tbuckley/cabot-search huggingface dataset:
Extraordinary Epidemiologic, Environmental Health Experience Emerges From Operation Restore Hope
Authors: Phil Gunby
Journal: JAMA (1993)

SIX MONTHS to the day after US military forces landed in Somalia to "Restore Hope"—as the operation was called—the United Nations is beginning a $1-billion—plus, 6-month to 2-year attempt to keep peace and start to rebuild that country's entire infrastructure, including health services. Health services are particularly important. The numerous diseases endemic to the region have gained an even greater foothold in the chaos since the government of this civil-war-ravaged northeast African coast nation collapsed, and US military medicine participated in rescuing American and other diplomatic personnel (<i>JAMA</i>. 1991;265:1791-1793, 1797; and 266:619-620). A few of the more immediately threatening endemic disorders include acute diarrheal diseases (species of<i>Shigella, Salmonella</i>, and<i>Campylobacter</i>, and<i>Escherichia coli</i>), Congo-Crimean hemorrhagic fever, dengue, louse- or tick-borne typhus, meningococcal meningitis, myiasis (<i>Cordylobia anthropophaga</i>[tumbu fly] larvae infestation), parenterally transmitted acute viral hepatitis (B, C, and D), hepatitis A and E, plague,<i>Plasmodium falciparum</i>(which accounts for
Determination of immunoglobulins responsible for histamine release induced by microbial antigens in AIDS patients
Authors: M. PEDERSEN, H. PERMIN, S. NORN, P. STAHL SKOV
Journal: Allergy (1989)

AIDS patients in contrast to healthy individuals show basophil histamine release by stimulation in vitro of their blood leukocytes with Candida albicans (CA) and Herpes simplex virus Type I (HSV‐I). Passive sensitization of cells from healthy individuals with the patient serum or surface immunoglobulins (Ig) derived from leukocytes of AIDS patients caused histamine release by the following stimulation of the cells with CA or HSV‐I. When IgE was removed from the surface Ig no response was obtained, whereas a removal of IgG did not diminish the response. In contrast, no passive sensitization was obtained by serum derived from healthy individuals. The results show that IgE is responsible for the histamine release caused by CA and HSV‐I in AIDS patients.
Cerebrospinal Fluid in Various Diseases
Authors: M. Locoge, J. N. Cumings
Journal: BMJ (1958)

BRff a smaller trunk in transverse section which was found to be responsible for a rise of 1 cm. of water in gastric pressure on stimulation.If the motor and sensory nerves are ran- domly distributed in both these trunks then it appears that the method as at present used can detect a nerve trunk of about 1/50 the size of an average posterior vagus nerve.Summary A method is described which will detect the presence of even small vagal nerve trunks at the time of operation for vagotomy.If this method is used complete nerve- trunk section can be obtained.We thank Professor Sir Lindor Brown for his advice; Dr. E. L. Harries for his help in the early stages of this work; Mr. H.Tennant and Mr. D
Endothelin association with the cultured rat Kupffer cell: Characterization and regulation
Authors: Katherine Stephenson, Stephen A. K. Harvey, Shamimunisa B. Mustafa, Ann T. Eakes, Merle S. Olson
Journal: Hepatology (1995)

Circulating endothelin (ET) levels are elevated in conditions such as endotoxemia, hepatic ischemia-reperfusion injury, or orthotopic liver transplantation, and this potent peptide may contribute to hepatic pathophysiology. We measured the surface binding of [125I]ET-1 to rat Kupffer cells in primary culture at 4 degrees C; the dissociation constant (Kd) was 270 pmol/L, and the apparent Bmax was 3,000 receptors/cell. At 37 degrees C, total association (surface binding plus internalization) was much greater than at 4 degrees C, indicating that internalization of the receptor-ligand complex is rapid; the apparent Kd was 30 pmol/L, comparable with other reports for hepatic-derived cells. Studies using [125I]ET-1, [125I]ET-3, and specific ET (ant)agonists showed that Kupffer cells possess predominantly ET(B) type receptors. Prior treatment with 500 pmol/L unlabeled endothelin rapidly ( < 15 minutes) occluded 60% of subsequent [125I]ET association; using 5 nmol/L unlabeled ET, this occlusion occurred within 1 minute. [125I]ET association with Kupffer cells was unaffected by short-term (approximately 1 hour) treatment with cyclic adenosine monophosphate (cAMP), but long-term (20 hour) treatment resulted in a twofold increase in [125I]ET association with no change in the apparent Kd. Stimulation of protein kinase C in Kupffer cells by phorbol 12-myristate acetate had a dual regulatory effect on [125I]ET association. Short-term ( < 1 hour) treatment with phorbol 12-myristate acetate decreased [125I]ET-3 association by 50%, whereas prolonged treatment (20 hour) increased association twofold. In both cases, the apparent Kd for [125I]-endothelin was unaltered.
Are second opinions a right or a concession?
Authors: V. Rippere
Journal: BMJ (1995)

technique, and outcome of peripheral thrombolysis for the past two years.2This is a continual process to provide a system for the national audit of peripheral arterial thrombolysis, and so far over 450 events of thrombolysis have been recorded.In these, only 13% of infusions were given with a pulse spray technique, in a median time of six hours (range 1-78 hours).Pulse spray lysis is certainly faster than conventional low dose techniques, but it requires expensive catheters and infusion systems.Other methods, such as high dose bolus thrombolysis and six hourly dose infusions, have also been reported to reduce infusion times without expensive equipment.34Personal communications with the manu- facturers of pulse spray infusion catheters also suggest that relatively few hospitals in Britain use the pulse spray technique.Little information is available on many of the techniques for peripheral thrombolysis, and low dose infusions remain the gold standard for many hospitals in Britain.
Edmund Mervyn Rosser
Authors: Hilary Rosser
Journal: BMJ (2007)

<h3>Abstract</h3> <h3>Objectives</h3> To undertake a preliminary hypothesis-generating analysis exploring putative risk factors for coronavirus diseae 2019 (COVID-19) population-adjusted deaths, compared with non-COVID-19 related deaths, at a local authority district (LAD) level in hospital, care homes and at home. <h3>Design</h3> Ecological retrospective cohort study <h3>Setting</h3> Local authority districts (LADs) in England, Scotland and Wales (Great Britain (GB)). <h3>Participants</h3> All LAD deaths registered by week 16 of 2020. <h3>Main Outcome Measures</h3> Death registration where COVID-19 is mentioned as a contributing factor per 100,000 people in all settings, and in i) cares homes, ii) hospitals or iii) home only, in comparison to non-COVID-19 related deaths. <h3>Results</h3> Across GB by week 16 of 2020, 20,684 deaths had been registered mentioning COVID-19, equivalent to 25.6 per 100,000 people. Significant risk factors for LAD COVID-19 death in comparison to non-COVID-19 related death were air pollution and proportion of the population who were female. Significant protective factors were higher air temperature and proportion of the population who were ex-smokers. Conversely, for all COVID-19 unrelated deaths in comparison to COVID-19 deaths, higher rates of communal living, higher population rates of chronic kidney disease, chronic obstructive pulmonary disease, cerebrovascular disease deaths under 75 and dementia were predictive of death, whereas, higher rates of flight passengers was protective. Looking at individual setttings, the most notable findings in care homes was Scotland being a significant risk factor for COVID-19 related deaths compared to England. For hospital setting, the proportion of the population who were from black and Asian minority ethnic (BAME) groups significantly predicted COVID-19 related death. <h3>Conclusions</h3> This is the first study within GB to assess COVID-19 related deaths in comparison to COVID-19 unrelated deaths across hospital, care homes and home combined. As an ecological study, the results cannot be directly extrapolated to individuals. However, the analysis may be informative for public health policy and protective measures. From our hypothesis-generating analysis, we propose that air pollution is a significant risk factor and high temperature a significant protective factor for COVID-19 related deaths. These factors cannot readily be modelled at an individual level. Scottish local authorities and local authorities with a higher proportion of individuals of BAME origin are potential risk factors for COVID-19 related deaths in care homes and in hospitals, respectively. Altogether, this analysis shows the benefits of access to high quality open data for public information, public health policy and further research.
The remodeling of cardiovascular bioprostheses under influence of stem cell homing signal pathways
Authors: Geofrey De Visscher, An Lebacq, Lindsay Mesure, Helga Blockx, Ilse Vranken, Ruth Plusquin, Bart Meuris, Marie-Christine Herregods, Hans Van Oosterwyck, Willem Flameng
Journal: Biomaterials (2009)
Antinuclear Factors in Rheumatoid Arthritis and Lupus Erythematosus.
Authors: Eugene V. Barnett
Journal: Annals of Internal Medicine (1964)

s1 October 1964Antinuclear Factors in Rheumatoid Arthritis and Lupus Erythematosus.Eugene V. Barnett, M.D., John J. Condemi, M.D., Ralph Jacox, M.D., F.A.C.P., John H. Vaughan, M.D., F.A.C.P.Eugene V. Barnett, M.D.Search for more papers by this author, John J. Condemi, M.D.Search for more papers by this author, Ralph Jacox, M.D., F.A.C.P.Search for more papers by this author, John H. Vaughan, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-4-796_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAntinuclear factors (ANF) have been found in the sera of adults and children with lupus erythematosus (LE) and in a proportion of adults and children with rheumatoid arthritis (RA). This study describes the incidence with which ANF occurs in the three major classes of immunoglobulins, γ2 γ1A, and γ1M globulins in these groups of patients. These findings are correlated with the incidence of rheumatoid factor and the duration and severity of disease.Positive tests for ANF were obtained in 18 of 20 adults with LE, 36 of 132 adults with RA, 8 of 22 children with RA, and 4% of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, N. Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1964Volume 61, Issue 4Page: 796-797KeywordsAtrial natriuretic peptidesChildrenGlobulinsLupus erythematosusRheumatoid arthritis Issue Published: 1 October 1964 PDF DownloadLoading ...
Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection
Authors: Robert J. Fontana, David E. Kleiner, Richard Bilonick, Norah Terrault, Nezam Afdhal, Steven H. Belle, Lennox J. Jeffers, Darmendra Ramcharran, Marc G. Ghany, Jay H. Hoofnagle
Journal: Hepatology (2006)

Assessment of histological stage is an integral part of disease management in patients infected with the hepatitis C virus (HCV). The aim of this study was to develop a model incorporating objective clinical and laboratory parameters to estimate the probability of severe fibrosis (i.e., Ishak fibrosis > or = 3) in previously untreated African American (AA) and Caucasian American (CA) patients with HCV genotype 1. The Ishak fibrosis scores of 205 CA and 194 AA patients enrolled in the Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study (Virahep-C) were modeled using simple and multiple logistic regression. The model was then validated in an independent cohort of 461 previously untreated patients with HCV. The distribution of fibrosis scores was similar in the AA and CA patients as was the proportion of patients with severe fibrosis (35% vs. 39%, P = .47). After accounting for the number of portal areas in the biopsy, patient age, serum aspartate aminotransferase, alkaline phosphatase, and platelet count were independently associated with severe fibrosis in the overall cohort, and the relationship with fibrosis was similar in both the AA and CA subgroups. The area under the receiver operating characteristic curve (AUROC) of the Virahep-C model (0.837) was significantly better than in other published models (P = .0003). The AUROC of the Virahep-C model was 0.851 in the validation population. In conclusion, a model consisting of widely available clinical and laboratory features predicted severe hepatic fibrosis equally well in AA and CA patients with HCV genotype 1 and was superior to other published models. The excellent performance of the Virahep-C model in an external validation cohort suggests the findings are replicable and potentially generalizable.
IOM: Curbing Fake Drugs Will Require National Tracking and Global Teamwork
Authors: Bridget M. Kuehn
Journal: JAMA (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 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
Iatrogenic epilepsy due to antidepressant drugs
Authors: V. Dallos, K. Heathfield
Journal: BMJ (1969)

AN ANALYSIS OF THE CASE HISTORIES OF NINE PATIENTS WHO DEVELOPED EPILEPTIC FITS SHORTLY AFTER STARTING TRICYCLIC ANTIDEPRESSANT DRUGS SHOWED THAT ALL OF THEM HAD ONE OR MORE OF THE FOLLOWING FACTORS: previous or family history of epilepsy, pre-existing brain damage, cerebral arteriosclerosis, alcoholism, withdrawal of barbiturates, and history of previous electric convulsive therapy. Before prescribing antidepressant drugs these factors should be sought for in the history, and if any are present prophylactic anticonvulsant medication is indicated. From a limited experience we do not think that chlordiazepoxide is adequate to counteract the convulsant effect of antidepressant drugs.
Tension Between Quality Measurement, Public Quality Reporting, and Pay for Performance
Authors: Steven A. Farmer, Bernard Black, Robert O. Bonow
Journal: JAMA (2013)

ACCURATE MEASURES OF OUTCOMES ARE NECESSARY TO improve the quality of US health care and address geographic, socioeconomic, and racial/ethnic variations in care quality. However, 2 major initiatives that seek to improve quality—public reporting of outcomes and pay for performance (P4P)—have the potential to reduce the reliabilityof theadministrativedataonwhich theyareoften based and generate spurious estimates of performance.
Technetium-99m Labeled Micro Aerosol “Pertechnegas” A New Agent for Ventilation Imaging in Suspected Pulmonary Emboli
Authors: WILLIAM L ASHBURN, ERNEST V. BELEZZUOLI, WESLEY A. DILLON, BRETT D. MENSH, DENNIS HOOGLAND, DAVID W. YEUNG, GEORGE E. COADE
Journal: Clinical Nuclear Medicine (1993)

In this preliminary study, four patients suspected of having pulmonary emboli underwent ventilation imaging after inhaling approximately 1 mCi (37 MBq) of Tc-99m Pertechnegas (micro aerosol carbon particles labeled with Tc-99m) in five breaths or less. Planar images in multiple projections were recorded for preset counts. A final posterior image was acquired to evaluate residual lung background activity. Immediately following ventilation imaging, perfusion imaging in the identical projections was performed using 4 mCi (148 MBq) of Tc-99m MAA. Two of the four patients demonstrated matched uniform ventilation and perfusion and two showed segmental ventilation-perfusion "mismatched" defects consistent with pulmonary emboli. In each case, residual Pertechnegas background lung activity (count rate) at the end of the last ventilation image was less than 10% of the initial Tc-99m MAA counts (count rate). The advantages of Pertechnegas, in comparison to aerosolized DTPA, include: less residual ventilation image activity superimposed on the MAA perfusion images, reduced demand for patient cooperation due to fewer required breaths (five or less), and lack of deposition of activity in the central airways. The authors conclude that Pertechnegas has properties that make it ideally suited for routine lung ventilation imaging.
Human airway and peripheral blood eosinophils enhance Th1 and Th2 cytokine secretion
Authors: L.‐Y. Liu, S. K. Mathur, J. B. Sedgwick, N. N. Jarjour, W. W. Busse, E. A. B. Kelly
Journal: Allergy (2006)

The effector function of eosinophils involves their release of toxic granule proteins, reactive oxygen species, cytokines, and lipid mediators. Murine studies have demonstrated that eosinophils can also enhance T cell function. Whether human eosinophils, in particular, airway eosinophils, have similar immunoregulatory activity has not been fully investigated. The aim of this study was to determine whether human blood and airway eosinophils can contribute to Th1 and Th2 cytokine generation from CD4+ T cells stimulated with superantigen.Eosinophils were obtained from blood or bronchoalveolar lavage fluid 48 h after segmental allergen bronchoprovocation. Purified eosinophils were co-cultured with autologous CD4+ blood T cells in the presence of staphylococcal enterotoxin B (SEB). Cytokine levels in the supernatant fluid were determined by enzyme-linked immunosorbent assay (ELISA). Eosinophil expression of major histocompatibility complex (MHC) class II and co-stimulatory molecules was assessed by flow cytometry before culture, 24 h after granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulation, and 24 h after co-culture with CD4+ T cells and SEB.Interleukin (IL)-5, IL-13, and interferon (IFN)-gamma generation increased when CD4+ T cells were co-cultured with either blood or airway eosinophils in the presence of SEB. The ability of eosinophils to enhance cytokine generation was independent of their source (blood vs airway), activation by GM-CSF, or detectable expression of human leukocyte antigen (HLA)-DR, CD80, or CD86.Our data demonstrate that SEB-induced generation of Th1 and Th2 cytokines is increased in the presence of human blood and airway eosinophils. Thus, eosinophils can have an immunoregulatory function in pathogen-associated allergic diseases such as atopic dermatitis, chronic sinusitis, and asthma exacerbations.
Decreased Beta-Adrenergic Receptors on Polymorphonuclear Leukocytes after Adrenergic Therapy
Authors: Stanley P. Galant, Lakshmi Duriseti, Sharon Underwood, Paul A. Insel
Journal: New England Journal of Medicine (1978)

β-ADRENERGIC catecholamines, which modulate function of a variety of tissues, are assumed to act by initially binding to receptors on target-cell plasma membranes, thereby activating adenylate cyclase and stimulating generation of adenosine 3′:5′-monophosphate (cyclic AMP). In addition to activating adenylate cyclase, β-adrenergic agonists commonly have a second action — regulation of responsiveness of the target cells. Thus, continued treatment with such agonists often results in decreased cellular response. This self-regulation of target-cell responsiveness, variously termed refractoriness, desensitization and down-regulation, has been observed with catecholamines, as well as with a number of other hormonal agonists.1 2 3 For catecholamines, studies in several experimental . . .
"Doing prescribing": how doctors can be more effective
Authors: G. Elwyn
Journal: BMJ (2003)

What is the best way to achieve concordance? The authors summarise the evidence and indicate the way ahead for doctors to involve patients in making decisions about treatment 

Much prescribed medicine is not taken, and we know that few patients adhere to “prescription” guidance.1 It is also clear that patients' beliefs and attitudes influence how they take drugs.2 This is particularly true for preventive medicine (thus largely for conditions without symptoms) and for drugs that have side effects or other drawbacks. As interest in the concept of patient autonomy increases, we are becoming more aware, and more respectful, of intentional dissent—where better informed patients decline certain drugs.3 Concordance describes the process whereby the patient and doctor reach an agreement on how a drug will be used, if at all. In this process doctors identify and understand patients' views and explain the importance of treatment, while patients gain an understanding of the consequences of keeping (or not keeping) to treatment.



“When we want your opinion, we'll give it to you”

Credit: PUNCH CARTOON LIBRARY



Few well conducted, randomised controlled trials of interventions to help patients follow their prescriptions have been done.4 Our article is based on a number of reviews in this field and a recent systematic review of concordance.1 4–6 Changes in terminology in this area have mirrored an increasing rejection of the power relation implicit in the term “to prescribe.” The authority laden term “compliance” gave way to the view that patients “adhered” (or not) to treatment. Recently the term concordance has been used to describe an agreed plan between patient and doctor about the use of treatment—one of the results of a shared decision making process.7 8

#### Box 1: Concordance tasks

Elicit the patient's views on the possibility of having to take medicine

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Course and outcome of hepatitis C
Authors: Jay H. Hoofnagle
Journal: Hepatology (2002)

The hepatitis C virus (HCV) is a small enveloped RNA virus belonging to the family flaviviridae and genus hepacivirus. The HCV RNA genome is 9,600 nucleotides in length and encodes a single polyprotein that is post-translationally cleaved into 10 polypeptides including t3 structural (C, E1, and E2) and multiple nonstructural proteins ([NS] NS2 to NS5). The NS proteins include enzymes necessary for protein processing (proteases) and viral replication (RNA polymerase). The virus replicates at a high rate in the liver and has marked sequence heterogeneity. There are 6 genotypes and more than 90 subtypes of HCV, the most common in the United States being 1a and 1b (approximately 75%), 2a and 2b (approximately 15%), and 3 (approximately 7%). Acute hepatitis C is marked by appearance of HCV RNA in serum within 1 to 2 weeks of exposure followed by serum alanine aminotransferase (ALT) elevations, and then symptoms and jaundice. Antibody to HCV (anti-HCV) tends to arise late. In acute resolving hepatitis, HCV RNA is cleared and serum ALT levels fall to normal. However, 55% to 85% of patients do not clear virus, but develop chronic hepatitis C. Chronic hepatitis C is often asymptomatic, but is usually associated with persistent or fluctuating elevations in ALT levels. The chronic sequelae of hepatitis C include progressive hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. Extra-hepatic manifestations include sicca syndrome, cryoglobulinemia, glomerulonephritis, and porphyria cutanea tarda. Knowledge of the course and outcome of hepatitis C is important in developing approaches to management and therapy. (Hepatology 2002;36:S21-S29).