tbuckley/cabot-search huggingface dataset:
The hematologic consequences of transjugular intrahepatic portosystemic shunt
Authors: A J Sanyal, A M Freedman, P P Purdum, M L Shiffman, V A Luketic
Journal: Hepatology (1996)

Transjugular intrahepatic portosystemic shunts (TIPS) are a recent innovation in the management of portal hypertension. In 1992, we had previously described an instance of severe hemolysis associated with this procedure. This study was undertaken to define and quantify the true incidence of TIPS-associated hemolysis and its clinical spectrum, as well as to test the hypothesis that portal decompression by TIPS would ameliorate hypersplenism in patients with portal hypertension. A total of 60 patients undergoing TIPS for prevention of recurrent variceal hemorrhage (n = 40) or refractory ascites (n = 20) were studied. Forty patients with cirrhosis who were followed concurrently served as controls. At entry, both groups were comparable with the exception of increased ascites in the TIPS group. A total of 7 instances of intravascular hemolysis were identified in 60 TIPS patients, whereas none occurred in controls. Of these, 4 patients were asymptomatic and detected on routine laboratory testing. Hemolysis led to a greater than 4-g/dL decrease in hemoglobin in 2 patients, 2- to 3-g/dL decrease in 2 others and a 3- to 4-gm/dL decrease in 1 patient. Two patients were able to compensate for hemolysis and did not develop anemia. In all but 1 case, the findings of hemolysis subsided by 12 to 15 weeks; in 1 patient, orthotopic liver transplantation was associated with resolution of the hemolysis. Overall, no significant changes in white blood cell or platelet counts were observed in patients undergoing TIPS despite adequate portal decompression. We conclude that TIPS-induced hemolysis occurs in approximately 10% of subjects. However, it is self-limited and rarely requires intervention. Potential mechanisms of such hemolysis are discussed. TIPS is also not recommended as a means of improving platelet counts in patients with severe hypersplenism.
Comparison of prostaglandins, leukotrienes, and reactive oxygen intermediates phoduction by Kupffer cells isolated from normal and from cirrhotic rat livers
Authors: J.M. Combis, B. Pipy, J.P. Vinel, M.F. Forgue, M. Béraud, H. Desmorat, M.C. Souqual, P. Calès, J.P. Pascal
Journal: Journal of Hepatology (1990)
Evolution, the emotions, and rationality in social interaction
Authors: David J. Butler
Journal: Behavioral and Brain Sciences (2003)

Although Colman's criticisms of orthodox game theory are convincing, his assessment of progress toward construction of an alternative is unnecessarily restrictive and pessimistic. He omits an important multidisciplinary literature grounded in human evolutionary biology, in particular the existence and function of social emotions experienced when facing some strategic choices. I end with an alternative suggestion for modifying orthodox game theory.
Duration of QRS Complex
Authors: GALEN S. WAGNER
Journal: Circulation (1973)

the A-V block occurs at the level of the bundle branches the deficit in blood supply must be in both the anterior and posterior circulations of the heart since branches to this area are supplied from both anterior and posterior perforating arteries.Thus involvement of both bundles necessarily implies extensive myocardial damage.1-Inour experience, patients with A-V block having a widened QRS all developed cardiac failure or shock even if these complications were not present at the moment of the onset of the block.Regardless of the electrocardiographic location of the infarction, the mortality rate despite pacing is about 90%.
Does Acyclovir Worsen Late Varicella?
Authors: Mark R. Wallace
Journal: Annals of Internal Medicine (1993)

Letters1 March 1993Does Acyclovir Worsen Late Varicella?Mark R. Wallace, MD, Stephanie K. Brodine, MD, and Edward C. Oldfield, MDMark R. Wallace, MDSearch for more papers by this author, Stephanie K. Brodine, MDSearch for more papers by this author, and Edward C. Oldfield, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-5-199303010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Klein's comments on our recent article. We also were puzzled by the statistically significant differences in new lesion formation and maximum number of lesions favoring placebo in the late treatment group (24 to 72 hours after rash onset). We suspect that these differences are partially the result of the randomization of a relatively small group of patients (72) yielding a late placebo group with a lesion count at entry of 20% less than that of the acyclovir group. Not surprisingly, given their initially lower lesion counts, the placebo group had a lower maximum number of ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1993Volume 118, Issue 5Page: 394-395KeywordsFeversLesionsRashes Issue Published: 1 March 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Healing the Wounds
Authors: James Curran
Journal: BMJ (2007)

David Hilfiker wrote Healing the Wounds in 1982; it is based on his experience of working in rural medicine in the 1970s in Grand Marais, a small town in Minnesota, USA, whose population in the summer months is supplemented by an influx of tourists. The book largely consists of a collection of anecdotal descriptions of semi fictionalised cases of patients he treated.

From the description so far, and a familiarity with the sort of autobiographical books doctors tend to write, one could expect a …
A FATAL REACTION TO METHAPYRILENE (THENYLENE®)
Authors: HUGH F. RIVES
Journal: JAMA (1949)

Methapyrilene hydrochloride is N,N-dimethyl-N′-(2-pyridyl)-N′-(2-thenyl) ethylenediamine hydrochloride (thenylene hydrochloride®, Abbott) and is an antihistaminic drug. Since the antihistaminic drugs have become available to the members of the medical profession, both the lay press and many physicians have hailed these preparations as practically nontoxic and as the solution to most allergic problems. That present indiscriminate use of these antihistaminic agents needs a critical review is evidenced in the literature. Although we have found no report of a fatality, there have been serious reactions. Roth and co-workers<sup>1</sup>from the Abbott Laboratories reported the pharmacologic properties of methapyrilene. On isolated portions of ileum in the guinea pig and rabbits, they demonstrated that this drug definitely prevented or abolished the spasmproducing activity of histamine. They also demonstrated its inhibitory action on anaphalaxis in the serum-sensitized guinea pig. The authors, in discussing acute toxicity in experimental animals, noted excitation followed by convulsions. In cats and
Expanding the Treatment Options for Influenza
Authors: Richard P. Wenzel
Journal: JAMA (2000)

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
Role of the urinary concentrating process in the renal effects of high protein intake
Authors: Nadine Bouby, Marie-Marcelle Trinh-Trang-Tan, Denise Laouari, Claire Kleinknecht, Jean-Pierre Grünfeld, Wilhelm Kriz, Lise Bankir, Monique Douté, Bruni Hähnel, Christine Coutaud
Journal: Kidney International (1988)
Factors Influencing Height and Weight Development in Children With Diabetes: Results of the Berlin Retinopathy Study
Authors: Thomas Danne, Olga Kordonouri, Ingo Enders, Bruno Weber
Journal: Diabetes Care (1997)

OBJECTIVE To investigate the influence of glycemic control and insulin therapy on the longitudinal growth and weight development of children with diabetes. RESEARCH DESIGN AND METHODS Prospective measurements of standing height and weight were recorded longitudinally in 634 children after IDDM onset (median age at onset, 9 years [range 1–15 years]; median diabetes duration at final examination, 11 years [range 1–19]; 3,236 patient-years on two or three injections daily; 399 patient-years on multiple injection therapy [MIT]). RESULTS Normal development was found until puberty, with a tendency toward stunted growth and overweight (weight &amp;gt; 97th centile) thereafter. Female sex (P &amp;lt; 0.01) and MIT (P &amp;lt; 0.01) were associated with overweight. Final height was evaluated in a subgroup of 197 young adults followed until age 18 years. Relative growth was calculated as the difference between the standard deviation scores (SDSs) at manifestation (median 0.2 [range −3.5 to 2.9]) and at 18 years of age (reduction of −0.5 [−2.5 to 1.8]), equivalent to a median loss of 2.9 cm in boys and 2.3 cm in girls. Significant linear correlations with the change in height SDS after diabetes manifestation were found for age at manifestation (r = 0.21, P &amp;lt; 0.001) and prepubertal (r = −0.40, P &amp;lt; 0.001) and postpubertal HbA1c (r = −0.15, P &amp;lt; 0.001). While children with poorer relative growth also had a higher BMI (P &amp;lt; 0.05), no influences of sex, prevalence of limited joint mobility, or presence of retinopathy were found. CONCLUSIONS Female sex and MIT are associated with diabetes-related obesity. Prepubertal and postpubertal glycemic control appear to be of importance for the diabetes-associated relative growth deficit.
Vagus nerve stimulation alters regional acetylcholine turnover in rat heart.
Authors: D D Lund, R P Oda, B J Pardini, P G Schmid
Journal: Circulation Research (1986)

The turnover of neurotransmitter is a direct measure of neuronal function, varying with the impulse activity of the nerve. It is not known if vagal stimulation increases acetylcholine release uniformly throughout the heart, or if modification of neural signals occurs between the vagal nerve trunks and postganglionic synaptic terminals. The rate constant of acetylcholine turnover was measured in conduction and contractile regions of heart by quantifying the incorporation of [3H]choline into acetylcholine after labeling of the blood choline pool in urethane-anesthetized rats during two levels of vagal activity. Choline and acetylcholine were assayed by high pressure liquid chromatography with electrochemical detection of post-column enzymic reaction product, peroxide. The specific activities of choline and acetylcholine in the tissues at sacrifice were used to calculate the fractional turnover rates in cardiac regions. Supramaximal bilateral vagal stimulation for 20 minutes decreased heart rate (P less than 0.05), while mean arterial blood pressure remained constant. The rate constants for acetylcholine turnover in right atrial regions containing the sinoatrial node, left atrial tissues, and interatrial septum doubled from control values during vagal stimulation. In contrast, the fractional rate constants of acetylcholine turnover did not change in the right and left ventricles during vagal stimulation. We interpret these results to indicate general activation of postganglionic parasympathetic fibers to the atria and selective modulation of postganglionic parasympathetic neural function to the ventricles.
Getting the vehicle moving
Authors: George N. Reeke
Journal: Behavioral and Brain Sciences (1999)

O'Brien &amp; Opie present an attractive alternative to the popular but flawed computational process approach to conscious awareness. Their “vehicle” theory, however, is itself seriously flawed by overstrict allegiance to the notion that explicit representation and stability are defining hallmarks of consciously experienced neural activity patterns. Including reentrant interactions among time-varying patterns in different brain areas can begin to repair their theory.
The Pseudokinase MLKL Mediates Necroptosis via a Molecular Switch Mechanism
Authors: James M. Murphy, Peter E. Czabotar, Joanne M. Hildebrand, Isabelle S. Lucet, Jian-Guo Zhang, Silvia Alvarez-Diaz, Rowena Lewis, Najoua Lalaoui, Donald Metcalf, Andrew I. Webb, Samuel N. Young, Leila N. Varghese, Gillian M. Tannahill, Esme C. Hatchell, Ian J. Majewski, Toru Okamoto, Renwick C.J. Dobson, Douglas J. Hilton, Jeffrey J. Babon, Nicos A. Nicola, Andreas Strasser, John Silke, Warren S. Alexander
Journal: Immunity (2013)
Neuropsychiatric Symptoms Associated With Topical Imiquimod Therapy: Report of 2 Cases
Authors: Allan S. Brett, Tracy Voss, Emily P. Ridley
Journal: JAMA Dermatology (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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Dermatology journal
Better evidence, improved care
Authors: Lee Goldman
Journal: BMJ (2006)

As is hopefully true for all doctors, I am inspired by the opportunity to spend my professional lifetime trying to improve the health and welfare of humanity. How to achieve that goal is intensely personal, however. In deciding to be a clinical investigator, teacher, and, more recently, a medical administrator rather than a full time clinician, my inspiration goes beyond the desire to help individual patients in a series of one-on-one encounters. I believe that individual doctors can become an even more powerful force when they are informed, educated, stimulated, and even moulded to benefit from collective knowledge and to raise their standards of performance. Nevertheless, my decision to maintain an active clinical practice underscores the recognition that these other activities have little merit unless they can be transformed by practitioners into improvements in patient care. 

While in medical school I made the unusual decision simultaneously to pursue a masters degree in public health. My peers on each side were equally perplexed. The medical students and medical faculty saw public health, at least in the United States, as largely outside the realm of real patient care. My public health colleagues saw doctors as unable to recognise the big picture of what truly influences the course of human health. I vacillated between being hopelessly discouraged that the two sides would never meet and hoping that a potentially powerful alliance …
Rheumatoid arthritis. Surgical treatment.
Authors: G. P. Arden, S. H. Harrison, B. M. Ansell
Journal: BMJ (1970)

ri Medical M nB sUML .50 to 100mg. of hydrocortisone, usually fqllowing the asjpration of fluid, into a particularly troublesome joint.Its local effect in preventing recurrent effusion and pain may be dra- matic though unpredictable.Repeated injections, however, may result in massive joint destruction resembling a neuro- trophic joint."Furthermore, there is a small risk of septic arthritis despite stringent aseptic precautions.Systemic steroids, usually as oral prednisone or enteric- coated prednisolone, have only a very limited place in the management of rheumatoid disease.They are used in special circumstances such as intractable iritis (common in juvenile patients), progressive rheumatoid neuropathy, or pericarditis with effusion when gold and safer anti-inflammatory drugs have failed to induce remission.Occasionally a .5 mg.. noctur- nal dose of prednisone is used to help a patient cope with a relapse that threatens his job.In any event, daily doses -of 7.5 mg.prednisone should rarely be exceeded because of the inevitable side effects, incuding adrenal suppression, complicating larger doses.O Immunosuppressive Agents- Much recent interest has been shown in the use-of immunosuppressive agents for rheumatoid disease.Their mechanism of action,.however, is unclear and it is uncertain whether they actually suppress the inmune response."Trials have been -reported on the.use of azathioprine,67 cyclophosphamide,06 67mercaptopurinej and even lymphatic drainage in rheumatoid arthritis.70The results have been dif- ficult to assess, variable, and complicated by serious side effects."Clearly, a good .chance of dramatic response is nec- essary before embarking on such potent therapy.. Thus, though careful trials in specialized units should continue, immunosuppressive agents at present ..have no clear role-in the treatment of rheumatoid.arthritis.Another interesting use of immunosuppressive drugs.isas an intra-articular injection in efforts to achieve a "medical" synovectomy.Clinical trials of intra-articulhr iotepan have been reported, and the application of cyclophosphamide con- sidered.7 Promising results in animals showing that injected radioactive materials may accumulate within synovial surface cells7' has been.followed by clinical trials of .intra-articular9uAu74 and "0Y.75 Results are variable, however, effusions have recurred, and probably extra-articular spread will limit the doses and possible usefulness of this approach. ConclusionsAll of the aspects of medical management outlined here might apply at some time to the illness in an individual patient with rheumatoid arthritis.It is therefore mandatory that the general practitioner, rheumatology unit, orthopaedic surgeon, ancillary services, and.welfare departments work as a team to alleviate the consequences of this common -and distressing disease.
Antipsychotic use among US young people has risen sixfold
Authors: Janice Hopkins Tanne
Journal: BMJ (2006)

Between 1993 and 2003 the number of prescriptions of antipsychotic drugs to children and teenagers in the United States increased sixfold, reports a study of prescriptions written during visits to doctors' and psychiatrists' practices. Psychotherapy was little used, it found.

The increase in prescriptions of these drugs to young people is thought to be due to the availability of new antipsychotic drugs that have fewer short term adverse affects in adults than older drugs and “declining access to and duration of inpatient psychiatric …
Familial Clustering of Barrett's Esophagus and Esophageal Adenocarcinoma in a European Cohort
Authors: Romy E. Verbeek, Lisanne F. Spittuler, Anique Peute, Martijn G.H. van Oijen, Fiebo J. ten Kate, Jacob R. Vermeijden, Ardi Oberndorff, Jantine W.P.M. van Baal, Peter D. Siersema
Journal: Clinical Gastroenterology and Hepatology (2014)
Cost-Effectiveness of Dabigatran for Stroke Prophylaxis in Atrial Fibrillation
Authors: Shimoli V. Shah, Brian F. Gage
Journal: Circulation (2011)

Recent studies have investigated alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation (AF), but whether these alternatives are cost-effective is unknown.On the basis of the results from Randomized Evaluation of Long Term Anticoagulation Therapy (RE-LY) and other trials, we developed a decision-analysis model to compare the cost and quality-adjusted survival of various antithrombotic therapies. We ran our Markov model in a hypothetical cohort of 70-year-old patients with AF using a cost-effectiveness threshold of $50 000/quality-adjusted life-year. We estimated the cost of dabigatran as US $9 a day. For a patient with an average risk of major hemorrhage (≈3%/y), the most cost-effective therapy depended on stroke risk. For patients with the lowest stroke rate (CHADS2 stroke score of 0), only aspirin was cost-effective. For patients with a moderate stroke rate (CHADS2 score of 1 or 2), warfarin was cost-effective unless the risk of hemorrhage was high or quality of international normalized ratio control was poor (time in the therapeutic range <57.1%). For patients with a high stroke risk (CHADS(2) stroke score ≥3), dabigatran 150 mg (twice daily) was cost-effective unless international normalized ratio control was excellent (time in the therapeutic range >72.6%). Neither dabigatran 110 mg nor dual therapy (aspirin and clopidogrel) was cost-effective.Dabigatran 150 mg (twice daily) was cost-effective in AF populations at high risk of hemorrhage or high risk of stroke unless international normalized ratio control with warfarin was excellent. Warfarin was cost-effective in moderate-risk AF populations unless international normalized ratio control was poor.
Agonal phase, ischaemic times, and renal vascular abnormalities and outcome of cadaver kidney transplants.
Authors: C L Hall, J R Sansom, M Obeid, P Dawson-Edwards, B H Robinson, A D Barnes, J D Blainey
Journal: BMJ (1975)

A retrospective study of 250 cadaver kidney transplants was carried out to determine the effects of the agonal period, the warm and cold ischaemic times, and the use of kidneys with vascular anomalies on the primary success and failure and the subsequent level of function of the transplants. Kidneys with vascular anomalies or from non-ventilated donors had a primary failure rate of over 30%, whereas those with normal vasculature or from ventilated donors had a rate of 17%. An initial warm ischaemic time of more than 60 minutes was associated with a primary failure rate of 57% and a cold ischaemic time of over 550 minutes with a primary failure rate of 47%. The interrelationship between the warm and cold ischaemic times in the primary success or failure of the transplants was examined and criteria defined for selecting potentially viable cadaver kidneys for transplantation, as follows: (1) The donor should be (a) ventilated, (b) aged 6-50 years, and (c) have normal ante-mortem renal function and have secreted more than 1-5 1 of urine in the 24 hours before death (or an equivalent volume if the urinary output was recorded for less than 24 hours before death); (2) the kidney should have normal renal vasculature enabling single arterial and venous anastomoses to be performed; (3) kidneys with I.W.I.T.s of longer than 60 minutes should not be used; (4) for kidneys with I.W.I.T.s of less than 20 minutes the C.I.T. is not critical but should not exceed 12 hours; (5) for kidneys with I.W.I.T.s of 20-60 minutes the C.I.T. should not exceed 450 minutes.