tbuckley/cabot-search huggingface dataset:
Calcium polystyrene sulfonate bezoar in the ileum: diagnosis and treatment with double-balloon endoscopy
Authors: Tien Lai, Chia Yang, Fu Siaop, Hsu Yen
Journal: Endoscopy (2013)

An 86-year-old man, admitted for transarterial chemoembolization of a hepatoma, developed fever and acute renal failure following the procedure. He was given antibiotic therapy and oral calcium polystyrene sulfonate (30 g daily) for hyperkalemia. After 1 week, the patient developed bilious vomiting with abdominal pain. An abdominal X-ray disclosed diffuse dilatation of the small bowel ([Fig. 1]) and computed tomography was suspicious for a bezoar in the ileum along with intestinal obstruction ([Fig. 2]). A surgeon was consulted but surgical therapy was declined due to the high surgical risk. The patient received conservative medical therapy but his intestinal obstruction failed to resolve. A decision was made to carry out retrograde enteroscopy to emove the bezoar. When the ileum was entered, we found a large, tubular-shaped, firm yellowish bezoar occupying the intestinal lumen ([Fig. 3] and [Video 1]). There were also some ileal ulcers. Irrigation with water and fragmentation using a snare helped mobilize the bezoar. Multiple small brownish granules were seen after the bezoar was fragmented ([Fig. 4]) and the aspirated fluid contained resin granules. Given the endoscopic findings and the drug history of the patient, he was diagnosed as having a calcium polystyrene sulfonate resin-associated bezoar. Despite the efforts to remove the bezoar, the patient died of multiple organ failure 1 month later.
Urinary Concentrations of Metabolites of Pyrethroid Insecticides in the General U.S. Population: National Health and Nutrition Examination Survey 1999–2002
Authors: Dana Boyd Barr, Anders O. Olsson, Lee-Yang Wong, Simeon Udunka, Samuel E. Baker, Ralph D. Whitehead, Melina S. Magsumbol, Bryan L. Williams, Larry L. Needham
Journal: Environmental Health Perspectives (2010)

Pyrethroid insecticides are the most commonly used residential insecticides in the United States.Our objective was to assess human exposure via biomonitoring to pyrethroid insecticides in a representative sample of the general U.S. population >or= 6 years of age.By using isotope-dilution high-performance liquid chromatography/electrospray chemical ionization/tandem mass spectrometry, we measured five urinary metabolites of pyrethroid insecticides in 5,046 samples collected as a part of the 1999-2002 National Health and Nutrition Examination Survey (NHANES). Univariate, multivariate, and Pearson correlation analyses were performed using SUDAAN and SAS software, incorporating the appropriate sample weights into the analyses. Multivariate analyses included age, sex, race/ethnicity, creatinine, fasting status, and urine collection time as covariates.We detected 3-phenoxybenzoic acid (3PBA), a metabolite common to many pyrethroid insecticides, in more than 70% of the samples. The least-squares geometric mean (LSGM) concentration (corrected for covariates) of 3PBA and the frequency of detection increased from 1999-2000 (0.292 ng/mL) to 2001-2002 (0.318 ng/mL) but not significantly. Non-Hispanic blacks had significantly higher LSGM 3PBA concentrations than did non-Hispanic whites and Mexican Americans in the 2001-2002 survey period and in the combined 4-year survey periods but not in the 1999-2000 survey period. Children had significantly higher LSGM concentrations of 3PBA than did adolescents in both NHANES periods and than adults in NHANES 1999-2000. Cis- and trans-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid were highly correlated with each other and with 3PBA, suggesting that urinary 3PBA was derived primarily from exposure to permethrin, cypermethrin, or their degradates.Pyrethroid insecticide exposure in the U.S. population is widespread, and the presence of its metabolites in the urine of U.S. residents indicates that children may have higher exposures than adolescents and adults.
Acute Bronchospasm Associated With Inhalation of Psyllium Hydrophilic Mucilloid
Authors: Richard Gross
Journal: JAMA (1979)

To the Editor.—  Psyllium powder, a commonly used bulk-forming laxative available without prescription, is infrequently associated with adverse effects. I saw a patient who showed symptoms that were strongly suggestive of acute bronchospasm from occupational inhalation exposure to the drug.  Report of a Case.—  A 21-year-old nurse had been in excellent health except for seasonal rhinitis that occurred for several weeks each spring and that was never associated with wheezing, shortness of breath, or chest discomfort.  In July 1978, shortness of breath, wheezing, and a sensation of tightness developed in her chest within two minutes after mixing psyllium powder for a patient. She had never experienced these symptoms previously, although she had prepared the medication on many occasions. She had never used the medication personally. After several hours of symptoms, she reported to an emergency department, where she was treated with subcutaneous epinephrine and orally administered aminophylline. After three hours
Diagnosis of Lesions on the Lesser Curvature below the Cardia by “Reverse U-turn Method” with the Fiberscope
Authors: T. Hayashi, M. Okada, A. Iwasaki, T. Honda, K. Ariga
Journal: Endoscopy (1971)

The recent progress of stomach endoscopy has made it possible to make 100% precise diagnosis on lesions in the lower part of the stomach. However, those in its upper part, especially on the lesser curvature below the cardia, cannot be observed and photographed well, because they are always in the shadow of the fiberscope itself even if the U-turn method is employed.
Omental Varices Detected on a Radionuclide Gastrointestinal Bleeding Study
Authors: MOZAFAR K. KARIMEDDINI, TIMOTHY J. DAMBRO, MICHAEL P. GABOR, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1992)

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Reversible Restrictive Lung Disease Simulating Asthma
Authors: DAVID W. HUDGEL
Journal: Annals of Internal Medicine (1976)

A young adult woman presented with spontaneous and exercise-induced episodic dyspnea without wheezing. During dyspneic episodes all static lung volumes decreased markedly, the inspiratory capacity fell from 3.0 to 1.1 litres and total lung capacity from 5.3 to 2.6 litres. Airway resistance (Raw) remained normal, and maximal expiratory flows at low absolute lung volume actually increased. Static compliance decreased from 0.153 to 0.077 litre/cmH2O, and the elastic recoil increased from 2.8 to 4.8 cmH2O at 50% of baseline total lung capacity when dyspneic. Upstream airway resistance (Rus) remained unchanged, 1.7 cmH2O/litre/sec. All physiologic variables indicated a reversible restrictive process exists, the origin of which is unclear. It is concluded that the episodic increase in elastic recoil properties results in [1] loss of volume primarily in the alveolar ducts and sacs, [2] preservation of normal Rus by an increase in driving pressure, and [3] maintenance of normal Raw by stabilization of larger airways.
KIAA1509 is a novel PDGFRB fusion partner in imatinib-responsive myeloproliferative disease associated with a t(5;14)(q33;q32)
Authors: R L Levine, M Wadleigh, D W Sternberg, I Wlodarska, I Galinsky, R M Stone, D J DeAngelo, D Gary Gilliland, J Cools
Journal: Leukemia (2004)
Postural influence on maternal capillary oxygen and carbon dioxide tension
Authors: C. K. Ang, T. H. Tan, W. A. W. Walters, C. Wood
Journal: BMJ (1969)

The effect of posture on maternal capillary blood Po<sub>2</sub> and Pco<sub>2</sub> was studied in pregnant and non-pregnant women. There was a significant decrease of Po<sub>2</sub> (mean 13·0 mm. Hg) and significant decrease of Pco<sub>2</sub> (mean 2·4 mm. Hg) when pregnant women sat up, but these changes did not occur in the non-pregnant. These findings may be relevant to debate on the optimum posture for labour.
Sleep-disordered Breathing in Neuromuscular Disease
Authors: Loutfi S. Aboussouan
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Sleep-disordered breathing in neuromuscular diseases is due to an exaggerated reduction in lung volumes during supine sleep, a compromised physiologic adaptation to sleep, and specific features of the diseases that may promote upper airway collapse or heart failure. The normal decrease in the rib cage contribution to the tidal volume during phasic REM sleep becomes a critical vulnerability, resulting in saw-tooth oxygen desaturation possibly representing the earliest manifestation of respiratory muscle weakness. Hypoventilation can occur in REM sleep and progress into non-REM sleep, with continuous desaturation and hypercarbia. Specific characteristics of neuromuscular disorders, such as pharyngeal neuropathy or weakness, macroglossia, bulbar manifestations, or low lung volumes, predispose patients to the development of obstructive events. Central sleep-disordered breathing can occur with associated cardiomyopathy (e.g., dystrophies) or from instability in the control of breathing due to diaphragm weakness. Mitigating factors such as recruitment of accessory respiratory muscles, reduction in REM sleep, and loss of normal REM atonia in some individuals may partially protect against sleep-disordered breathing. Noninvasive ventilation, a standard-of-care management option for sleep-disordered breathing, can itself trigger specific sleep-disordered breathing events including air leaks, patient-ventilator asynchrony, central sleep apnea, and glottic closure. These events increase arousals, reduce adherence, and impair sleep architecture. Polysomnography plays an important role in addressing pitfalls in the diagnosis of sleep-disordered breathing in neuromuscular diseases, identifying sleep-disordered breathing triggered by noninvasive ventilation, and optimizing noninvasive ventilation settings.
STUDIES ON EXPERIMENTAL PNEUMONIA
Authors: Russell L. Cecil, Francis G. Blake
Journal: The Journal of Experimental Medicine (1920)

1. Virulent influenza bacilli, when injected into the nose and throat of monkeys (Cebus capucinus and Macacus syrichtus), excite an acute inflammation of the upper respiratory tract, characterized by swelling and hyperemia of the mucous membrane, infiltration of the mucosa and subrnucosa with leucocytes, desquamation of epithelial cells, and the production of a mucopurulent exudate. The accessory sinuses are often implicated in the infection. 2. Experimental Bacillus influenzae infections of the upper respiratory tract are frequently accompanied or followed by bronchiolitis, peribronchial infiltration, and bronchopneumonia with hemorrhage and edema in the early stage, emphysema and bronchiectasis in the later stages. In general, the process closely resembles uncomplicated Bacillus influenzae pneumonia in man. 3. The injection of virulent influenza bacilli directly into the trachea of monkeys induces in them an experimental bronchiolitis and hemorrhagic bronchopneumonia, similar in all respects to spontaneous Bacillus influenzae pneumonia. 4. In experimental Bacillus influenzaeinfections of either the upper or lower respiratory tract the influenza bacillus can usually be recovered during .the acute stage by culture, either pure or in association with other bacteria. 5. In experimental Bacillus influenzae infections in monkeys characteristic changes occur in the thymus gland-hyperplasia of the follicles, distention of the lymphatic channels, and infiltration of the parenchyma with leucocytes. This enlargement appears to be merely part of a general hyperplasia of the lymphoid structures in the cervical and thoracic regions.
Neutropenia during combination therapy of interferon alfa and ribavirin for chronic hepatitis C
Authors: Alejandro Soza, James E. Everhart, Marc G. Ghany, Edward Doo, Theo Heller, Kittichai Promrat, Yoon Park, Jake T. Liang, Jay H. Hoofnagle
Journal: Hepatology (2002)

Interferon therapy of hepatitis C causes a decrease in neutrophil counts, and neutropenia is a common reason for dose adjustment or early discontinuation. However, it is unclear whether neutropenia caused by interferon is associated with an increased rate of infection. In this study, we assessed factors associated and clinical consequences of neutropenia before and during interferon therapy of chronic hepatitis C. A total of 119 patients with chronic hepatitis C treated with the combination of interferon alfa and ribavirin were analyzed. In these studies, neutropenia was not used as an exclusion or dose modification criterion. In multivariate analysis, only black race was associated with baseline neutropenia. During treatment, neutrophil counts decreased by an average of 34%. Among 3 blacks with baseline neutropenia without cirrhosis or splenomegaly, there was little or no decrease in neutrophil counts (despite typical decreases in platelet and lymphocyte counts). Documented or suspected bacterial infections developed in 22 patients (18%), but in no patient with neutropenia. United States population estimates suggest that 76,000 blacks with hepatitis C have neutrophil counts below 1,500 cells/μL and might be denied therapy if this exclusion criterion was generally applied. In conclusion, neutropenia is frequent during treatment of hepatitis C with interferon and ribavirin, but it is not usually associated with infection. Constitutional neutropenia, which is common among blacks, should not exclude patients from therapy with interferon as these patients usually have minimal further decreases in neutrophil counts on therapy and are not excessively prone to bacterial infections.
Blood Transfusion and Cardiac Surgery—Reply
Authors: Ludhmila A. Hajjar
Journal: JAMA (2011)

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
Changes in Hospital Mortality Rates in 425 Patients With Acute ST-Elevation Myocardial Infarction and Cardiac Rupture Over a 30-Year Period
Authors: Jaume Figueras, Oscar Alcalde, José A. Barrabés, Vicens Serra, Joan Alguersuari, Josefa Cortadellas, Rosa-Maria Lidón
Journal: Circulation (2008)

Background— Possible changes in the incidence and outcome of cardiac rupture in patients with ST-elevation myocardial infarction over a long period of time have not been investigated. Methods and Results— The incidence of cardiac rupture in ST-elevation myocardial infarction patients and its mortality rate were investigated during a 30-year period divided into 5 intervals (1977 to 1982, 1983 to 1988, 1989 to 1994, 1995 to 2000, and 2001 to 2006). Of a total of 6678 consecutive patients, 425 experienced a free wall rupture (280 with cardiac tamponade: 227 with electromechanical dissociation and 53 with hypotension) or a septal rupture (145). After the exclusion of referrals from other centers (n=44), the incidence of definite cardiac rupture (septal rupture, anatomic evidence of free wall rupture, or electromechanical dissociation) declined progressively (6.2% in 1977 to 1982 to 3.2% in 2001 to 2006; P &lt;0.001) in parallel with a progressive use of reperfusion therapy (0% to 75.1%; P &lt;0.001). In addition, among patients with cardiac rupture, there was a progressive fall in the rate of death (94% to 75%; P &lt;0.001) despite a trend toward increasing age (66±8 to 75±8 years; P &lt;0.054) in conjunction with better control of systolic blood pressure at 24 hours (130±24 versus 110±18 mm Hg; P &lt;0.001); an increased use of reperfusion therapy (0% to 59%; P &lt;0.001), β-blockers (0% to 45%; P &lt;0.001), angiotensin-converting enzyme inhibitors (0% to 38%; P &lt;0.001), and aspirin (0% to 96%; P &lt;0.001); and a lower use of heparin (99% to 67%; P &lt;0.001). Conclusion— The decline in the incidence in cardiac rupture and its rate of death over the last 30 years appears to be associated with the increasing use of reperfusion strategies and adjunct medical therapy.
THE PREVAILING PANDEMIC OF INFLUENZA
Authors: J. J. KEEGAN
Journal: JAMA (1918)

During the past two weeks, August 28 to September 11, there has begun a severe and rapidly spreading epidemic of influenza in the First Naval District. More than 2,000 cases have been reported in these two weeks, and there are indications of a rapid spread of the infection. This is undoubtedly the same disease which, first heard of in Spain last spring, and hence called Spanish influenza, has in recent months spread over nearly all of Europe, including Germany, Italy, France, England and Ireland, attacking from 30 to 40 per cent. of the people. The outstanding feature of this epidemic is its high degree of communicability; in fact, in pandemics of this nature, influenza is the most contagious of all infections. The last pandemic (1889-1890) also moved from east to west along the lines of travel. We, therefore, have every indication that this outbreak will soon spread all over the
Special clinics are inappropriate for treating depression
Authors: R. Churchill
Journal: BMJ (2000)

EDITOR—Kendrick proposes introducing special clinics for the management of depression in general practice because depression is a chronic remitting condition.1 He draws analogies with other chronic conditions such as diabetes and asthma, where care is often provided in clinics devoted to the management of the specific condition. His argument is flawed on several counts.

Firstly, diabetes and asthma are relatively homogeneous physical illnesses for which there are acceptable treatments, objective measures of control, defined management targets, and some knowledge …
Return of normal conduction after paroxysmal heart block. Report of a case with major discordance of electrophysiological and pathological findings.
Authors: K M Rosen, D Wu, C Kanakis, P Denes, S Bharati, M Lev
Journal: Circulation (1975)

This report describes a 52-year-old male with paroxysmal heart block as well as left and right bundle branch block, resulting in Stokes-Adams attacks. The patient experienced a return to 1:1 atrioventricular (A-V) conduction with narrow QRS within 48 hours of the attacks and heart block never recurred. Electrophysiological studies three weeks later revealed a narrow QRS, a normal H-V interval (36 msec), 1:1 A-V conduction up to an atrial paced rate of 210 beats/min, and normal refractory periods with atrial extrastimulus techniques (His-Purkinje system refractory periods less than 370 msec). The patient died from a cerebral embolus incurred during diagnostic left heart catheterization two days after electrophysiological studies. Postmortem examination revealed calcific aortic stenosis with calcific impingement upon the pars membranacea resulting in compression of the distal His bundle and marked disruption of the proximal portions of both bundle branches. This report documents a major limitation of electrophysiological studies, this limitation being that these studies may be totally normal on one occasion in a patient with pathologically significant chronic conduction disease, which may become clinically manifest on another occasion.
IMPACT OF LOADING CONDITION ON THE TWO-DIMENSIONAL SPECKLE TRACKING-DERIVED LEFT VENTRICULAR DYSSYNCHRONY INDEX IN NON-ISCHEMIC DILATED CARDIOMYOPATHY
Authors: Hyung-Kwan Kim, Hyo-Eun Park, Sung-A Chang, Ji-Hyun Kim, Myung-Ki Seo, Yong-Jin Kim, Goo-Yeong Cho, Dae-Won Sohn, Byung-Hee Oh, Young-Bae Park
Journal: Journal of the American College of Cardiology (2010)