expectations of fertility treatments. Natural human fertility is low compared with most other species. Peak human fertility (the chance of pregnancy per menstrual cycle in the most fertile couples) is no higher than 33%, and it is unrealistic to expect a higher chance of pregnancy than this from any fertility treatment. This review of the management of infertility, or more correctly subfertility, focuses on investigations (including over the counter fertility tests) and appropriate actions and treatments in response to test results.

### Summary points

Natural human fertility is low, and most couples have falsely high hopes of fertility treatments

The major causes of subfertility are sperm dysfunction, ovulation disorder, and fallopian tube damage

Most investigations to establish a cause of subfertility are simple to undertake

For most couples, history and examination will not indicate a cause, and full subfertility investigations will be needed

Couples with sperm dysfunction or likely tubal damage should be referred early for specialist opinion

Ovulation disorders often respond to simple treatments that can be safely initiated in primary care

This article is based on 20 years' combined experience of running tertiary infertility clinics, together with the resources and regularly updated literature searches we have used over the past 14 years in preparation for annual postgraduate study days for primary care doctors.

Within a year of regular intercourse, 90% …
Therapeutic Potential of Transfer Factor
Authors: Charles H. Kirkpatrick
Journal: New England Journal of Medicine (1980)

The ability of a low-molecular-weight material from sensitized lymphocytes to transfer cell-mediated immune responses to previously unreactive recipients was reported many years ago.1 During the past decade, there have been several investigations into the possibility that this form of passive sensitization might be efficacious in patients with cancer, autoimmune diseases, immunodeficiency syndromes, or a variety of inflammatory disorders of uncertain origin. The reports have been promising but inconclusive; either too few patients were studied or the "transfer factor" was used in combination with other agents that may have produced similar results.It is still too early to state that transfer . . .
An Undignified Letter.
Authors: None Constancy.
Journal: JAMA (1894)

<h3>To the Editor:</h3> —The complaint of Dr. Cohen, published in theJournalseveral weeks ago, was no doubt prompted by a keen sense of professional propriety; but did he not forget his high aim in the unprofessional and undignified tone of the latter part of his communication? As a matter of fact, a portion of it should not have been printed.
The interaction of human macrophages and lymphocytes in the phytohemagglutinin-stimulated production of interferon
Authors: Lois B. Epstein, Martin J. Cline, Thomas C. Merigan
Journal: Journal of Clinical Investigation (1971)

In studies of 13 normal adults to determine the blood cell types responsible for interferon production induced by phytohemagglutinin, the following observations were made. (a) In cultures containing 96-100% pure macrophages derived from blood monocytes, no interferon was detected in either the presence or the absence of phytohemagglutinin for up to 92 hr. (b) In cultures of 99.5-100% pure lymphocytes, low levels of interferon were detected in the presence, but not in the absence, of phytohemagglutinin. (c) An average fivefold increase in interferon titers occurred when pure lymphocytes were combined with the macrophages in culture with phytohemagglutinin. The peak response of interferon occurred at 68 hr after the initiation of the combined cultures. For maximum response, phytohemagglutinin was required for the duration of the culture, and both cell types in association were necessary. Medium from phytohemagglutinin-stimulated macrophages or lymphocytes could not substitute for the corresponding intact cell. However, frozen-thawed macrophages in combination with lymphocytes and phytohemagglutinin produced an intermediate interferon response. An increase in either cell type produced an increased response in the range studied: lymphocytes, 0.45-1.8 x 10(6) per ml; and macrophages, 0.5-2.1 x 10(5) per ml. Syngeneic fibroblasts, HeLa cells, or mouse macrophages could not substitute for the human macrophages in the combined cultures with phytohemagglutinin. (d) Although all cultures producing interferon showed some degree of transformation (thymidine-(3)H incorporation into deoxyribonucleic acid), no direct correlation between the degree of phytohemagglutinin-induced lymphocyte transformation and the interferon titers was observed.The demonstration of macrophage-lymphocyte interaction in the production of interferon is of interest in view of the known interrelationship of these same cell types in antibody synthesis and cellular immunity.
Effect of Dialyzer Reuse on Survival of Patients Treated With Hemodialysis
Authors: Harold I. Feldman
Journal: JAMA (1996)

To evaluate the impact of dialyzer reuse on the survival of US hemodialysis patients.Nonconcurrent cohort study of 27938 patients beginning hemodialysis in the United States in 1986 and 1987.Patient survival.Dialysis in freestanding facilities reprocessing dialyzers with the combination of peracetic and acetic acids was associated with greater mortality than treatment in facilities not reprocessing dialyzers (rate ratio [RR],1.10, 95% confidence interval [CI], 1.02-1.18; P=.02) In contrast, there was no significant difference between survival in freestanding facilities reprocessing dialyzers with either formaldehyde (RR,1.03, 95% CI, 0.96-1.10; P=.45) or glutaraldehyde (RR, 1.13, 95% CI, 0.95-1.35, P=.18) and survival in freestanding facilities not reprocessing dialyzers. Among freestanding facilities reprocessing dialyzers, use of peracetic/acetic acid was associated with a higher rate of death than use of formaldehyde (RR = 1.08, 95% CI, 1.01-1.14; P=.02). There was no statistical difference between survival in hospital-based facilities reprocessing dialyzers with either peracetic/acetic acid (RR=0.95, 95% CI, 0.85-1.06; P=.40), formaldehyde (RR=1.06, 95% CI, 0.98-1.15; P=.12), or glutaraldehyde (RR=1.09, 95% CI, 0.71-1.67; P=.70) and survival in hospital-based facilities not reprocessing dialyzers. In addition, choice of sterilant was not associated with a statistically significant difference in survival among hospital-based facilities reprocessing dialyzers.Dialysis in freestanding facilities reprocessing dialyzers with peracetic/acetic acid may be associated with worse survival than dialysis in free-standing facilities not reprocessing dialyzers or in those reprocessing with formaldehyde. We were unable to determine whether these relationships arose from greater comorbidity among patients treated in facilities using peracetic/acetic acid, poor quality of dialysis procedures in these facilities, or direct toxicity of peracetic/acetic acid. These findings raise important concerns about potentially avoidable mortality among US hemodialysis patients treated in dialysis facilities reprocessing hemodialyzers.
Striation of bones in focal dermal hypoplasia: manifestation of functional mosaicism?
Authors: RUDOLF HAPPLE, WIDUKIND LENZ
Journal: British Journal of Dermatology (1977)

Striation of the metaphyseal regions of the long bones, a characteristic feature of the focal dermal hypoplasia syndrome, may be explained by functional X chromosome mosaicism. The following arguments are in favour of this hypothesis: (I) The striation of bones coincides with the zones of osteogenesis. (2) The skin lesions are distributed in a linear pattern as well. (3) The syndrome is probably inherited as an X-linked dominant trait. Thus, the linear pattern of both skin and bone lesions could be due to random X inactivation.