tbuckley/cabot-search huggingface dataset:
Primary Sjögren's Syndrome After Infectious Mononucleosis
Authors: SENGA WHITTINGHAM
Journal: Annals of Internal Medicine (1985)

A healthy young woman developed primary Sjogren's syndrome after protracted infectious mononucleosis. The diagnosis of primary Sjögren's syndrome was supported by histologic evidence of sialadenitis in labial salivary glands, rheumatoid factor, hypergammaglobulinemia, the HLA-B8 phenotype, and a high titer antibody to the La (SS-B) nucleoprotein that co-precipitated the small ribonucleic acids encoded by Epstein-Barr virus, EBER 1 and EBER 2, as well as "host" RNA. There was strong humoral immunity to the Epstein-Barr nuclear and capsid antigens, but weak T-lymphocyte-mediated cytotoxicity to Epstein-Barr-transformed lymphoblasts, anergy to antigens used to elicit delayed-type hypersensitivity, and a low T-helper/T-suppressor cell ratio. The series of events initiated by infectious mononucleosis was attributed to a genetic defect in the immune response. Association of viral RNA with the La nucleoprotein resulted in a break in immunologic tolerance via a T-cell bypass effect with induction of anti-La (SS-B) by polyclonally activated B lymphocytes leading to autoimmune sialadenitis.
A descriptive epidemiology of netball injuries during competition: a five year study.
Authors: D Hopper, B Elliott, J Lalor
Journal: British Journal of Sports Medicine (1995)

OBJECTIVE: To investigate the relation between injury profiles - including assessment, treatment, severity, and the perceived reason for the injury - and participation in competitive netball. METHODS: Between 1985 and 1989, approximately 11,228 netball players participated in a 14 week netball competition held at the major competitive centre in Western Australia; 608 netball players presented to the first aid room with an injury and were assessed and treated by the same physiotherapist and St John First Aid officer. RESULTS: The overall incidence rate during competition was 5.4%, with more injuries occurring in the A grade level of play. Ankle injuries (84%) were most frequent, with 67% of these injuries diagnosed as lateral ligament sprains while a further 10% of players who suffered this classification of injury sustained a fracture to the ankle or foot. Few injuries occurred at the knee joint (8.3%) and only 1.8% of these injuries were diagnosed as an injury to the anterior cruciate ligament. The direct probability of a netball players' risk estimate was 0.054 per person per match which implied that netball was a relatively safe game. Injuries sustained during practice were not included in this study. CONCLUSIONS: Netball is a relatively safe game though the potential for injury increases with the level of competition.
Adrenergic Influences on the Distal Purkinje System of the Canine Heart
Authors: LURA ANN HARRISON, JOHN WITTIG, ANDREW G. WALLACE
Journal: Circulation Research (1973)

The purpose of these experiments was to examine the effects of norepinephrine and propranolol on distal Purkinje fibers of the canine heart. Previous studies have indicated that action potential duration is normally greatest in distal Purkinje fibers 3-4 mm from the Purkinje-muscle junction. In such preparations, premature beats initiated either proximal or distal to the area of maximal action potential duration may propagate with delay or block. Our experiments were performed on the right bundle branch and the distal Purkinje fibers of dog hearts and used standard microelectrode techniques. Premature beats with a coupling interval comparable to the duration of action potentials at the area of maximal duration were conducted with delay. Earlier beats were confined to fibers proximal to the area of maximal action potential duration. Norepinephrine (1 x 10 -5 M ) increased action potential duration in some fibers, consistently prolonged the functional refractory period of distal Purkinje fibers, and produced a marked delay in the propagation of early premature beats. Propranolol (0.25-1.0 mg/liter) shortened action potential duration, shortened the functional refractory period of distal fibers, and reduced or abolished conduction delay and block of early premature beats. These observations suggest that the unique properties of the Purkinje-muscle junction may contribute to the genesis of arrhythmias and that this region is an important site of action of propranolol. The action of propranolol on the Purkinje-muscle junction was dose dependent.
Research on the Mental Health Effects of Terrorism
Authors: Carol S. North, Betty Pfefferbaum
Journal: JAMA (2002)

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
AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATT
Authors: LESTER R. WHITAKER
Journal: Annals of Internal Medicine (1937)

Article1 August 1937AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATTCONGENITAL ADHESIONS OF THE GALL-BLADDER*LESTER R. WHITAKER, M.D., F.A.C.S.LESTER R. WHITAKER, M.D., F.A.C.S.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-2-379 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAbnormal peritoneal attachments to the gall-bladder are more common than inflammatory adhesions. Though often described these congenital adhesions1are not generally recognized, so strong is the obsession in the medical profession that all disturbances of the gall-bladder are inflammatory in origin. Yet, it should be obvious to the careful observer that these sheets of tissue, running from lesser omentum to gall-bladder, duodenum and colon, are simple folds of peritoneum having definite relations, definite structure, and regular arrangement of vessels. They cannot possibly be the result of inflammation. Often with these attachments there is no evidence of a past infection of...Bibliography1. HARRIS ML: Constrictions of the duodenum due to abnormal folds of the anterior mesogastrium, Jr. Am. Med. Assoc., 1914, lxii, 1211-1216. CrossrefGoogle Scholar2. MEYERSBLOOM SGAR: Periduodenitis and pericholecystitis, Arch. Int. Med., 1933, li, 558-570. CrossrefGoogle Scholar3. HOMANS J: A study of the symptoms and treatment of congenital trans-duodenal bands, Boston Med. and Surg. Jr., 1916, clxxv, 665-673. CrossrefGoogle Scholar4. MILLIKENWHITAKER GLR: The clinical use of sodium tetraiodophenolphthalein in cholecystography, Surg., Gynec. and Obst., 1925, xl, 646-653. Google Scholar5. LEVENEWHITAKER GLR: New methods for the clinical study of the gall-bladder, New Eng. Jr. Med., 1930, ccii, 203-214. CrossrefGoogle Scholar6. WHITAKERELLSWORTH LRSW: An improved oral method for cholecystography, New Eng. Jr. Med., 1931, ccv, 1183. CrossrefGoogle Scholar7. WHITAKER LR: The "double-oral" method for cholecystography, Am. Jr. Roent. and Rad. Therapy, 1936, xxxv, 200. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts*Received for publication April 16, 1937.From the Department of Anatomy, Boston University School of Medicine and the Surgical Clinic of Massachusetts Memorial Hospitals, Boston, Mass. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byClinical aspects of cholecystoduodenocolic bandsTraumatic perforation in carcinoma of the oesophagusCholecysto-Duodeno-Colic Ligament Causing High Grade Obstruction of the Duodenum: Report of a CaseObstruction of the large bowel in newborninfants due to congenital bands 1 August 1937Volume 11, Issue 2Page: 379-386KeywordsColonDuodenumHospital medicineInflammationPeritoneumRunning Issue Published: 1 August 1937 PDF downloadLoading ...
Hospitals will be fined for emergency readmissions, says Lansley
Authors: Z. Kmietowicz
Journal: BMJ (2010)

The government is to introduce financial penalties for hospitals who discharge patients before they are fully fit in a bid to reduce the rising number of emergency readmissions.

In his first major speech as health secretary Andrew Lansley said hospitals would take over the responsibility from primary care trusts and GPs of caring for patients during 30 days after discharge and be paid accordingly. But if patients are readmitted with a related problem they will not be paid again for the hospital care they receive.

Mr Lansley said this would improve links between hospital and community services and improve quality and performance. It would also shift the focus to the outcome for the patient, rather than the volume of activity paid to the hospital.

The scheme is designed …
Protein Kinase Cβ Is an Effective Target for Chemoprevention of Colon Cancer
Authors: Alan P. Fields, Shelly R. Calcagno, Murli Krishna, Sofija Rak, Michael Leitges, Nicole R. Murray
Journal: Cancer Research (2009)

Abstract Colon cancer develops over a period of 10 to 15 years, providing a window of opportunity for chemoprevention and early intervention. However, few molecular targets for effective colon cancer chemoprevention have been characterized and validated. Protein kinase CβII (PKCβII) plays a requisite role in the initiation of colon carcinogenesis in a preclinical mouse model by promoting proliferation and increased β-catenin accumulation. In this study, we test the hypothesis that PKCβII is an effective target for colon cancer chemoprevention using enzastaurin (LY317615), a PKCβ-selective inhibitor, in a mouse model of colon carcinogenesis. We find that enzastaurin potently reduces azoxymethane-induced colon tumor initiation and progression by inhibiting PKCβII-mediated tumor cell proliferation and β-catenin accumulation. Biochemically, enzastaurin reduces expression of the PKCβII- and β-catenin/T-cell factor–regulated genes PKCβII, cyclooxygenase II, and vascular endothelial growth factor, three genes implicated in colon carcinogenesis. Our results show that enzastaurin is an effective chemopreventive agent in a mouse model of sporadic colon cancer that significantly reduces both tumor initiation and progression by inhibiting expression of proproliferative genes. Thus, PKCβII is an important target for colon cancer chemoprevention and the PKCβ-selective inhibitor enzastaurin may represent an effective chemopreventive agent in patients at high risk for colon cancer. [Cancer Res 2009;69(4):1643–50]
P202 Studying The Relationship Between Matrix Metalloproteinases And Lung Tissue Damage During A Clinical Exacerbation Of Cystic Fibrosis
Authors: H. Passman, T. Daniels, P. Elkington
Journal: Thorax (2014)

<h3>Background</h3> Cystic Fibrosis (CF) is the commonest fatal autosomal recessive condition of Caucasians. The lung in CF is characterised by chronic bacterial colonisation, inflammation, and lung tissue destruction. Matrix Metalloproteinases (MMPs) are proteases that are expressed in inflammatory states that degrade lung matrix. Whilst MMPs are known to be raised in many inflammatory lung conditions, their role in CF is poorly understood. <h3>Aims</h3> The study aimed to compare lung function and MMP levels throughout an exacerbation. <h3>Methods</h3> Sputum samples and clinical information were obtained with written consent from 23 adult subjects with CF. Samples were collected at day 0, day 14 and week 6 of an exacerbation of CF. Samples were frozen, before Luminex bioassay and IL-8 ELISA was performed. The sputum concentration of MMP 1, 2, 3, 7, 8, 9,10,12,13 and IL-8 were measured. <h3>Results</h3> A statistically significant increase in IL-8 concentration (pg/ml) occurred between day 14 and week 6 (p = 0.0387). The concentration of MMP-9 decreased from day 0 to day 14 (p = 0.006), and then rose significantly between day 14 and week 6 (p = 0.0412). However, the concentration of MMP-9 at week 6 was significantly less than at day 0 (0.0453). A significant decrease in the concentration of MMP-8 occurred between day 0 and day 14 (p = 0.0124); and between day 0 to week 6 (p = 0.0426). <h3>Conclusions</h3> MMPs and other inflammatory markers are raised during exacerbations, and fall with treatment. High proteolytic activity may lead to a worsening lung function and contribute significantly to structural changes within the CF lung. Furthering our understanding of this diverse group of proteases could lead to potential novel therapeutic targets which could help prevent irreversible lung damage.
Clinical Experience With Penicillin Skin Testing in a Large Inner-City STD Clinic
Authors: Jyothi Gadde
Journal: JAMA (1993)

<h3>Objective.</h3> —To establish (1) the prevalence of positive penicillin skin tests among outpatients with well-defined but variable history of penicillin allergy and (2) the reproducibility, safety, and negative predictive value of skin testing with benzylpenicilloyl polylysine (PPL) and a minor-determinant mixture (MDM). <h3>Design.</h3> —Serial consenting outpatients with current indications for penicillin therapy were skin-tested in duplicate with PPL and MDM. Subjects with negative skin tests (93% of those positive by history and 95% of those negative by history) received therapeutic courses of benzylpenicillin (81%) or ampicillin (19%). Negative predictive value of skin testing was established by 72-hour follow-up for adverse reactions to drug. <h3>Setting/Patients.</h3> —A total of 5063 consecutive, qualifying outpatients in a Baltimore, Md, sexually transmitted disease (STD) clinic. The study group was young (73% between 20 and 40 years old), 66% male, and 90% black; 25% had history of atopy. Follow-up was 94% complete. <h3>Results.</h3> —Positive skin tests were observed in 7.1% of 776 individuals with previous history of penicillin allergy and in 1.7% of 4287 subjects negative by history (<i>P</i>&lt;&lt;.001). Previous history of anaphylaxis or urticaria was associated with significantly higher rates of positive skin tests of 17.3% and 12.4%, respectively (<i>P</i>&lt;&lt;.001). Only 4% with history of exanthem had positive skin tests (<i>P</i>=.03). The coefficient of variation for duplicate skin tests was 11%. Time intervals since last penicillin treatment did not influence the rate of positive skin tests. Adverse reactions to skin tests occurred in 13 (1.2% of patients positive by history; 9.4% of those with positive skin tests). A mild anaphylactic reaction occurred in one individual whose preliminary scratch testing was inadvertently omitted; systemic pruritus or urticaria occurred in 11 subjects; one had a large local reaction. After penicillin administration to individuals with negative skin tests, acute allergic reactions occurred in 0.5% of subjects negative by history compared with 2.9% of subjects positive by history (χ<sup>2</sup>=33.3;<i>P</i>=.0001). Reactions were generally mild and self-limited; only two cases of mild anaphylactic reaction occurred, both in patients with history of severe IgE-mediated reaction. <h3>Conclusions.</h3> —Skin testing with both major and minor penicillin determinants is safe using current recommendations, and both reagents are necessary for maximizing the identification of sensitized subjects. Routine penicillin skin testing can facilitate the safe use of penicillin in 90% of individuals with a previous history of penicillin allergy. (<i>JAMA</i>. 1993;270:2456-2463)
Prognostic Significance of Vascular Endothelial Growth Factor Protein in Node-Negative Breast Carcinoma
Authors: G. Gasparini, E. Bonoldi, C. Gatti, O. Vinante, M. Toi, T. Tominaga, M. Gion, R. Dittadi, P. Verderio, P. Boracchi, M. Hanatani, I. Matsubara, H. Suzuki
Journal: JNCI Journal of the National Cancer Institute (1997)

Background: The clinical outcome is generally positive for patients with node-negative breast carcinoma (i.e., those who do not have detectable metastases in the lymph nodes) who have been treated with surgery or surgery plus radiation therapy. In about 30% of the patients, however, the disease recurs, and they are at risk of death. Determination of valid new prognostic indicators would improve the ability to identify patients at high risk of recurrence. Breast cancer can entail substantial development of new blood vessels within the tumor tissue, and it is known that the growth and metastasis of solid tumors are dependent on such angiogenesis. The conversion of tumor cells to an angiogenic phenotype may be preceded by a change in the balance of angiogenic growth factors and angiogenesis inhibitors. Purpose: This study was conducted to determine if the levels of vascular endothelial growth factor (VEGF) protein, a potent endothelial growth factor and mediator of vascular permeability and angiogenesis, measured in the primary tumors of women with node-negative breast cancer are associated with known prognostic factors and patient survival. Methods: By use of a selective enzymatic immunoassay, levels of VEGF protein were measured in cytosolic extracts of primary tumor tissue surgically obtained from 260 women with node-negative breast carcinoma who had been treated with surgery with or without radiation therapy but not with adjuvant therapy and who had been followed for a median time of 66 months. The relationships between VEGF concentrations and other prognostic dichotomous variables or clinical outcome were tested by the use of the Kolmogorov-Smirnov test and univariate and multivariate Cox analyses, respectively. The relationship between VEGF and hormone receptors (i.e., those for estrogen and progesterone) was examined by the use of Spearman's correlation analyses. All P values resulted from the use of two-sided statistical tests. Results: Tumors from 247 (95%) of the 260 patients had detectable VEGF, ranging in concentration from 5.0 to 6523 pg/mg protein (median, 126.25 pg/mg protein). No statistically significant associations were found between VEGF and the other prognostic factors (e.g., age, menopausal status, histologic tumor type, tumor size, and hormone receptors) examined. Levels of VEGF were found to be prognostic for both relapse-free and overall survival in univariate and multivariate analyses (likelihood ratio tests; all four P values <.001). In the multivariate analysis, the first-order interaction term of VEGF and estrogen receptor was also prognostic for overall survival (likelihood ratio test; P = .05). Conclusions: The results show that cytosolic levels of VEGF in tumor tissue samples are indicative of prognosis for patients with node-negative breast carcinoma.
Hemodynamic changes mimicking a vasodilator drug response in the absence of drug therapy after right heart catheterization in patients with chronic heart failure.
Authors: M Packer, N Medina, M Yushak
Journal: Circulation (1985)

We suspected that patients with severe chronic heart failure may show hemodynamic changes after cardiac catheterization in the absence of drug therapy that could complicate assessment of the hemodynamic effects of new vasodilator and inotropic agents. To evaluate this phenomenon prospectively, hemodynamic variables were measured in 21 patients with heart failure 30 min and 2, 6, 24, and (in 12 patients) 48 hr after right heart catheterization, during which time therapy was not altered. During the first 2 hr we noted a significant increase in cardiac index and decreases in left ventricular filling pressure, mean arterial pressure, mean right atrial pressure, and systemic vascular resistance (p less than .01); a further decline in left ventricular filling pressure was noted over the next 24 hr, after which all hemodynamic variables remained stable. The magnitude of these hemodynamic changes resembled the effects of many established vasodilator drugs and was further enhanced after meals. These data indicate that hemodynamic improvement may be observed without any therapeutic intervention during the course of invasive studies in patients with severe chronic heart failure; such changes may lead investigators to attribute efficacy to ineffective drug therapy. To minimize the occurrence of such responses, we recommend that intravascular catheters be inserted the day before drug evaluation and that hemodynamic measurements be made with patients in a postprandial state.
Presynaptic BDNF Required for a Presynaptic but Not Postsynaptic Component of LTP at Hippocampal CA1-CA3 Synapses
Authors: Stanislav S Zakharenko, Susan L Patterson, Ioannis Dragatsis, Scott O Zeitlin, Steven A Siegelbaum, Eric R Kandel, Alexei Morozov
Journal: Neuron (2003)
FDG PET Imaging of Acute Cholecystitis
Authors: Mary T. Kitazono, Patrick M. Colletti
Journal: Clinical Nuclear Medicine (2005)

Recent reports have shown that FDG PET imaging may be useful in distinguishing malignant from benign gallbladder lesions based on the intensity of radiotracer uptake. However, inflammatory and infectious gallbladder lesions may mimic a neoplastic process and are the most common cause of a false-positive FDG PET study. In the current case, the PET findings of ring-like radiotracer uptake in a patient diagnosed with acute cholecystitis are consistent with the few previously reported FDG PET findings of cholecystitis and suggest that the ringed appearance may be an additional clue aiding in the differentiation of cholecystitis from gallbladder carcinoma.
PERCUTANEOUS VASCULAR INTERVENTION MARKET TRENDS: BULLISH ON LEGS, BEARISH ON RENALS- THE BLUE CROSS BLUE SHIELD OF MICHIGAN CARDIOVASCULAR CONSORTIUM EXPERIENCE
Authors: Michael P. Thomas, Yeo Jung Park, Theodore Schreiber, Hitinder Gurm, Dale Leffler, Thomas Davis, Paul Grossman
Journal: Journal of the American College of Cardiology (2014)
ACUTE APPENDICITIS WITH PERFORATION
Authors: R. Randolph Bradham
Journal: JAMA (1960)

A group of 98 patients with appendicitis with perforation was studied to determine symptoms and findings that might help predict perforation in patients suspected of having acute appendicitis. Management of appendicitis with perforation is outlined on the basis of the results in this series. The initial symptom was pain and tenderness in the right lower abdominal quadrant, and it occurred in 97 patients; there was nausea in 82, vomiting in 77, diarrhea in 19, and constipation in 13. Eighty-nine patients had fever, an elevated pulse rate, and an elevated leukocyte count. The duration of symptoms was not informative. The incidence of perforation was much higher in children than adults. There were 30 patients 10 years of age or younger, and 61 were 20 years of age or younger. The authors are inclined to advise immediate operation provided the patient is adequately prepared.