tbuckley/cabot-search huggingface dataset:
Problems with Patients: Managing Complicated Transactions
Authors: R. Neighbour
Journal: BMJ (1995)

Kingsley Norton, Sam Smith, Cambridge University Press, pounds sterling14.95, pp 174, ISBN 0 5214 3628 1

In Problems with Patients Kingsley Norton (a consultant psychotherapist) and Sam Smith (a general practitioner in Warrington) have produced an important and timely contribution to the literature of general practice. Important because the ability to emerge unscathed or even satisfied from encounters with a small but familiar coterie of heartsink or “fist-clench” patients is the holy grail every general practitioner longs to lay hands on. Timely because it seems (to me at least) …
Abstract 4371: RRx-001 modulates intratumor blood flow in SCCVII and U87 tumors
Authors: Jan Scicinski, Bryan Oronsky, Shoucheng Ning, Andrew Minchinton, Susan Knox
Journal: Cancer Research (2012)

Abstract The tumor-specific provascular effects of the anti-cancer agent RRx-001, a novel nitrogen oxide donor and allosteric hemoglobin modifier in Phase 1 clinical trials were investigated using contrast enhanced ultrasound (CEUS) and whole tissue section quantitative immunohistological staining. Changes in tumor blood flow by CEUS in SCCVII tumor bearing mice following RRx-001 (3, 6, 12 mg/kg) were dose and time dependent, reaching maximum perfusion 6 h after treatment, returning to baseline within 72 h. Microregional effects of RRx-001 (15 mg/kg) on tumor blood flow and oxygenation by immunohistological staining were studied in mouse SCCVII and human U87 tumors. SCCVII tumors exhibited regions of intermittent perfusion exemplified by co-localization of vessels with the hypoxia marker pimonidazole commonly occurring throughout the tissue. Only 21% of vessels showed perfusion after a bolus dose of the perivascular stain DiOC7. This increased to 28% 12 h post RRx-001. Paradoxically, an increase in tissue oxygenation was not seen while modestly increased pimonidazole binding was observed. However, preliminary radiobiological assessment suggested tumors were radiosensitized when irradiated 10 min after 12 mg/kg RRx-001. In the U87 tumor a decrease in vessel perfusion at 90 min post RRx-001 administration was observed. Blood flow over large areas of treated tumors was completely shut down. These areas stained positive for CD31 and tissue did not appear necrotic. Analysis indicated 25% reduction in the fraction of perfused vessels and un-perfused tissue by area at 90 min returning to near normal levels at 12 h. There was no significant increase in the fraction of necrosis at 12 h suggesting that the large un-perfused regions seen at 90 min had recovered rather than become necrotic. No significant change in tumor hypoxia was seen at 90 min or 12 h. For both tumor types, RRx-001 appeared to cause the loss of perfusion in large regions of the tumor however, at the 12 h time point, both tumor types showed increase in vessel perfusion but no significant decrease in hypoxia. These data suggest a redistribution of blood flow in both tumor types while differences between the tumors were related to tumor architecture and distribution of α-SMA. RRx-001 shows promise for short-term blood flow redistribution in tumors with a pericyte-rich vasculature with contractile proteins such as α-SMA. Expression of α-SMA in tumor vasculature could therefore be useful for predicting tumor response to RRx-001. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4371. doi:1538-7445.AM2012-4371
Random Testing During Training, Competition May Be Only Way to Combat Drugs in Sports
Authors: Virginia S. Cowart
Journal: JAMA (1988)

BRIEFLY LOOKING back while preparing for 1992, physicians say that, other than  highly publicized injury to American diver Greg Louganis, US athletes at  Olympic Games in Seoul were a mostly healthy lot and usually emerged unscathed.  However, James C. Puffer, MD, head physician for  US team, says he was inundated with questions from  news media about drugs. Puffer is an associate professor and chief of family medicine at  University of California at Los Angeles, School of Medicine.  'Greatest Threat'  He calls  drug problem in sports the single greatest threat to  integrity of amateur sport as we know it. He says that the day after [disqualified sprinter] Ben Johnson's test results were announced, we were besieged with calls attempting to confirm that some American athletes had tested positive for drugs, and that made it particularly hectic for us. Although American swimmer Angel Myers was
Rules for Research in Nursing Homes
Authors: George J. Annas, Leonard H. Glantz
Journal: New England Journal of Medicine (1986)

We do not generally think of the residents of nursing homes as research subjects. They reside in institutions having little contact with teaching facilities that do research. As part of our society's indifference to this population, research on their problems has not been encouraged or funded. However, the expanding field of geriatrics and our increasing sensitivity to the needs of the residents of nursing homes have brought a new interest in attempting to ameliorate the problems they face. Properly conducted and monitored research on this population can improve their care and treatment, but it raises critical issues of how to . . .
Eosinophil cationic protein serum levels and allergy in chronic fatigue syndrome
Authors: F. Conti, L. Magrini, R. Priori, G. Valesini, S. Bonini
Journal: Allergy (1996)

Chronic fatigue syndrome (CFS) is a syndrome of uncertain etiopathogenesis characterized by disabling fatigue associated with a variable number of somatic and/or neuropsychologic symptoms. In patients with CFS, several immunologic abnormalities can be detected, including a higher prevalance of allergy. The aim of this study was to determine whether CFS patients, well studied for their allergy profile, show signs of eosinophil activation, as detectable by the measurement in serum of eosinophil cationic protein (ECP) levels. In 35 consecutive CFS outpatients (diagnosis based on the Centers for Disease Control case definition), ECP was measured in serum by a competitive enzyme immunoassay (ECP-FEIA kit, Kabi Pharmacia Diagnostics, Uppsala, Sweden). Fourteen disease-free subjects with no history of CFS or allergy were selected as controls. ECP serum levels were significantly higher in CFS patients than in controls (18.0 +/- 11.3 micrograms/l vs 7.3 +/- 2.1 micrograms/l; P < 0.01). In the CFS population, the prevalence of RAST positivity to one or more allergens was 77%, while no control showed positive RAST. Twelve of the 14 CFS patients with increased ECP serum levels were RAST-positive. However, CFS RAST-positive patients had no significantly higher ECP serum levels than CFS RAST-negative patients (19.3 +/- 12.4 micrograms/l vs 13.6 +/- 3.7 micrograms/l; P = 0.4). This is the first report of increased serum levels of ECP in CFS. On the basis of the available data, it is discussed whether eosinophil activation has a pathogenetic role in CFS or is linked to the frequently associated allergic condition, or, finally, whether a common immunologic background may exist for both atopy and CFS.
Proto-numerosities and concepts of number: Biologically plausible and culturally mediated top-down mathematical schemas
Authors: Rafael E. Núñez
Journal: Behavioral and Brain Sciences (2008)

Abstract Early quantitative skills cannot be directly extended to provide the richness, precision, and sophistication of the concept of natural number. These skills must interact with top-down mathematical schemas, which can be explained by bodily grounded everyday mechanisms for abstraction and imagination (e.g., conceptual metaphor, blending) that are both biologically plausible and culturally shaped (established beyond the child's mind).
Gene-expression profiling and not immunophenotypic algorithms predicts prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy
Authors: Gonzalo Gutiérrez-García, Teresa Cardesa-Salzmann, Fina Climent, Eva González-Barca, Santiago Mercadal, José L. Mate, Juan M. Sancho, Leonor Arenillas, Sergi Serrano, Lourdes Escoda, Salomé Martínez, Alexandra Valera, Antonio Martínez, Pedro Jares, Magdalena Pinyol, Adriana García-Herrera, Alejandra Martínez-Trillos, Eva Giné, Neus Villamor, Elías Campo, Luis Colomo, Armando López-Guillermo
Journal: Blood (2011)
Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of the Platelet Integrin Glycoprotein IIb/IIIa Blocker Integrelin in Elective Coronary Intervention
Authors: James E. Tcheng, Robert A. Harrington, Kandice Kottke-Marchant, Neal S. Kleiman, Stephen G. Ellis, Dean J. Kereiakes, Matthew J. Mick, Frank I. Navetta, Jack E. Smith, Seth J. Worley, Joyce A. Miller, Diane M. Joseph, Kristina N. Sigmon, Michael M. Kitt, Charles P. du Mée, Robert M. Califf, Eric J. Topol
Journal: Circulation (1995)

Background Platelet aggregation and thrombosis have been implicated in the pathogenesis of coronary angioplasty complications. Integrelin, a synthetic cyclic heptapeptide with high affinity and marked specificity for platelet integrin glycoprotein IIb/IIIa, effectively blocks ADP-induced platelet aggregation. Methods and Results In 150 patients undergoing elective percutaneous coronary intervention, random assignment was made to one of three treatment regimens: placebo; a 90-μg/kg bolus of Integrelin before angioplasty followed by a 1.0-μg · kg −1 · min −1 infusion of Integrelin for 4 hours; or a 90-μg/kg bolus followed by a 1.0-μg · kg −1 · min −1 infusion of Integrelin for 12 hours. Patients were followed to 30 days for the composite occurrence of myocardial infarction, stent implantation, repeat urgent or emergency percutaneous intervention or coronary bypass surgery, or death. Pharmacodynamic data were obtained in a subset of 31 patients. Administration of a 90-μg/kg bolus of Integrelin achieved an 86% inhibition of platelet aggregation, and this inhibition was maintained by a 1.0-μg · kg −1 · min −1 infusion. There was a trend toward reduction in end-point events from 12.2% (placebo) to 9.6% (4-hour infusion) to 4.1% (12-hour infusion), although these differences were not statistically significant ( P =.13 for the 12-hour group compared with placebo). Major bleeding occurred in 8%, 8%, and 2% of patients, while minor bleeding was observed in 14%, 33%, and 47% of patients, respectively. There was no difference in bleeding index among groups (1.5, 1.7, and 1.3, respectively), defined as [(change in hematocrit/3)+red blood cell units transfused]. Conclusions This first clinical investigation of Integrelin during routine, elective, low- and high-risk coronary intervention supports the potential efficacy of Integrelin in routine coronary interventions. Pharmacodynamic analyses demonstrate that profound and sustained inhibition of platelet function is achieved, although a higher bolus dose may be required. Definitive assessment of efficacy and safety will need to await a large-scale study powered to achieve statistical significance.
[715] EVALUATION OF LIVER DAMAGE IN HIV-1 -POSITIVE PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) WITH CHRONIC TRANSAMINASES ELEVATION OF UNKNOWN ORIGIN (THE HEALTH STUDY)
Authors: P. Ingiliz, M.A. Valantin, C. Duvivier, A. Simon, S. Dominguez, R. Tubiana, K. Falconer, F. Charlotte, C. Katlama, Y. Benhamou
Journal: Journal of Hepatology (2007)
All-Cause Mortality Trends in a Large Population-Based Cohort With Long-Standing Childhood-Onset Type 1 Diabetes
Authors: Aaron M. Secrest, Dorothy J. Becker, Sheryl F. Kelsey, Ronald E. LaPorte, Trevor J. Orchard
Journal: Diabetes Care (2010)

Although management of type 1 diabetes improved dramatically in the 1980s, the effect on mortality is not clear.We report trends in 30-year mortality using the Allegheny County (Pennsylvania) childhood-onset (age <18 years) type 1 diabetes registry (n = 1,075) with diagnosis from 1965-1979, by dividing the cohort into three diagnosis year cohorts (1965-1969, 1970-1974, and 1975-1979). Local (Allegheny County) mortality data were used to calculate standardized mortality ratios (SMRs).As of 1 January 2008, vital status was ascertained for 97.0% of participants (n = 1,043) when mean age ± SD and duration of diabetes were 42.8 ± 8.0 and 32.0 ± 7.6 years, respectively. The 279 deaths (26.0%) observed were 7 times higher than expected (SMR 6.9 [95% CI 6.1-7.7]). An improving trend in SMR was seen by diagnosis cohort at 30 years of diabetes duration (9.3 [7.2-11.3], 7.5 [5.8-9.2], and 5.6 [4.0-7.2] for 1965-1969, 1970-1974, and 1975-1979, respectively). Although no sex difference in survival was observed (P = 0.27), female diabetic patients were 13 times more likely to die than age-matched women in the general population (SMR 13.2 [10.7-15.7]), much higher than the SMR for men (5.0 [4.0-6.0]). Conversely, whereas 30-year survival was significantly lower in African Americans than in Caucasians (57.2 vs. 82.7%, respectively; P < 0.001), no differences in SMR were seen by race.Although survival has clearly improved, those with diabetes diagnosed most recently (1975-1979) still had a mortality rate 5.6 times higher than that seen in the general population, revealing a continuing need for improvements in treatment and care, particularly for women and African Americans with type 1 diabetes.
Cholecystokinin infusion and gall bladder dysfunction
Authors: G W MIDDLETON, J H WILLIAMS
Journal: Gut (1999)

EDITOR,-In reply, I would like to state that, while we agree that sphincter of Oddi hypertension may be an important contributor to the phenomenon of acalculus biliary pain, the purpose of the CCK provocation test is to select patients who might benefit from cholecystectomy.Whether subselection can be made on the basis of sphincter of Oddi testing remains to be seen but, certainly, the CCK provocation test should not be recommended as a selection tool for symptom relief after a cholecystectomy.
Atrioventricular Nodal Conduction During Atrial Fibrillation
Authors: Stéphane Garrigue, Kent A. Mowrey, Gerard Fahy, Patrick J. Tchou, Todor N. Mazgalev
Journal: Circulation (1999)

Background —Posteroseptal ablation of the atrioventricular node (AVN) has been proposed as a means to slow the ventricular rate during atrial fibrillation (AF). The suggested mechanism is elimination of the AVN “slow pathway.” On the basis of the unpredictable success of the procedure, we hypothesize that, in fact, the slow pathway is preserved. Therefore, the slowing of the ventricular rate results from reduced bombardment of the AVN. Methods and Results —In 8 rabbit heart atrial-AVN preparations, cooling of the posterior and/or the anterior AVN approaches revealed nonspecific effects on the slow and fast pathway portions of the AVN conduction curve. In 13 other preparations, simulated AF during posterior cooling (n=6) prolonged the His-His (H-H) intervals but did not reveal specific slow pathway injury. In the remaining 7 preparations, AF was applied before and after posteroseptal surgical cuts. During AF with posterior origin, the cuts resulted in longer mean H-H along with slowing of the AVN bombardment rate. However, there was no change in the minimum observed H-H, suggesting an intact slow pathway. During AF with anterior origin, the mean and the shortest H-H remained unchanged before and after the cuts in all preparations. This was associated with the maintenance of high-rate AVN bombardment. Conclusions —Posteroseptal ablation does not eliminate the slow pathway. Ventricular rate slowing can be obtained if the ablation procedure results in a posteroanterior intra-atrial block leading to a reduction of the rate of AV nodal bombardment.
403 CLINICALLY SIGNIFICANT VARIABILITY OF LIVER STIFFNESS MEASUREMENTS ALTERS SHORT-TERM FOLLOW-UP OF PATIENTS WITH CHRONIC LIVER DISEASES
Authors: P. Lebray, L. Fedchuk, A. Varaut, P. Ingiliz, Y. Ngo, M. Munteanu, M. de Torres, T. Poynard, V. Ratziu
Journal: Journal of Hepatology (2010)
Population Health and Accountable Care Organizations—Reply
Authors: Douglas J. Noble, Lawrence P. Casalino
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
TCT-836 The impact of biodegradable versus durable polymer drug-eluting stents on stent thrombosis in patients with coronary artery disease: a meta-analysis of 15 randomized trials
Authors: Yao-Jun Zhang, Javaid Iqbal, Christos Bourantas, Shao Liang Chen, Hector Garcia-Garcia, Takashi Muramatsu, Patrick W. Serruys, Dong Sheng-Jie, Bo Xu
Journal: Journal of the American College of Cardiology (2013)
The Hand: Diagnosis and Indications
Authors: Reginald R. Cooper
Journal: JAMA (1977)

To inject still another treatise on a subject about which current writings nearly reach the supersaturation point demands a unique approach. In my opinion, Lister, despite his modest disclaimer that the work is "entirely derivative," has indeed arranged the text in a most informative and novel manner. He has written a book on physical diagnosis as the indispensable prerequisite for managing a variety of hand injuries and diseases. In so doing, he reached his goal of showing how to "arrive at logical decisions based entirely on meticulous examination." The table of contents, with a short, valuable statement summarizing each chapter, provides the first clue that the reader can expect much of this concisely and lucidly written, well-illustrated volume. This initial impression receives rapid confirmation from the superb chapter on injury, which shows how a precise history, knowledge of surface anatomy, and physical diagnosis serve as the basis for a plan
Keeping up with orthopaedic epidemics.
Authors: C Bulstrode
Journal: BMJ (1987)

only in those women who have unremitting dyspareunia associated with focal vulvitis for at least six months.5Dyspareunia is a distressing symptom that may lead to serious conflicts in relationships, and those conflicts are sometimes considered to perpetuate introital pain after conventional treatment has failed.Perhaps, however, failure to examine the vulva adequately has meant that the doctor has failed to diagnose focal vulvitis in such patients.
Complement inhibition decreases the procoagulant response and confers organ protection in a baboon model of Escherichia coli sepsis
Authors: Robert Silasi-Mansat, Hua Zhu, Narcis I. Popescu, Glenn Peer, Georgia Sfyroera, Paola Magotti, Lacramioara Ivanciu, Cristina Lupu, Tom E. Mollnes, Fletcher B. Taylor, Gary Kinasewitz, John D. Lambris, Florea Lupu
Journal: Blood (2010)
Diagnosis of Ischemic Necrosis of the Hip-Reply
Authors: Harry J. Griffiths
Journal: JAMA (1982)

In Reply.—  I would like to make a brief comment on the use of radionuclides in the early diagnosis of avascular necrosis from any cause. There is no consensus on which is the best way to image a femoral head. Dr Easton uses technetium Tc 99m sulfur colloid scanning and gives a reference to one article published in 1977. Although it appears that few other people use this technique, I am grateful that he drew our attention to it. In the two years since I originally wrote my article, nuclear medical techniques have advanced considerably. In our institution we are now using technetium Tc 99m pyrophosphate and taking blood pool types of image using pinhole views immediately after injection as well as taking delayed images. This technique seems to be much more accurate than the previously used techniques in the early diagnosis of avascular necrosis of the femoral head.
Diabetes and Outcome of Community-Acquired Pneumococcal Bacteremia
Authors: Reimar W. Thomsen, Heidi H. Hundborg, Hans-Henrik Lervang, Søren P. Johnsen, Henrik T. Sørensen, Henrik C. Schønheyder
Journal: Diabetes Care (2004)

OBJECTIVE—Patients with diabetes may carry a higher case fatality of invasive pneumococcal infection compared with nondiabetic patients due to decreased immunity, risk of metabolic derangement, or angiopathy. We conducted a population-based cohort study to assess the impact of diabetes on mortality within 90 days in patients with pneumococcal bacteremia. RESEARCH DESIGN AND METHODS—All patients with community-acquired pneumococcal bacteremia in North Jutland County, Denmark, from January 1992 to December 2001 were retrieved from the County Bacteremia Registry. Using civil registry numbers, patients with diabetes were identified by record linkage with the County Prescription Database (for antidiabetic drugs) and the County Hospital Discharge Registry. Mortality within 90 days was determined through the Central Population Registry. Mortality rates were compared for diabetic and nondiabetic patients and adjusted for sex, age, and comorbidity. RESULTS— Among 628 patients aged &amp;gt;15 years with community-acquired pneumococcal bacteremia, 63 (10.0%) had diabetes. The diabetic patients were slightly older (median age 71.7 years) than the nondiabetic patients (67.0 years), and the proportion of patients with comorbidity was higher in the diabetic group (59 vs. 46%). Mortality in diabetic patients compared with nondiabetic patients was 11.1 vs. 16.5% after 30 days and 16.0 vs. 19.5% after 90 days, respectively. After adjustment for sex, age, and comorbidity, the mortality rate ratio for diabetic patients was 0.6 (95% CI 0.3–1.2) compared with the nondiabetic patients. CONCLUSIONS—Diabetic patients with community-acquired pneumococcal bacteremia appear not to have a higher case fatality than nondiabetic patients.
Guidelines for Platelet Transfusion
Authors: Scott Murphy
Journal: JAMA (1988)

Thirty years ago platelet transfusions were not available. Thrombocytopenic bleeding led to morbidity and mortality in patients with aplastic anemia and hematologic malignancies. Now, platelet transfusions generally are as available as any physician wishes. This ready availability and the development of potent antibiotics have allowed hematologists and oncologists to employ increasingly aggressive chemotherapy and radiotherapy in the treatment of a wide variety of malignancies. This in turn has dramatically increased the size of the pool of thrombocytopenic candidates for platelet transfusion. Unfortunately, as this pool expands, the pool of physicians who cared for patients without having platelet transfusions available shrinks. Collectively, we do not remember who really needs a platelet transfusion and who does not. In this issue ofTHE JOURNAL, McCullough et al<sup>1</sup>estimate that our annual national expenditure for platelet transfusion therapy is approximately $100 million. We should ask how much of this money is well spent