tbuckley/cabot-search huggingface dataset:
OBSERVATIONS ON THE SITES OF REMOVAL OF BACTERIA FROM THE BLOOD IN PATIENTS WITH BACTERIAL ENDOCARDITIS
Authors: Paul B. Beeson, Emmett S. Brannon, James V. Warren
Journal: The Journal of Experimental Medicine (1945)

In 6 patients with bacterial endocarditis studies were made of the bacterial content of arterial and venous blood. Paired samples were collected, approximately simultaneously, from two different locations in the circulatory system, and colony counts were determined. As many as 48 specimens were taken for culture during a single period of study. Venous blood was drawn not only from different locations in the extremities, but also from the superior and inferior venae cavae, the right auricle, and the hepatic and renal veins. As would be expected, colony counts were highest in arterial blood. Blood from the antecubital veins gave colony counts only slightly lower than arterial blood. In the femoral veins, on the other hand, there were appreciably fewer organisms. This difference is attributed to the type of tissues drained by the two veins. Colony counts in blood from the superior and inferior venae cavae were also lower than arterial counts, the ratio being comparable to that found in femoral vein blood. In the renal veins colony counts were only slightly below the arterial level indicating that few organisms are removed from the blood during passage through the kidneys. The greatest reduction in bacterial content was found in hepatic vein blood. In 3 of the 6 subjects this reduction amounted to more than 95 per cent, and in all subjects the difference was very considerable. Mixed venous blood in the right auricle of the heart gave colony counts which were usually one-half to two-thirds as high as in corresponding samples of arterial blood. An interesting finding in these studies was a remarkable constancy of the bacterial content of arterial blood, during periods of 1 or 2 hours. Despite the fact that a considerable portion of the bacteria which leave the heart in arterial blood appear to be removed during a single circuit of the body, the number of bacteria in successive samples of arterial blood shows little change. This indicates that in bacterial endocarditis organisms are discharged into the blood from the endocardial vegetations at a comparatively even rate, rather than in a haphazard fashion as a result of the breaking off of infected particles.
Electronic Health Records and Adolescent Privacy
Authors: Charles G. Kels
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 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
Recovery from pulmonary hypertension in an adolescent with mixed connective tissue disease.
Authors: D M Friedman, H J Mitnick, D Danilowicz
Journal: Annals of the Rheumatic Diseases (1992)

This paper describes the case of an 11 year old girl who presented with mixed connective tissue disease which was complicated by the development of pulmonary hypertension. This case is unique with respect to the young age of onset, the serial non-invasive method used to follow the disease process, and the favourable response to treatment with vasodilator and anti-inflammatory drugs.
Antigen–specific human monoclonal antibodies from mice engineered with human Ig heavy and light chain YACs
Authors: L.L. Green, M.C. Hardy, C.E. Maynard-Currie, H. Tsuda, D.M. Louie, M.J. Mendez, H. Abderrahim, M. Noguchi, D.H. Smith, Y. Zeng, N.E. David, H. Sasai, D. Garza, D.G. Brenner, J.F. Hales, R.P. McGuinness, D.J. Capon, S. Klapholz, A. Jakobovits
Journal: Nature Genetics (1994)
Nonadherence to Imatinib adversely affects event free survival in chronic phase chronic myeloid leukemia
Authors: Prasanth Ganesan, Tenali Gnana Sagar, Biswajit Dubashi, Rejiv Rajendranath, Krishnarathinam Kannan, Sanju Cyriac, Manjunath Nandennavar
Journal: American Journal of Hematology (2011)

There is limited data on the impact of treatment interruptions due to nonadherence in patients with chronic phase chronic myeloid leukemia (CP-CML) treated with Imatinib. We looked at factors (including adherence to therapy) affecting the outcome in a large cohort of patients with CP-CML. All the 516 patients received Imatinib free-of-cost through a company sponsored scheme, which mandated regular three monthly visits for drug procurement. Data regarding the disease characteristics, adherence to treatment and outcomes, were obtained from patients records. Unwarranted interruption of treatment for more than 1 week was defined as nonadherence. With a median follow-up of 39 months, the estimated 5-year event free survival (EFS) was 70.8% (95%, CI = 63.3-78.3). Nearly one-third of the patients (29.6%) were found to be nonadherent at some point during their treatment. On univariate analysis, the factors adversely affecting the EFS were prolonged symptom duration before diagnosis, treatment with hydroxyurea for more than 1 month before start of Imatinib, and nonadherence to therapy. Only nonadherence was significant in multivariate analysis (HR1.6; P = 0.048). The 5-year EFS in adherent and nonadherent patients was 76.7% and 59.8% respectively (P = 0.011, log rank test). Nonadherent patients were less likely to achieve complete cytogenetic responses (26% versus 44%; P = 0.004; χ(2) test) at any point. A significant proportion of patients with CP-CML have drug interruptions due to nonadherence during therapy and this compromises the EFS. Adherence to therapy must be included as an important evaluation parameter in all future studies of CML.
Cerebrospinal Fluid Dynamics in Health and Disease
Authors: George A. Schumacher
Journal: JAMA (1962)

This monograph presents the experimental investigations of 2 centuries, and the important advances of the past decade. Five chapters are devoted to the accumulated evidence on the absorption of cerebrospinal fluid, the production of cerebrospinal fluid, dynamic factors, the mechanics and treatment of hydrocephalus, and to other disorders of cerebrospinal fluid mechanics. Among the older hypotheses some stand as even more likely, whereas other notions must now be abandoned in favor of entirely fresh concepts which have emerged. This work shows how the availability of new materials and new techniques permit the overcoming of obstacles inherent in former methods of investigation. Two factors previously hampered the study of the cerebrospinal fluid system in its natural state—the alteration, through opening the system, of the hydrodynamic conditions under which it normally exists, and the great susceptibility to irritation of the meninges and blood vessels of the neuraxis caused by the introduction of
Academia: the view from below
Authors: B. Chaudhry, P. Winyard, C. Cale
Journal: BMJ (1997)

The problems of training and recruitment of academic medical staff have been the subject of a recent independent working party report1 and several editorials.2 3 All suggest long term changes in the academic career structure, but they fail to address the real life problems of “partially trained” junior doctors currently employed in academic posts. This editorial reflects the views of just such a group of academic trainees engaged in research at the Institute of Child Health and Great Ormond Street Hospital, London, UK. The current uncertainties in academic training have led many of us to question our future in academic medicine, and we suggest that a more structured and consistent approach to the academic career ladder would improve academic recruitment.

Our decisions to embark on academic training were made for a variety of reasons: some aimed to improve career prospects, others relished the intellectual challenge of being at the …
Effect of Host, Tumor, Diagnostic, and Treatment Variables on Outcomes in a Large Cohort With Merkel Cell Carcinoma
Authors: Maryam M. Asgari, Monica M. Sokil, E. Margaret Warton, Jayasri Iyer, Kelly G. Paulson, Paul Nghiem
Journal: JAMA Dermatology (2014)

Merkel cell carcinoma (MCC) is a rare, aggressive, neuroendocrine-derived skin cancer with high rates of recurrence and associated mortality. Few published studies have used comprehensive patient data and long-term follow-up to examine factors that predict MCC outcomes.To characterize MCC in a large defined-population cohort and analyze predictors of disease recurrence and survival.Retrospective cohort study of 218 patients with MCC from the cancer registry of Kaiser Permanente Northern California, a large integrated health care delivery system. Patients were diagnosed as having MCC and followed up from January 1, 1995, through December 31, 2009. We examined host (age, sex, race, and immunosuppression), tumor (anatomic site, size, and extent), diagnostic (results of imaging and pathologic nodal evaluation), and treatment (surgery, radiation therapy, and chemotherapy) variables for their association with MCC outcomes.Host, tumor, diagnostic, and treatment factors.Recurrence (locoregional and distant) of MCC and patient survival (overall and MCC specific).We estimated adjusted hazard ratios (AHRs) and 95% CIs for outcomes using Cox proportional hazards regression models. After adjustment for host, tumor, diagnostic, and treatment variables, tumor extent (categorized as local, regional, and distant) remained significantly associated with all outcomes. Immunosuppression was associated with higher MCC-specific mortality (AHR, 4.9 [95% CI, 1.7-14.4]), and an unknown primary site was associated with a lower risk for distant metastasis (0.1 [0.0-0.7]) and improved survival (0.4 [0.2-0.9]). Pathological nodal evaluation was associated with a lower risk for metastasis (AHR, 0.2 [95% CI, 0.0-1.0]) and improved survival. Radiation treatment was associated with a decreased risk for locoregional recurrence (AHR, 0.3 [95% CI, 0.1-0.6]), whereas chemotherapy was not associated with any alteration in outcomes.Tumor site and extent, results of pathologic nodal evaluation, and the presence of radiation treatment were associated with MCC recurrence. Immunosuppression, tumor extent, and results of pathologic nodal evaluation were associated with MCC-specific survival, whereas chemotherapy was not associated with any outcomes. Our findings may help to inform diagnostic and therapeutic management of MCCs.
A CASE OF ACCIDENTAL ESERIN (PHYSOSTIGMIN) POISONING WITH RECOVERY.
Authors: B. F. STEVENS
Journal: JAMA (1905)

<h3>Patient.</h3> —A woman, aged 28, because of a mistake in telephoning a prescription, received a dose of two grains of eserin sulphate hypodermically, instead of a fiftieth of a grain as was intended. <h3>History.</h3> —I had operated on this patient four hours previously for a double pyosalpinx, and gave the eserin to aid in passing flatus. An hour before receiving the eserin she had been given morphin, ⅛ grain, with atropin, 1/200 grain, for pain. Within two or three minutes after receiving the eserin, she turned purple and her bowels moved profusely and involuntarily. Respirations became shallow, the trachea, pharynx and larynx filled with mucus, and the pulse became imperceptible, even over the carotids. She remained unconscious for about twelve hours. <h3>Treatment.</h3> —The following drugs were given hypodermically in divided doses: Atropin, 1/10 grain; nitroglycerin, 1/30 grain; strychnia, 1/10 grain; brandy, a dram, and aromatic sulphuric acid, a dram; 1,200
Allergic burden and the risk of venous thromboembolism
Authors: Christof J. Majoor, Elisabeth H.D. Bel
Journal: European Respiratory Journal (2013)

Moreover, PE has been reported to occur more frequently than DVT in patients suffering from chronic obstructive pulmonary disease, which is associated with a moderately increased risk of VTE [7].It is possible that the association between severe asthma and PE, but not DVT, reported by MAJOOR et al.[1] had a random component.However, if it is real, the differential effect of severe asthma on PE versus DVT occurrence might indicate that prolonged immobility and hospitalisation had no major impact on the VTE risk in this population, and allergic inflammation per se produces prothrombotic alterations, particularly if combined with the unfavourable effects of corticosteroids.Further investigations are needed to replicate the current findings by MAJOOR et al. [1] and to elucidate their pathogenetic mechanisms, both genetic and environmental, including a potential influence of allergy on thrombosis.
Panic Attacks and Idiopathic Cardiomyopathy
Authors: Jeffrey P. Kahn
Journal: JAMA (1986)

To the Editor.—  Idiopathic cardiomyopathy is a syndrome of progressive myocardial dysfunction, often associated with recurrent myocarditis. 1 Routine psychiatric evaluation of cardiac transplant candidates suggests that many patients with end-stage idiopathic cardiomyopathy have panic disorder. Panic disorder is a syndrome of recurrent episodes of abrupt-onset anxiety, associated with certain symptoms of autonomic arousal. Panic anxiety is readily treated by alprazolam, although not by other benzodiazepines. Preliminary clinical observation of these cardiac transplant candidates suggests that their panic attacks are distinct from, and may precede, initial cardiac symptoms. Some patients also report a history similar to William Harvey's 1649 description of a man overwhelmed with suppressed rage who died with a massively enlarged heart. 2   Report of a Case.—  A 28-year-old man described himself as a former hotheaded rowdy with a history of binge drinking. He changed his behavior when he married six years ago. At about that time, he began
Fundus Functionality and Ghrelin Concentrations after Bariatric Surgery
Authors: Gema Frühbeck, Alberto Diez Caballero, Maria J. Gil
Journal: New England Journal of Medicine (2004)

To the Editor: Circulating ghrelin concentrations have been reported to be suppressed in morbidly obese patients after Roux-en-Y gastric bypass surgery,1 whereas no significant changes have been observed after adjustable gastric banding.2 The placement of an adjustable gastric band is a purely restrictive technique, producing an approximately 30-ml stomach pouch with functional conservation of the fundus. In contrast, gastric bypass surgery leaves a 15-ml pouch near the esophagogastric junction and excludes the major curvature, thus isolating the fundus — the richest source of ghrelin production3 — from direct contact with food. We hypothesized that circulating ghrelin concentrations in patients undergoing . . .
Inappropriate Drug Prescribing
Authors: Frank A. Lederle
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The classification of reserpine as an example of "inappropriate prescribing" by Dr Willcox and colleagues<sup>1</sup>is without justification. Reserpine has been repeatedly shown to be an excellent choice for the treatment of hypertension when used in low doses.<sup>2</sup>A recent large Veterans Affairs Cooperative Study comparing different drugs for hypertension in the elderly concluded that treatment with reserpine plus a thiazide had a number of advantages for elderly patients.<sup>3</sup>
Sleep — A New Cardiovascular Frontier
Authors: Virend K. Somers
Journal: New England Journal of Medicine (2005)

Sleep occupies a third of our lives. The cardiovascular implications of normal and disturbed sleep, and of sleep apnea1 in particular, have only recently gained prominence. Central sleep apnea is characterized by intermittent loss of respiratory drive, resulting in apnea followed by compensatory periods of hyperventilation. Obstructive sleep apnea occurs when mechanisms that maintain upper-airway tone during sleep are dysfunctional, resulting in a narrowing or collapse of the airway. Obstructive sleep apnea is often treatable by some combination of postural change, weight loss, and therapy with continuous positive airway pressure (CPAP); treatment paradigms for central sleep apnea are less clear. . . .
Reflux Drugs Linked to C difficile–Related Diarrhea
Authors: Bridget M. Kuehn
Journal: JAMA (2012)

Patients taking proton pump inhibitors (PPIs) may be at increased risk of Clostridium difficile –associated diarrhea, according to a safety communication from the US Food and Drug Administration (FDA) (http://tinyurl.com/7w5hrwk).
Longitudinal Tracking of Recipient Macrophages in a Rat Chronic Cardiac Allograft Rejection Model With Noninvasive Magnetic Resonance Imaging Using Micrometer-Sized Paramagnetic Iron Oxide Particles
Authors: Qing Ye, Yijen L. Wu, Lesley M. Foley, T. Kevin Hitchens, Danielle F. Eytan, Haval Shirwan, Chien Ho
Journal: Circulation (2008)

Long-term survival of heart transplants is hampered by chronic rejection (CR). Studies indicate the involvement of host macrophages in the development of CR; however, the precise role of these cells in CR is unclear. Thus, it is important to develop noninvasive techniques to serially monitor the movement and distribution of recipient macrophages in chronic cardiac allograft rejection in vivo.We have employed a rat heterotopic working-heart CR model for a magnetic resonance imaging experiment. Twenty-one allograft (PVG.1U-->PVG.R8) and 9 isograft (PVG.R8-->PVG.R8) transplantations were performed. Recipient macrophages are labeled via intravenous injection of micron-sized paramagnetic iron oxide particles (0.9 microm in diameter) at a dose of 4.5 mg Fe per rat 1 day before transplantation. Serial in vivo magnetic resonance images were acquired for up to 16 weeks. The migration of labeled recipient cells in our CR model, in which cardiac CR is evident at 3 weeks and most extensive by 16 weeks after transplantation, can be assessed with the use of in vivo magnetic resonance imaging for >100 days after a single micron-sized paramagnetic iron oxide injection. The location and distribution of labeled recipient cells were confirmed with magnetic resonance microscopy and histology.This approach may improve our understanding of the immune cells involved in CR and the management of heart transplantation. Moreover, this study demonstrates the feasibility of noninvasively observing individual targeted cells over long time periods by serial in vivo magnetic resonance imaging.
Differentiation of chronic lymphocytic leukemia cells after in vitro treatment with epstein‐barr virus or phorbol ester. I. Immunologic and morphologic studies
Authors: Michael J. Deegan, Koichi Maeda
Journal: American Journal of Hematology (1984)

Leukemic cells from ten patients with "nonsecretory," B-type chronic lymphocytic leukemia (CLL) were cultured alone or in the presence of Epstein-Barr virus (EBV) or a phorbol ester (12-0-tetradecanoylphorbol-13-acetate; TPA) for 7 days. At periodic intervals the cell morphology, cytoplasmic immunoglobulin content (direct immunofluorescence) and capacity for immunoglobulin secretion (hemolytic plaque assay) were assessed. A variable but significant number of the TPA-treated CLL cells from all patients expressed cytoplasmic immunoglobulin of a single light-chain type at some stage, usually within the first 3 days. EBV induced similar changes in seven of eight cases tested. Untreated cell cultures were negative or contained a few cytoplasmic immunoglobulin-positive cells. Cells from five of nine cases secreted immunoglobulin of a single light-chain type. In every instance this was identical to the surface and cytoplasmic immunoglobulin. Cytologic changes were observed in the leukemic cells after treatment with one or both agents in nine of ten cases. The major feature was an increase in cell size associated with immunoblastic or plasma-cytoid features. Mitotic figures and binucleate cells were also present. These studies indicate that EBV and TPA are effective at inducing immunoglobulin synthesis and secretion in "nonsecretory" B cell neoplasms and are useful tools for studying the maturation potential inherent in these tumors. The study also suggests that the secreted immunoglobulin is a monoclonal product.
Error and Deception in Science: Essays on Biological Aspects of Life
Authors: William B. Bean
Journal: JAMA (1962)

Those who are not hostile to criticism and are not bewildered by a dour and pessimistic view of the actual accomplishments of science, as compared to its great promise, should get a great deal of pleasure from this series of brilliant critiques and frontal attacks on the complacency which often envelops men who fix their attention so doggedly on minutiae that they lose contact with the real world in which they move. Jean Rostand, the son of the French poet who gave us<i>Cyrano de Bergerac</i>, has achieved distinction as a scientist working in the field of experimental biology. Certain biological aspects of the melancholy longevity of error are explored under the title, The Natural History of Error. Perhaps the most delicious morsel in Rostand's rich banquet of confusion, chaos, and mistakes in science, often propagated unwittingly by true scientists, and even more often perverted by quacks, mystics, and fanatics
The glucose-lowering potential of exendin-4 orally delivered via a pH-sensitive nanoparticle vehicle and effects on subsequent insulin secretion in vivo
Authors: Ho-Ngoc Nguyen, Shiaw-Pyng Wey, Jyuhn-Huarng Juang, Kiran Sonaje, Yi-Cheng Ho, Er-Yuan Chuang, Chia-Wei Hsu, Tzu-Chen Yen, Kun-Ju Lin, Hsing-Wen Sung
Journal: Biomaterials (2011)