tbuckley/cabot-search huggingface dataset:
NHS should replace PIP implants even when privately fitted
Authors: I. Torjesen
Journal: BMJ (2012)

The NHS should replace implants made by the discredited French manufacturer Poly Implant Prosthese (PIP) at the same time as removing them, even when the procedure was carried out by a private provider, MPs have recommended.

PIP closed last year after it emerged that the company had used non-medical grade silicone in its breast implants and women with the implants were advised to seek medical advice on their removal.

Where a private provider no longer exists or refuses to provide treatment, the NHS has agreed to remove the implants but not replace them ( BMJ 2012;344:e478, 17 Jan, doi:10.1136/bmj.e478).

But a report by the Health Select Committee has urged the government to agree a protocol under which a replacement implant can be …
Hypofibrinolysis: A common, major cause of osteonecrosis
Authors: Charles J. Glueck, Richard Freiberg, Helen J. Glueck, Clyde Henderson, Michael Welch, Trent Tracy, Davis Stroop, Tracey Hamer, Felix Sosa, Mark Levy
Journal: American Journal of Hematology (1994)

Abstract In 30 patients with osteonecrosis of the hip (12 idiopathic, 18 secondary), we assessed the role of hypofibrinolysis mediated by high levels of piasminogen activator inhibitor (PAI). We evaluated hypofibrinoiysis as a common, potentially reversible, pathophysiologic cause of idiopathic osteonecrosis. In all 18 patients with secondary osteonecrosis. PAI was normal, as was the ability to activate fibrinoiysis. Nine of the 12 patients with idiopathic osteonecrosis had exceptionally high PA1 levels and could not normally elevate tissue piasminogen activator (tPA‐Fx), the major stimulator of fibrinolysis, after 10 min of venous occlusion at 100 mm Hg. The group of 12 patients with idiopathic osteonecrosis, compared to the 18 with secondary osteonecrosis, had low mean stimulated tPA‐Fx (1.92 vs. 7.6 IU/mi, P .001) and very high stimulated PAI‐Fx (70 vs. 7.6 U/mi, P ⩽ .01). Three of the 12 patients with idiopathic osteonecrosis had both normal PAI and normal Stimulated tPA‐Fx. These three patients and 14 of the 18 with secondary osteonecrosis had high lipoprotein (a) [Lp(a)] (&gt;20 mg/dI). Mean Lp(a) was much higher (60 mg/dI) in the patients with secondary osteonecrosis than Lp(a) (16 mg/dI, P ⩽ .001) in the 12 patients with idiopathic osteonecrosis. These findings suggest that hypofibrinoiysis mediated by high PAI is a common cause of idiopathic osteonecrosis, whereas high Lp(a) may play an etiologic role in secondary osteonecrosis. Prospective studies of patients with high PA1 and/or high Lp(a) should be carried out to assess further their apparently causal roles in osteonecrosis. © 1994 Wiley‐Liss, Inc.
Cryofibrinogenemia Aggravated during Hypothermia
Authors: Samuel Waxman, James T. Dove
Journal: New England Journal of Medicine (1969)

HYPOTHERMIA could be hazardous in patients with malignant disorders because of the frequency of cryofibrinogenemia. It is with this in mind that we report the complication of skin necrosis at the points of contact with a hypothermic blanket in a patient with chronic lymphocytic leukemia, marked cryofibrinogenemia and infection.Case ReportA 59-year-old woman with a 7-year history of chronic lymphocytic leukemia was admitted to Mount Sinai Hospital with cough and fever. Physical examination revealed a temperature of 103°F and petechiae and ecchymoses on the upper and lower extremities. A few fine rales were heard over the right-middle-lung field. There . . .
Human atopic dermatitis complicated by eczema herpeticum is associated with abnormalities in IFN-γ response
Authors: Donald Y.M. Leung, Pei-Song Gao, Dmitry N. Grigoryev, Nicholas M. Rafaels, Joanne E. Streib, Michael D. Howell, Patricia A. Taylor, Mark Boguniewicz, Jennifer Canniff, Brian Armstrong, Daniel J. Zaccaro, Lynda C. Schneider, Tissa R. Hata, Jon M. Hanifin, Lisa A. Beck, Adriana Weinberg, Kathleen C. Barnes
Journal: Journal of Allergy and Clinical Immunology (2011)
Use of insulin as an anabolic agent.
Authors: R T Dawson, M W Harrison
Journal: British Journal of Sports Medicine (1997)

sider it in the same way as any other health problem.This would mean taking into account the factors that encourage it as well as the clinical symptoms, desired effects, immediate or delayed complications, thera- peutic acceptance, and social implications.In other words, doctors must change their attitude to doping in order not to limit this subject merely to a question of a list of banned substances.Moreover, doping should form an integral and specialised part of the studies undertaken by every medical student.This is urgently required considering the fact that doping agents such as anabolic steroids, human growth hormones, and stimulants are also used by people not taking part in sports.
The human NPM1 mutation A perturbs megakaryopoiesis in a conditional mouse model
Authors: Paolo Sportoletti, Emanuela Varasano, Roberta Rossi, Oxana Bereshchenko, Debora Cecchini, Ilaria Gionfriddo, Niccolò Bolli, Enrico Tiacci, Tamara Intermesoli, Pamela Zanghì, Arianna Masciulli, Maria Paola Martelli, Franca Falzetti, Massimo F. Martelli, Brunangelo Falini
Journal: Blood (2013)
Deletion of the epidermal growth factor receptor in renal proximal tubule epithelial cells delays recovery from acute kidney injury
Authors: Jianchun Chen, Jian-Kang Chen, Raymond C. Harris
Journal: Kidney International (2012)

To determine the role of epidermal growth factor receptor (EGFR) activation in renal functional and structural recovery from acute kidney injury (AKI), we generated mice with a specific EGFR deletion in the renal proximal tubule (EGFR(ptKO)). Ischemia-reperfusion injury markedly activated EGFR in control littermate mice; however, this was inhibited in either the knockout or wild-type mice given erlotinib, a specific EGFR tyrosine kinase inhibitor. Blood urea nitrogen and serum creatinine increased to a comparable level in EGFR(ptKO) and control mice 24 h after reperfusion, but the subsequent rate of renal function recovery was markedly slowed in the knockout mice. Twenty-four hours after reperfusion, both the knockout and the inhibitor-treated mice had a similar degree of histologic renal injury as control mice, but at day 6 there was minimal evidence of injury in the control mice while both EGFR(ptKO) and erlotinib-treated mice still had persistent proximal tubule dilation, epithelial simplification, and cast formation. Additionally, renal cell proliferation was delayed due to decreased ERK and Akt signaling. Thus, our studies provide both genetic and pharmacologic evidence that proximal tubule EGFR activation plays an important role in the recovery phase after acute kidney injury.
Preoperative Cardiac Risk Assessment for Patients Having Peripheral Vascular Surgery
Authors: Turnly Wong, Allan S. Detsky
Journal: Annals of Internal Medicine (1992)

To review the methods used for preoperative cardiac risk stratification of patients having peripheral vascular surgery.Relevant studies published before August 1991 were identified using a MEDLINE search of the English-language literature, followed by a manual search of the references of all identified articles.All clinical studies evaluating methods used for preoperative cardiac risk stratification of patients having peripheral vascular surgery.The key data extracted from each article included the inclusion and exclusion criteria of the study patients, the techniques used for testing and the corresponding definitions of positive test results, and the clinical outcomes of the tested patients. Data were analyzed using a Bayesian conceptual framework, and pretest probabilities were converted to post-test probabilities using calculation of likelihood ratios.Patients with high scores on clinical cardiac risk indexes (Goldman index greater than 12 or Detsky index greater than 15), or more than three of the criteria identified by Eagle (age greater than 70 years, diabetes, angina, Q waves on electrocardiogram, or ventricular arrhythmias) are likely to be at higher risk for cardiac death and myocardial infarction after vascular surgery. Those with both low scores and none of Eagle's criteria may be at lower risk, but this result has not been reproduced by independent studies. Neither group of patients would benefit from further investigation for cardiac risk stratification. Patients with one or two of these criteria may be at intermediate risk and would benefit most from further testing for the purposes of risk stratification. Most of the published evidence shows that the absence of redistribution on dipyridamole-thallium scanning identifies a low risk for postoperative cardiac complications, whereas the presence of redistribution predicts a high risk. Preliminary reports suggest that preoperative monitoring for silent myocardial ischemia may also be useful in identifying a high-risk subset of patients.Patients identified clinically to be at either very low or high risk for cardiac complications after peripheral vascular surgery are unlikely to benefit from further risk stratification. Dipyridamole-thallium scanning is the test of choice for further evaluation of patients at intermediate clinical risk because studies have shown that it is sensitive enough to rule out a high-risk status for patients who do not have redistribution.
Medical Education for Women.
Authors: Rosalie M. Ladova
Journal: JAMA (1902)

Chicago, May 22, 1902. <h3>To the Editor:</h3> Your editorial on medical education of women inThe Journal, May 17, is evidently written as a friend, but, I fear, a misguided one. You advocate a special curriculum for women, claiming that their peculiar psychophysical status is not met under the present conditions. You wish to exclude major surgery, on the ground that women lack the courage and quick judgment necessary for this work. Is this true? Any one acquainted with the work of medical women knows better. The matter of adaptation of women to major surgery is a matter of individuality, just as it is with men. There are men who faint at the sight of blood and there are women who can do major surgery. I have seen the late Dr. Marie J. Mergler perform a double ovariotomy, through the abdominal route, in a case of sarcoma of the ovaries,
Cyclophosphamide and Thiotepa With Autologous Bone Marrow Transplantation in Patients With Solid Tumors
Authors: J. P. Eder, K. Antman, A. Elias, T. C. Shea, B. Teicher, W. D. Henner, S. M. Schryber, S. Holden, R. Finberg, J. Chritchlow, M. Flaherty, R. Mick, L. E. Schnipper, E. Frei
Journal: JNCI Journal of the National Cancer Institute (1988)

Autologous bone marrow transplantation to avoid dose-limiting myelosuppression may allow significant drug dose escalations and exploitation of the linear-log correlation between chemotherapy and tumor cytotoxicity. In a phase I trial of cyclophosphamide and thiotepa (with subsequent addition of melphalan), 23 patients were entered; there were two deaths due to toxic effects. The maximum tolerated dose was 6 g of cyclophosphamide/m2 and 720 mg of thiotepa/m2. No significant dose of melphalan could be added. Stomatitis was dose limiting. Eleven of 20 patients who were able to be evaluated responded. Plasma thiotepa concentrations correlated more closely with toxicity and response than with drug dose level. Continuous infusion cyclophosphamide and thiotepa is an active core regimen for the further design of high-dose combination chemotherapy regimens.
Post-Exercise Assessment of Cardiac Repolarization Alternans in Patients With Coronary Artery Disease Using the Modified Moving Average Method
Authors: Michael P. Slawnych, Tuomo Nieminen, Mika Kähönen, Katherine M. Kavanagh, Terho Lehtimäki, Darlene Ramadan, Jari Viik, Sandeep G. Aggarwal, Rami Lehtinen, Linda Ellis, Kjell Nikus, Derek V. Exner
Journal: Journal of the American College of Cardiology (2009)
Response of the rheumatoid synovial membrane to exogenous immunization
Authors: Jerome H. Herman, John Bradley, Morris Ziff, J. Donald Smiley
Journal: Journal of Clinical Investigation (1971)

The secondary immune response to tetanus toxoid in 14 patients with rheumatoid arthritis (RA) has been studied in suspension cultures of peripheral blood lymphocytes (PBL) and synovial membrane obtained at synovectomy. Sequential cultures of PBL from three normal subjects established the optimal time of antibody response at 5 days. At this time, the antitetanus antibody produced was predominantly IgG, comprising half of this immunoglobulin fraction. Rheumatoid synovium synthesized 5-9 times more IgG than PBL, expressed as per cent of total protein synthesis, but only negligible amounts of tetanus antibody. The same results were observed in synovial cultures following repeated immunization and after the additional intra-articular injection of tetanus antigen. This marked limitation of the synovium to respond to exogenous antigen in spite of its large immunoglobulin production was considered consistent with a prior commitment of the synovial lymphoid infiltrate to other antigen.
A Doctor’s Dilemma
Authors: Benjamin Spector
Journal: JAMA (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
A NEW NASAL IRRIGATOR
Authors: Alexander DeSushko
Journal: JAMA (1927)

The value and usefulness of nasal irrigation has been exhaustively discussed and recommended by the most prominent rhinologists since the time of Thudichum and Weber to the present.<sup>1</sup>It is sufficient to mention here such names as: J. Solis Cohen (1872); F. H. Bosworth (1881, 1897); D. B. Kyle (1899 and 1900); De Schweinitz (1899); C. H. Burnett (1893 and 1911); E. L. Shurly (1905); J. Wright and Newcomb (1900); J. J. Kyle (1906); W. L. Ballenger (1908); C. S. Coacley (1923), and A. L. Turner (1925). The observations of such early otologists as Moos of Heidelberg, and Knapp and Roosa of New York, and their followers<sup>2</sup>could not shatter the pure and simple logic of nasal irrigation. Since Weber and Thudichum introduced their method in 1864, a great many "douches" or "irrigators" have been devised. The Surgeon General's Library quotes thirteen patent specifications for irrigation and nebulization
New Light on Neonatal Jaundice
Authors: Roger Lester, Robert F. Troxler
Journal: New England Journal of Medicine (1969)

BILE pigment and light are associated in an ancient and honorable relation. A host of phylogenetically primitive unicellular plants contain pigmented compounds that are nearly identical to bilirubin in their structure and characteristics.1 , 2 In many species of algae, these plant "bile pigments," rather than chlorophyll, are the primary light receptor for the photosynthetic evolution of oxygen.The capacity of bile pigments to "trap light" is related to their molecular structure. Bile pigments are composed of four pyrrole rings (hence the term "tetrapyrrole") linked to each other by carbon bridges (Fig. 1A). The tetrapyrroles that are pigmented have a series . . .
Can We Agree to Disagree?
Authors: Rebecca L. Sudore
Journal: JAMA (2009)

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
Fatal endotoxic shock of biliary tract origin complicating transhepatic cholangiography.
Authors: M R Keighley, G Wilson, J P Kelly
Journal: BMJ (1973)

A case of proved endotoxic shock from the biliary tract after transhepatic cholangiography is reported.We know of no previous report in the literature. Case ReportA 70-year-old man was admitted to hospital with a five-month history of painless jaundice.Previous history included quiescent Pott's disease of the spine, endogenous depression, and Parkin- sonism.Exammation showed obvious jaundice and a pronounced lumbar kyphosis.There was no ascites, hepatosplenomegly, or a palpable abdominal tumour.Haematological investigations were normal.The E.S.R. (Westergren) was 135 mm/in the first hour.Liver function tests were: total bilirubin 150 mg/100 ml (8-5 mg conjugated), alkaline phosphatase 27 K.A. units, SGPT 37 units, phrombin time 17 seconds (control 12 seconds), serum proteins were normal.There was no evidence of occult gastrointestinal bleeding.Liver biopsy showed changes of extrahepatic obstruction.Hypotonic duo- denogphy and pancreatic arteriography were thought to be normal.Arrangements were made for percutaneous transhepatic cholangiography to be followed by laparatomy.The lateral approach was ture of endotoxic shock.Though the cause of these two con- ditions may be similar, the pathogenesis, presentation, and prognosis are quite different (Rogers et al., 1965).This is prob- '4hlv due to toxins released from the bacterial cell wall (Borden an.d Hall, l9si.A from pathogenesis, the mortality of en-
962 Influence of HBV genotype and basal core promoter mutations to PX-induced apoptosis
Authors: T KANDA, O YOKOSUKA, F IMAZEKI, H SAISHO, K NAGAO
Journal: Hepatology (2003)

The aim of this study is to detect the possible association of hepatitis B virus (HBV) core mutation, hepatitis B e antigen (HBeAg) status and the viral load in chronic hepatitis B (CHB) patients. Sixty-six patients with CHB were enrolled. Hepatitis markers and hepatitis C virus antibody (HCV-Ab) were tested using micro particle enzyme immunoassay kits. Viral load was measured by real-time polymerase chain reaction (PCR) and the mutation was analyzed by nested PCR followed by restriction fragment length polymorphism. Most of CHB patients were HBeAg (−ve). The HBeAg status did not have an influence on the presence or absence of T1762/A1764 mutation. HBV-DNA serum level was not significantly different in patients with core mutation and patients without core mutation in HBeAg (−ve) group, while in HBeAg (+ve) group HBV-DNA serum level was significantly higher in patients with core mutation. This study reports the predominance of HBeAg (−ve) and HBV core promoter mutation.
The use of a monoclonal antibody against α-fetoprotein for the radioimmunodetection of hepatocellular carcinoma
Authors: Elsa Springolo, Michael C. Kew, Jan Esser, Margaretha Beyers, Jan D. Conradie, Joseph Levin
Journal: Hepatology (1989)

The purpose of this study was to investigate the use of a radiolabeled mouse monoclonal antibody (and its F(ab′)2 fragment) against α-fetoprotein in the scinti-graphic diagnosis of hepatocellular carcinoma. Twenty-six southern African Blacks and one Caucasian with hepatocellular carcinoma and four patients with other malignant tumors of the liver were studied. Although six hepatocellular carcinomas appeared to selectively concentrate α-fetoprotein antibody, one of these tumors was not producing α-fetoprotein. Moreover, in another 18 patients with α-fetoprotein-producing hepatocellular carcinomas, uptake of α-fetoprotein antibody was at best only equal to that in nontumorous hepatic tissue, and three hepatocellular carcinomas that were not producing α-fetoprotein concentrated the antibody to the same extent as did the α-fetoprotein-producing tumors and hepatic tissue. All four tumors other than hepatocellular carcinoma concentrated α-fetoprotein antibody as well as did hepatic tissue. These findings suggest that the penetration of hepatocellular carcinomas by α-fetoprotein antibody is a passive and nonselective process. This conclusion is supported by an in vitro study in which a non-α-fetoprotein-producing hepatic metastasis took up as much radiolabeled α-fetoprotein antibody as did three of four α-fetoprotein-producing hepatocellular carcinomas. A likely explanation for the failure of α-fetoprotein monoclonal antibody to be selectively concentrated by hepatocellular carcinomas is that α-fetoprotein is an export protein and is not expressed on the cell membranes of malignant hepatocytes.
Baby Doe Five Years Later
Authors: John Lantos
Journal: New England Journal of Medicine (1987)

Five years ago, an unfortunate baby with Down's syndrome and esophageal atresia was allowed to die of starvation in Indiana.1 His death, coming 10 years after the Supreme Court decision that legalized abortion and 2 years into the Reagan administration, triggered a political controversy over the legality and morality of passive euthanasia in the neonatal intensive care unit (NICU). The outcome of this controversy has important implications for child health in this country. I will try to put the controversy into its historical context and to offer a personal interpretation of the outcome.Until the 1970s, passive euthanasia of imperiled . . .