tbuckley/cabot-search huggingface dataset:
Crossing the Cultural Chasm
Authors: Paul Roman Chelminski
Journal: Annals of Internal Medicine (2007)

On Being a Doctor3 July 2007Crossing the Cultural ChasmPaul Roman Chelminski, MD, MPHPaul Roman Chelminski, MD, MPHFrom the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-1-200707030-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A colleague requested that I provide general medical care for a friend of his, a French citizen. The patient wanted a physician who would provide medical care in her language. My Francophone credentials derive from my service as a Peace Corps Volunteer some 20 years previously, when I did community development work in the former French colony of Mali in West Africa. Fresh out of college with a major in Medieval and Renaissance Studies, I had not contemplated a career in medicine. Yet, it was there that I had my first clinical encounter—in French.It happened a few days after ... Author, Article, and Disclosure InformationAffiliations: From the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Corresponding Author: Paul Roman Chelminski, MD, MPH, Department of Medicine, Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, 5039 Old Clinic, CB7110, Chapel Hill, NC, 27599; e-mail, [email protected]unc.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 July 2007Volume 147, Issue 1Page: 67-68KeywordsCardiovascular disease riskCardiovascular diseasesCholesterolDecision makingLow density lipoproteinMedical risk factorsMedical servicesMotivationOintmentsSystolic pressure ePublished: 3 July 2007 Issue Published: 3 July 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Syphilis in Pregnancy
Authors: Albert Heyman, John R. McCain
Journal: New England Journal of Medicine (1949)

THE incidence of infantile congenital syphilis has decreased considerably in the United States during the past two decades; nevertheless, cases continue to appear in significant numbers in most city hospitals.1 Approximately 77 living infants with congenital syphilis have been treated at Grady Memorial Hospital in the past four years. Since congenital syphilis is preventable, it is necessary to inquire into the reasons for its continued occurrence.Although several articles on factors influencing the outcome of syphilis in pregnancy have been published, the criteria for diagnosis of infantile congenital syphilis in many of these studies are no longer accepted. Thus, in . . .
Evidence for abnormal regulation of circulating 1 alpha,25-dihydroxyvitamin D in patients with sarcoidosis and normal calcium metabolism.
Authors: P H Stern, J De Olazabal, N H Bell
Journal: Journal of Clinical Investigation (1980)

The effects of vitamin D, 2.5 mg (100,000 U)/d for 4 d, on serum calcium, serum 25-hydroxyvitamin D (25-OHD), and serum 1 alpha,25-dihydroxyvitamin D [1 alpha,25(OH)2D] were compared in 17 normal subjects and 6 patients with sarcoidosis who had normocalcemia and no history of hypercalcemia. The diagnosis was confirmed histologically in each of them. Vitamin D increased mean serum 25-PHD from 30 +/- 4 to 99 +/- 15 ng/ml (P < 0.001) and did not change mean serum 1 alpha,25(OH)2D (32 +/- 3 vs. 29 +/- 3 pg/ml) or mean serum calcium (9.5 +/- 0.1 vs. 9.6 +/- 0.1 mg/dl) in the normal subjects. In contrast, vitamin D increased mean serum 25-OHD from 19 +/- 3 to 65 +/- 19 ng/ml (p < 0.05), increased mean serum 1 alpha,25(OH)2D threefold from 40 +/- 7 to 120 +/- 24 pg/ml, and increased mean serum calcium from 9.4 +/- 0.2 to 9.8 +/- 0.2 mg/dl (P < 0.01). There was a significant positive correlation between the serum 1 alpha,25(OH)2D and serum calcium in these individuals (r = 0.663, P < 0.01) but not in the normal subjects. The results (a) provide further evidence for abnormal regulation of circulating 1 alpha,25(OH)2D in sarcoidosis and (b) indicate that the abnormality may exist in patients with normal calcium metabolism. Thus, the defect in vitamin D metabolism in sarcoid apparently is more common than was previously recognized.
Incidence of Type 2 Diabetes in Individuals With Central Obesity in a Rural Japanese Population: The Tanno and Sobetssu Study
Authors: Eiji Oda
Journal: Diabetes Care (2006)

Ohnishi et al. (1) applied International Diabetes Federation criteria of central obesity for Japanese patients (waist circumference ≥85 cm in men and ≥90 cm in women) in their study evaluating the relative importance of central and general obesity for incidence of type 2 diabetes in Japan. These International Diabetes Federation criteria of abdominal obesity were proposed by the Examination Committee of Criteria for “Obesity Disease” in …
Biochemical selectivity of oral versus intravenous aspirin in rats. Inhibition by oral aspirin of cyclooxygenase activity in platelets and presystemic but not systemic vessels.
Authors: C Cerletti, M C Gambino, S Garattini, G de Gaetano
Journal: Journal of Clinical Investigation (1986)

In rats intravenous aspirin was only slightly more effective an inhibitor of platelet thromboxane B2 (TxB2) than of aorta 6-keto-prostaglandin (PGF)1 alpha generation (1.9 versus 2.1 mg/kg). In contrast, oral aspirin was about five times more effective on platelet than on aorta cyclooxygenase activity. The "biochemical selectivity" of aspirin as an inhibitor of platelet and vascular cyclooxygenase thus was not apparent after intravenous administration of the drug. However, this could be achieved by relatively low doses of oral (or intraduodenal) aspirin, on account of "presystemic" acetylation of platelet cyclooxygenase. Even in this condition, though, aspirin selectivity was relative to "systemic" peripheral vessels but not to the vessels of the enterohepatic circulation. Indeed after an oral or intraduodenal dose of 5 mg/kg aspirin, generation of portal vein 6-keto-PGF1 alpha was inhibited to much the same extent as platelet TxB2, while inferior vena cava 6-keto-PGF1 alpha formation was spared.
β-Blockade Prevents Sustained Metalloproteinase Activation and Diastolic Stiffening Induced by Angiotensin II Combined With Evolving Cardiac Dysfunction
Authors: Hideaki Senzaki, Nazareno Paolocci, Yehezkiel A. Gluzband, Merry L. Lindsey, Joseph S. Janicki, Michael T. Crow, David A. Kass
Journal: Circulation Research (2000)

Abstract —Angiotensin II (Ang II)–mediated sympathostimulation may worsen the progression of cardiac failure, although the nature and mechanisms of such interactions are largely unknown. We previously demonstrated that Ang II combined with evolving cardiodepression (48-hour tachycardia pacing, 48hP) induces marked chamber stiffening and increases metalloproteinases (MMPs). Here, we test the hypothesis that both abnormalities stem from sympathostimulatory effects of Ang II. Forty-eight dogs were instrumented to serially assess conscious ventricular mechanics, MMP abundance and activity, and myocardial histopathology. 48hP combined with 5 days of Ang II (15±5 ng · kg −1 · min −1 IV) more than doubled chamber stiffness (end-diastolic pressure &gt;25 mm Hg, P &lt;0.001), whereas stiffness was unchanged by Ang II or 48hP alone. In vitro and in situ zymography revealed increased MMP abundance and activity (principally 92-kDa gelatinase) from Ang II+48hP. Both stiffening and MMP changes were prevented by cotreatment with high-dose atenolol (which nearly fully inhibited isoproterenol-induced inotropy) but not partial β-blockade. Myocellular damage with fibroblast/neutrophil infiltration from Ang II+48hP was also inhibited by high- but not low-dose atenolol, whereas collagen content was not elevated with either dose. These data support a role of sympathostimulation by Ang II in modulating myocardial MMP abundance and activity and diastolic stiffening in evolving heart failure and suggest a novel mechanism by which β-blockade may limit chamber remodeling and diastolic dysfunction.
Nonalcoholic steatohepatitis (NASH) and occupational exposure: a case-control study among petrochemical workers
Authors: H.P. Cotrim, F.M. Carvalho, L.A. de Freitas, A.M. Silvany-Neto, R. Parana, C.J. de Souza, L. Lyra, Z. Andrade
Journal: Journal of Hepatology (2001)
Cardiac sympathetic neuronal activity and function in the early phase of left ventricular volume and pressure overload
Authors: G.Aemout Somsen, Eric A. Dubois, Kor Brandsma, Jan de Jong, Poll A. van der Wouw, Harry D. Balink, Eric A. van Royen, Kong I. Lie, Pieter A. van Zwieten
Journal: Journal of the American College of Cardiology (1996)
Usefulness of tissue velocity imaging technique in the detection of multi vessel coronary artery disease during dobutamine stress echocardiography
Authors: Yasuaki Wada, Kazuya Murata, Nobuaki Tanaka, Kayo Ueda, Jinyao Liu, Rikimaru Ohyama, Nozomu Harada, Yoko Hamada, Masunori Matsuzaki
Journal: Journal of the American College of Cardiology (2002)
Abstract PD4-5: Longitudinal massively parallel sequencing analysis of circulating cell-free tumor DNA: A feasibility study
Authors: L De Mattos-Arruda, J Cortes, C Saura, P Nuciforo, F-C Bidard, HH Won, B Weigelt, M Berger, J Seoane, JS Reis-Filho
Journal: Cancer Research (2013)

Abstract Background: Plasma-derived cell-free tumor DNA (ctDNA) has been shown to constitute a potential surrogate for tumor DNA obtained from tissue biopsies. We posit that the genetic data obtained from massively parallel sequencing analysis of ctDNA may be more informative than analysis of single tumor tissue biopsies, and would, therefore, constitute a tool to identify the presence of potentially actionable driver somatic genomic alterations, and monitor changes in the genetic landscape during the course of therapy. Methods: Our index case is a patient with an estrogen receptor (ER)+/ HER2 -, highly proliferative, grade 2, mixed ductal/lobular breast cancer and synchronous bone and liver metastases at diagnosis. DNA extracted from archival tumor material and plasma, and from peripheral blood leukocytes was subjected to targeted massively parallel sequencing using a platform comprising 280 cancer genes known to harbor actionable mutations. Multiple plasma samples were collected during the fourth line of treatment with an AKT inhibitor. Results: Average read depths of &amp;gt;100x were obtained from the archival primary tumor sample and between 200x and 900x from the ctDNA samples. Sixteen somatic non-synonymous mutations were detected at high frequencies in all plasma samples, of which 11 (CDKN2A, AKT1, TP53, CDH1, TSC1, NF1, JAK3, ESR1, MML3, EPHB1, PIK3C2G) were also detected in &amp;gt;5% of alleles obtained from the primary tumor sample. Importantly, allelic frequencies of approximately 50% for missense mutations of AKT1(p.E17K) and ESR1(p.E380Q) were detected in the plasma ctDNA, providing strong evidence to suggest that most of the cell-free plasma DNA obtained from this patient was tumor-derived. The allelic frequency of ESR1 in the tumor sample was &amp;lt;5%, whereas for AKT1 it was 80%. In ctDNA samples, there was enrichment for mutant ESR1 alleles as compared to the primary. The mutant allelic frequencies identified in ctDNA samples were reduced following the targeted therapy administered, which mirrored the pharmacodynamic response as assessed by PET-CT. Subsequently, the mutant allelic frequencies were increased again at the time of progression. Single agent treatment with an AKT inhibitor provided benefit in terms of long-lasting biochemical and radiologic responses (stable disease: 8 months) as shown by CA15.3 levels and radiologic assessment (RECIST 1.1), respectively. Conclusions: Targeted capture massively parallel sequencing of plasma-derived ctDNA represents a potential tool to uncover and monitor tumor somatic alterations during the course of targeted therapy. The clinical and therapeutic impact of actionable mutations in luminal/ER+ breast cancers warrants further investigation. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD4-5.
Addition of Clopidogrel to Aspirin and Fibrinolytic Therapy for Myocardial Infarction with ST-Segment Elevation
Authors: Marc S. Sabatine, Christopher P. Cannon, C. Michael Gibson, Jose L. López-Sendón, Gilles Montalescot, Pierre Theroux, Marc J. Claeys, Frank Cools, Karen A. Hill, Allan M. Skene, Carolyn H. McCabe, Eugene Braunwald
Journal: New England Journal of Medicine (2005)

A substantial proportion of patients receiving fibrinolytic therapy for myocardial infarction with ST-segment elevation have inadequate reperfusion or reocclusion of the infarct-related artery, leading to an increased risk of complications and death.We enrolled 3491 patients, 18 to 75 years of age, who presented within 12 hours after the onset of an ST-elevation myocardial infarction and randomly assigned them to receive clopidogrel (300-mg loading dose, followed by 75 mg once daily) or placebo. Patients received a fibrinolytic agent, aspirin, and when appropriate, heparin (dispensed according to body weight) and were scheduled to undergo angiography 48 to 192 hours after the start of study medication. The primary efficacy end point was a composite of an occluded infarct-related artery (defined by a Thrombolysis in Myocardial Infarction flow grade of 0 or 1) on angiography or death or recurrent myocardial infarction before angiography.The rates of the primary efficacy end point were 21.7 percent in the placebo group and 15.0 percent in the clopidogrel group, representing an absolute reduction of 6.7 percentage points in the rate and a 36 percent reduction in the odds of the end point with clopidogrel therapy (95 percent confidence interval, 24 to 47 percent; P<0.001). By 30 days, clopidogrel therapy reduced the odds of the composite end point of death from cardiovascular causes, recurrent myocardial infarction, or recurrent ischemia leading to the need for urgent revascularization by 20 percent (from 14.1 to 11.6 percent, P=0.03). The rates of major bleeding and intracranial hemorrhage were similar in the two groups.In patients 75 years of age or younger who have myocardial infarction with ST-segment elevation and who receive aspirin and a standard fibrinolytic regimen, the addition of clopidogrel improves the patency rate of the infarct-related artery and reduces ischemic complications.
Delayed Treatment and Inadequate Surgical Margins for Invasive Melanoma in Elderly Patients
Authors: John G. Albertini, Nicholas B. Countryman
Journal: JAMA Dermatology (2013)

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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Dermatology journal
T-Strains of Mycoplasma in Bronchopneumonic Lungs of an Aborted Fetus
Authors: N. Romano, F. Romano, F. Carollo
Journal: New England Journal of Medicine (1971)

VARIOUS types of mycoplasma have been found associated with spontaneous abortions during the last few years. Clinical conditions in which they have been observed include premature deliveries with accompanying maternal febrile illness,1 , 2 premature rupture of placental membranes3 , 4 and cases with a history of recurrent reproductive failure.Verifying the effect of mycoplasmas infecting aborted and malformed fetuses, we recovered a T-strain of mycoplasma from the placenta and from the heart and lung of a fetus with intrauterine bronchopneumonia in the fifth month of pregnancy.Materials and MethodsCollection of Internal OrgansThe aborted fetus was carefully opened, and pieces of internal . . .
Are Universal Precautions Effective in Reducing the Number of Occupational Exposures Among Health Care Workers?
Authors: Edward S. Wong
Journal: JAMA (1991)

Using a daily questionnaire, we prospectively studied 277 physicians from two hospital medical services for incidents of exposure to blood and body fluids and barrier use before and after the implementation of universal precautions. We found that implementation significantly increased the frequency of barrier use during exposure incidents from 54% before implementation to 73% after implementation of universal precautions. Implementation led to a decrease in the number of exposure incidents that resulted in direct contact with blood and body fluids (actual exposures), from 5.07 to 2.66 exposures per physician per patient care month, and to an increase in averted exposures in which direct contact was prevented by the use of barrier devices, from 3.41 exposures per patient care month before implementation to 5.90 exposures per patient care month after implementation. Implementation affected neither the types of body fluid or procedures involved nor the overall rate of exposure incidents (8.5 per patient care month) but, through an increase in barrier use, it did prevent direct contact with blood and body fluids and thus converted what would have been an actual exposure into an averted one. We conclude that universal precautions were effective in reducing the risk of occupational exposures among physicians on a medical service.
P658 LOW RISK OF HEPATITIS B VIRUS REACTIVATION IN HBsAg NEGATIVE, ANTI-HBc POSITIVE CARRIERS UNDERGOING RITUXIMAB FOR RHEUMATOID ARTHRITIS
Authors: M. Viganò, V. Varisco, P. Lampertico, A. Batticciotto, A. Mascheroni, P. Gibertini, R. Pellerito, G. Rovera, R. Caporali, M. Todoerti, M. Covelli, A. Notarnicola, M. Colombo, P. Sarzi-Puttini
Journal: Journal of Hepatology (2014)
Alkylmercury Contamination Of Foods
Authors: F. C. Lu
Journal: JAMA (1971)

<h3>To the Editor.—</h3> My attention has recently been drawn to an EDITORIAL entitled "Methylmercury Contamination of Foods" by Eyl (<b>215</b>: 287, 1971), in which the writer refers to the "World Health Organization recommended limit of 0.5 ppm" for mercury in foods. At no time has WHO recommended a limit for mercury in foods. At the 1967 Joint FAO/WHO Meeting on Pesticide Residues the Meeting<i>suggested</i>(but not recommended) practical residue limits of 0.02 to 0.05 ppm of mercury in foods (cereals, fruits, and vegetables) according to local conditions. These levels were suggested as levels which might arise following the use of organomercurial fungicides<i>in agriculture</i>. More recently, the 1970 Joint FAO/WHO Expert Committee on Food Additives made the following statement concerning mercury<i>as a contaminant</i>: There are no data on which to assign an ADI to mercury: this is urgently required as a guide to levels above which food should
The Incidence of Childhood IDDM in New South Wales, Australia
Authors: Charles F Verge, Martin Silink, Neville J Howard
Journal: Diabetes Care (1994)

OBJECTIVE To determine the incidence of insulin-dependent diabetes mellitus (IDDM) in children 0–14 years of age in the state of New South Wales, Australia, which has a total population of 5.73 million. RESEARCH DESIGN AND METHODS We established a prospective register, identifying 361 incident cases over a 2-year period (1990–1991) with two independent sources of case ascertainment. The primary source was the reporting of newly diagnosed patients by physicians and diabetes educators. The secondary source was a subsidized syringe scheme. RESULTS Using the capture-recapture method, ascertainment was estimated to be 99.4% complete. The age-standardized incidence rate was 14.5 per 100,000 person-years (95% confidence interval: 13.0–16.0). No significant differences were found when comparing the first and second years of the register, boys and girls, geographical areas, or Aboriginal and non-Aboriginal children. There was seasonal variation in the onset (with more cases in winter), which was evident in the 10- to 14-year age-group (P = 0.01), but not in younger age-groups. A first-degree relative was already affected in 6.9% of the cases. No significant difference was noted in the age at onset when comparing cases with and without an affected first-degree relative. CONCLUSIONS The incidence of childhood IDDM in New South Wales is similar to rates found in other predominantly Anglo-Saxon populations. IDDM occurs in Aboriginal children with a frequency comparable to that in the rest of the population.
Cognate antigen directs CD8+ T cell migration to vascularized transplants
Authors: Jeffrey M. Walch, Qiang Zeng, Qi Li, Martin H. Oberbarnscheidt, Rosemary A. Hoffman, Amanda L. Williams, David M. Rothstein, Warren D. Shlomchik, Jiyun V. Kim, Geoffrey Camirand, Fadi G. Lakkis
Journal: Journal of Clinical Investigation (2013)

The migration of effector or memory T cells to the graft is a critical event in the rejection of transplanted organs. The prevailing view is that the key steps involved in T cell migration - integrin-mediated firm adhesion followed by transendothelial migration - are dependent on the activation of Gαi-coupled chemokine receptors on T cells. In contrast to this view, we demonstrated in vivo that cognate antigen was necessary for the firm adhesion and transendothelial migration of CD8+ effector T cells specific to graft antigens and that both steps occurred independent of Gαi signaling. Presentation of cognate antigen by either graft endothelial cells or bone marrow-derived APCs that extend into the capillary lumen was sufficient for T cell migration. The adhesion and transmigration of antigen-nonspecific (bystander) effector T cells, on the other hand, remained dependent on Gαi, but required the presence of antigen-specific effector T cells. These findings underscore the primary role of cognate antigen presented by either endothelial cells or bone marrow-derived APCs in the migration of T cells across endothelial barriers and have important implications for the prevention and treatment of graft rejection.
THE VALUE OF HEAT-KILLED CULTURES FOR THE PREVENTION OF THE BACILLUS ABORTUS INOCULATION DISEASE OF GUINEA PIGS
Authors: William A. Hagan
Journal: The Journal of Experimental Medicine (1922)

From the data presented it seems permissible to draw the following conclusions. 1. Guinea pigs cannot be rendered immune to the Bacillus abortus inoculation disease by treatment with heat-killed cultures of this organism. This agrees with the work of Ascoli, and with the general conclusions of many that dead cultures confer very little or no immunity to infectious abortion in cattle. 2. The progress of the disease can be delayed appreciably by such treatment. This is supported by the following observations: (a) the loss in body weight due to the disease is delayed; (b) the development of splenic enlargement is partially inhibited or delayed; (c) the development of renal lesions is delayed or prevented; and (d) the rapidity of multiplication of Bacillus abortus in the splenic pulp is reduced.