tbuckley/cabot-search huggingface dataset:
Dilation of Arterial Stenoses
Authors: Thomas H. Hunt
Journal: JAMA (1980)

<h3>To the Editor:—</h3> The recent CLINICAL NOTE "Renovascular Hypertension Secondary to Arterial Fibrodysplasia: Treatment by Dilation Using a Fogarty Balloon" (242:1396, 1979) invites reply. The article reports the operative dilation of an angiographically demonstrated fibromuscular stenosis of a main renal artery. There is currently a surge in the treatment of occlusive vascular disease by the interventional angiographic technique of percutaneous transluminal angioplasty (PTA). This interest has been kindled by the development of maneuverable, percutaneous catheters incorporating polyvinyl balloons for dilation.<sup>1</sup>Unlike the latex of Fogarty balloons, polyvinyl has a low compliance and a nonlinear, pressure-volume relationship. This balloon can be inflated to a predetermined cylindrical shape and diameter, with minimal risk of overdistension and undesirable vascular injury. Furthermore, in contrast to previous rigid dilating catheters, these newer systems allow selective percutaneous catheterization, and, because of the affixed balloon, greater degrees of dilation are possible with catheters of small diameter.
FDA Advisory Decision Highlights Some Problems Inherent in Pragmatic Trials
Authors: M. Mitka
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
A 70-Year-Old Man With a Transient Ischemic Attack
Authors: Louis R. Caplan
Journal: JAMA (2008)

Mr V, a man with severe coronary, aortic, and peripheral artery disease, had an episode of brain ischemia caused by severe preocclusive carotid artery disease in the neck. The major treatment options for his symptomatic carotid artery disease are optimizing medical treatment, carotid endarterectomy, and carotid artery stenting. Selection of treatment must take into consideration his severe symptomatic coronary artery disease as well as Mr V's concerns about surgery. Carotid endarterectomy presents a risk of myocardial infarction unless his coronary disease is treated effectively before surgery. Carotid stenting is problematic because the severity of the preocclusive arterial narrowing makes passing a protective device beyond the stenosis difficult without first performing potentially hazardous angioplasty. Optimizing medical treatment may be the best option for his severe systemic atherosclerosis. Treatment decisions in complex patients like Mr V require weighing the particular risks and benefits of available options, and the patient's own wishes and fears. These decisions, in this and other complex patients, often cannot be directly informed by results from randomized trials.
Gap junction distribution is altered between cardiac myocytes infected with Trypanosoma cruzi.
Authors: A C de Carvalho, H B Tanowitz, M Wittner, R Dermietzel, C Roy, E L Hertzberg, D C Spray
Journal: Circulation Research (1992)

Conduction disturbances frequently accompany both acute and chronic Chagas' disease. To explore the possibility that changes in gap junction distribution or abundance might play a role in these disturbances, we have investigated intercellular communication between rat neonatal cardiac myocytes in cultures infected with Trypanosoma cruzi. Contractile activity of infected cells was characterized by regional asynchrony within the culture as well as by irregular contraction patterns. Junctional conductance between infected cell pairs was found to be significantly lower than in uninfected cell pairs, and the rapidity and extent of intercellular transfer of the dye lucifer yellow was markedly reduced between infected cells. Immunocytochemical studies demonstrated that the parasitic infection significantly decreased connexin43 expression at junctional membrane regions, correlating with the detected functional uncoupling. These findings of reduced gap junction abundance and function in trypanosome-infected cells may provide important insight into the pathogenesis of the cardiac arrhythmias that attend Chagas' disease.
Menders of the Maimed: The Anatomical and Physiological Principles Underlying the Treatment of Injuries to Muscles, Nerves, Bones, and Joints
Authors: Reginald R. Cooper
Journal: JAMA (1977)

Any orthopedist who fails to read this reprint of the original 1919 edition misses a superb opportunity to acquire an enjoyable and valuable historical perspective of his specialty. The remarkable volume combines a careful delineation of the development of orthopedics with many valuable (and still valid) dissertations on therapy of diseases and disorders of the musculoskeletal system. The conversational style of writing provides a vivid portrayal of pioneer orthopedists that would undoubtedly be impossible in a more traditional style. The lucid description of the personality, motivation, emotions, and eccentricities of giants such as John Hunter, Hugh Owen Thomas, William Little, Duchenne, Bauer, Lane, and others provides a unique insight into the reasons underlying many of their published ideas. This book contains sections that focus on some of the most forceful of these men. Most of the book, however, examines the development of various segments of orthopedics (tenotomy, mechanism of muscle
Does Menopausal Hormone Replacement Therapy Interact With Known Factors to Increase Risk of Breast Cancer?
Authors: Giske Ursin, Chiu Chen Tseng, Annlia Paganini-Hill, Shelley Enger, Peggy C. Wan, Silvia Formenti, Malcolm C. Pike, Ronald K. Ross
Journal: Journal of Clinical Oncology (2002)

PURPOSE: We and other investigators have previously shown that postmenopausal combined estrogen and progestin replacement therapy (EPRT) increases the risk of breast cancer and that the risk associated with EPRT is substantially higher than for estrogen replacement therapy (ERT) alone. The present study was conducted to determine whether any particular subgroup of women are at particularly high risk of breast cancer if they use EPRT and whether tumor characteristics in women who develop cancer while on ERT or EPRT are different from those in women not using ERT or EPRT. PATIENTS AND METHODS: We conducted a population-based case-control study in Los Angeles, CA, with patients diagnosed with breast cancer in the late 1980s and early 1990s. Control subjects were matched to patients on age, ethnicity, and neighborhood of residence. We present data on 1,897 postmenopausal patients and 1,637 controls aged 55 to 72 years who had not undergone a simple hysterectomy. RESULTS: Relative risk of breast cancer associated with EPRT use did not vary with body mass index (body mass index at or below v above median [24.6 kg/m2]; P = .98), alcohol intake (≥ one v < one drink per week; P = .16), parity (nulliparous v parous; P = .45), history of benign breast disease (yes v no; P = .99), or family history of breast cancer (first degree v none; P = .57). All of these results were compatible with our previously reported estimate of an increased risk of breast cancer of 5% per year of use of EPRT. Hormone users, principally EPRT users, were more likely to have hormone receptor–positive, especially progesterone-positive, tumors. CONCLUSION: We found no evidence that the risk of breast cancer associated with EPRT is limited to subgroups of women with specific cofactors. Tumors in EPRT users are more often hormone receptor–positive, indicating that they may have a better prognosis than breast cancer overall.
Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome: a series of 136 patients from the Eurofever Registry
Authors: R Levy, L Gérard, J Kuemmerle-Deschner, H J Lachmann, I Koné-Paut, L Cantarini, P Woo, A Naselli, B Bader-Meunier, A Insalaco, S M Al-Mayouf, S Ozen, M Hofer, J Frenkel, C Modesto, I Nikishina, T Schwarz, S Martino, A Meini, P Quartier, A Martini, N Ruperto, B Neven, M Gattorno
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objective</h3> To evaluate genetic, demographic and clinical features in patients with cryopyrin-associated periodic syndrome (CAPS) from the Eurofever Registry, with a focus on genotype-phenotype correlations and predictive disease severity markers. <h3>Methods</h3> A web-based registry retrospectively collected data on patients with CAPS. Experts in the disease independently validated all cases. Patients carrying <i>NLRP3</i> variants and germline-mutation-negative patients were included. <h3>Results</h3> 136 patients were analysed. The median age at disease onset was 9 months, and the median duration of follow-up was 15 years. Skin rash, musculoskeletal involvement and fever were the most prevalent features. Neurological involvement (including severe complications) was noted in 40% and 12% of the patients, respectively, with ophthalmological involvement in 71%, and neurosensory hearing loss in 42%. 133 patients carried a heterozygous, germline mutation, and 3 patients were mutation-negative (despite complete <i>NLRP3</i> gene screening). Thirty-one different <i>NLRP3</i> mutations were recorded; 7 accounted for 78% of the patients, whereas 24 rare variants were found in 27 cases. The latter were significantly associated with early disease onset, neurological complications (including severe complications) and severe musculoskeletal involvement. The T348M variant was associated with early disease onset, chronic course and hearing loss. Neurological involvement was less strongly associated with V198M, E311 K and A439 V alleles. Early onset was predictive of severe neurological complications and hearing loss. <h3>Conclusions</h3> Patients carrying rare <i>NLRP3</i> variants are at risk of severe CAPS; onset before the age of 6 months is associated with more severe neurological involvement and hearing loss. These findings may have an impact on treatment decisions.
Memphis in 1902.
Authors: W. Britt Burns
Journal: JAMA (1901)

The Memphis Medical Society has, after thoroughly convassing the situation through proper committees, unanimously voted to invite theAmerican Medical Associationto meet in Memphis. Tenn., at its regular annual meeting in 1902. The Cotton Exchange. Business Men's Club, Passenger Association and all commercial interests in the city are anxious to have Memphis selected as the next meeting-place. Memphis, while her hotel capacity is not as large as it might be, compares favorably with any other city of her size. The hotel capacity is approximately 1500, without crowding, and there are definite promises to care for 1560 comfortably, 2200 by crowding, and 3225 by auxiliary resources, namely respectable boarding-houses. The auxiliary resources will cover only rooms in easy reach of the hotels and cafes. Aside from the hotels Memphis offers her homes. Meeting-places for the different Sections, and banquet halls, etc., have been fully planned for
Bradykinin modulation of isolated rabbit heart function is mediated by intrinsic cardiac neurons
Authors: I IZRAILTYAN, J KRESH
Journal: Cardiovascular Research (1997)

Objective: Bradykinin (BK) is an endogenous peptide exerting a potent influence on the behavior of the heart. The local regulatory mechanisms responsible for BK modulation of cardiac automaticity and contractility remain poorly understood. The role of the intrinsic cardiac nervous system (ICNS) in mediating the BK-induced regulatory effects was investigated. Methods: Heart rate (HR) and intramyocardial pressure (IMP) changes in response to BK (1.2–80 nmol) were studied in isolated rabbit hearts ( n = 37). The intrinsic neural mechanisms underlying the cardiac effects of BK were characterized by use of atropine (ATR, 10 −6 M), timolol (TIM, 10 −5 M), hexamethonium (HEX, 10 −4 M), and tetrodotoxin (TTX, 10 −7 M). Modulation of β-adrenergic tone by dobutamine (DOB, 1.6 × 10 −6 M) was used to expose the physiological importance of intrinsic cholinergic systems in mediating the cardiac action of BK. Results: A single dose of BK induced an increase in IMP and a biphasic HR response. The negative chronotropic response to BK was correlated with negative HR change induced by nicotine activation of ICNS. BK-elicited 'bradycardiars was abolished by ATR and TTX, and attenuated (≈ 50%) by HEX. ATR and TTX potentiated the positive HR-response which was not affected by TIM. BK selectively antagonized [by 48.1(5.1)%] the DOB-induced tachycardia but did not modify the accompanied inotropic potentiation. Conclusions: These findings are the first demonstration that in the autonomically decentralized heart, the negative chronotropic action of BK is mediated by intrinsic cardiac cholinergic neurons. It would appear that the intrinsic neural network response, and not merely the BK-induced potentiation of cardiac postganglionic neural activity is involved in the local neuromodulatory action of BK. This intrinsic cardiac regulatory mechanism seems to play a major role in mitigating the adrenergically induced tachycardia, thus endowing this peptide with the capacity for cardioprotection.
Critical care of Ebola patients: a crisis situation
Authors: Talha Khan Burki
Journal: The Lancet Respiratory Medicine (2014)

Last month, the US National Institutes of Health (NIH) published an article titled "Preparing for Critical Care Services to Patients with Ebola". It proved timely; 6 days later, the country saw its first case of the disease. As The Lancet Respiratory Medicine went to press, the UK Department of Health was preparing to test its response to a simulated Ebola outbreak. The UK has agreed to deploy troops to Sierra Leone to assist with control efforts; they will join the 3000 or so troops President Barack Obama has pledged to west Africa.
Survival and drug discontinuation analyses in a large cohort of methotrexate treated rheumatoid arthritis patients.
Authors: G S Alarcon, I C Tracy, G M Strand, K Singh, M Macaluso
Journal: Annals of the Rheumatic Diseases (1995)

To determine the probability of drug continuation in a large cohort of methotrexate treated rheumatoid arthritis (RA) patients, the reasons for discontinuation of methotrexate, the overall survival of the members of this cohort, and the causes of death in these patients.Yearly follow up was conducted in methotrexate treated RA patients who formed a cohort between 1981 and 1986 at a tertiary care centre. The probability of drug continuation and the patients' survival were calculated using standard statistical procedures; standardised mortality ratios were calculated using death certificate data and USA general population and mortality tables.The probability of methotrexate continuation at 10 years from the time the first members entered the cohort was 30%. Toxicity (and its severity) was the most frequent cause of discontinuing methotrexate. The cumulative probability of survival was 85% for women and 45% for men. A greater than expected number of deaths from infections was observed, but the number of deaths from cancer and cardiovascular diseases were within the range expected.Toxicity remains the most common cause for methotrexate discontinuation. Survival was comparable to that of other RA cohorts. Methotrexate may be implicated as an associated factor in the deaths from infections.
Genome-wide association studies of asthma indicate opposite immunopathogenesis direction from autoimmune diseases
Authors: Xingnan Li, Elizabeth J. Ampleford, Timothy D. Howard, Wendy C. Moore, Dara G. Torgerson, Huashi Li, William W. Busse, Mario Castro, Serpil C. Erzurum, Elliot Israel, Dan L. Nicolae, Carole Ober, Sally E. Wenzel, Gregory A. Hawkins, Eugene R. Bleecker, Deborah A. Meyers
Journal: Journal of Allergy and Clinical Immunology (2012)
The Biology of Myopia
Authors: Edwin B. Dunphy
Journal: New England Journal of Medicine (1970)

FOR many years myopia has been an enigma to the ophthalmologist and a source of worry to the parents of nearsighted children. In many cases the progressive nature of the disorder, in spite of correcting glasses, has given rise to a sense of hopelessness and a consequent turning to various quack methods of treatment.Myopia was recognized centuries ago. As far back as 1611 Kepler1 defined the condition. In 1632 Plempius2 examined a myopic eye anatomically and confirmed the impression that myopia was due to a lengthening of its axial diameter. One cannot say that much progress has been made . . .
Relationship between ionic perturbations and electrophysiologic changes in a canine Purkinje fiber model of ischemia and reperfusion.
Authors: R Yee, K K Brown, D E Bolster, H C Strauss
Journal: Journal of Clinical Investigation (1988)

Standard and ion-sensitive microelectrodes were used to identify the basis of electrophysiologic changes that occur in canine cardiac Purkinje fibers superfused with "ischemic" solution (40 min) and then returned to standard Tyrode's solution. Maximum diastolic potential (EMDP) decreased (-92.6 +/- 2.4 to -86.0 +/- 4.0 mV; n = 19; P less than 0.001) during exposure to "ischemia," and after reperfusion, rapidly hyperpolarized to -90.0 +/- 4.7 (2 min) and then depolarized to -47.0 +/- 7.5 mV (10 min; P less than 0.001). No significant change in intracellular K activity (alpha ik) was noted throughout. Extracellular K activity (alpha ek) changed only during reperfusion, reaching a nadir at 5 min (3.5 +/- 0.4 to 2.6 +/- 0.5 mM, P less than 0.03), and thus can not account for the decrease in EMDP during reperfusion. Mean alpha iNa increased (8.7 +/- 1.3 to 10.9 +/- 1.9 mM; n = 10; P less than 0.01) during ischemia, but rapidly declined during reperfusion to 5.1 +/- 2.2 mM (10 min; P less than 0.01). Exposure to acetylstrophanthidin (4-5 x 10(-7) M) during the final 10 min of ischemia increased alpha iNa to 19.9 +/- 3.8 mM (n = 5), which was unchanged at 5 min of reperfusion. This suggests that Na-K pump inhibition during ischemia was minimal and that the pump was stimulated early during reperfusion, accounting for the initial transient hyperpolarization. Resting tension did not change significantly during exposure to ischemia; however, return to control Tyrode's solution caused a marked rise to 11.3 +/- 9.9 mg/mm2 (n = 13, P less than 0.001). This is consistent with a calcium overload state during reperfusion. The depolarization seen during reperfusion may result from activation of a Ca-activated, nonselective cation channel or enhanced electrogenic Na/Ca exchange.
Refining Molecular Analysis in the Pathways of Colorectal Carcinogenesis
Authors: Andrew Rowan, Sarah Halford, Michelle Gaasenbeek, Zoe Kemp, Oliver Sieber, Emmanouil Volikos, Eleanor Douglas, Heike Fiegler, Nigel Carter, Ian Talbot, Andrew Silver, Ian Tomlinson
Journal: Clinical Gastroenterology and Hepatology (2005)
The Occurrence of Malignant Hypertension and Renal Insufficiency in Progressive Systemic Sclerosis (Diffuse Scleroderma).
Authors: Gerald P. Rodnan
Journal: Annals of Internal Medicine (1964)

s1 April 1964The Occurrence of Malignant Hypertension and Renal Insufficiency in Progressive Systemic Sclerosis (Diffuse Scleroderma).Gerald P. Rodnan, M.D. (Associate), Alvin P. Shapiro, M.D., F.A.C.P., Emanuel Krifcher, M.D.Gerald P. Rodnan, M.D. (Associate)Search for more papers by this author, Alvin P. Shapiro, M.D., F.A.C.P.Search for more papers by this author, Emanuel Krifcher, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-4-737_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the past 10 years there has been increasing awareness of the frequency and ominous significance of arterial hypertension in patients with progressive systemic sclerosis (PSS). In our experience, the development of hypertension in these individuals has been associated with uniformly fatal renal insufficiency, which has accounted for approximately 50% of the over-all death rate in PSS.The present report is concerned with clinical and pathological findings in a group of 21 patients with this disorder. There were 14 women and 7 men, the majority of whom had had scleroderma for 2 years or less prior to the appearance of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Pittsburgh, Pennsylvania PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByImmunohistochemical findings in the renal vascular lesions of progressive systemic sclerosisProgressive Systemic Sclerosis (PSS)Pathologic observations in systemic sclerosis (scleroderma)Retinopathy due to progressive systemic sclerosis 1 April 1964Volume 60, Issue 4Page: 737-737KeywordsDeath ratesHypertensionScleroderma Issue Published: 1 April 1964 PDF DownloadLoading ...
The Effect of a School Entry Law on Mumps Activity in a School District
Authors: Barry P. Chaiken
Journal: JAMA (1987)

Sixty-three cases of clinical mumps occurring in a New Jersey school district presented an opportunity to determine compliance with the state's 1978 mumps "new entrants" school immunization law, investigate the effect of the law on the pattern of the outbreak, estimate the efficacy of mumps vaccine, and quantitate the economic impact of the outbreak. Only students in kindergarten (K) through grade 5 would have been affected by the immunization law. Students in the sixth grade were nearly seven times more likely to develop mumps than students in grades K through 5. The observed differences between the sixth graders and those in grades K through 5 most likely reflect the fact that sixth graders were not covered by the school law. Vaccine efficacy was estimated to be 91% (95% confidence interval = 77% to 93%). The total direct cost of the outbreak was $10,937 (clinic costs plus total cost to households). This outbreak demonstrates the significant impact of appropriate school vaccination laws on limiting the morbidity and economic and social costs of mumps.
General practitioners' continuing medical education within and outside their practice.
Authors: P. A. Owen, L. A. Allery, K. G. Harding, T. M. Hayes
Journal: BMJ (1989)

To study continuing medical education 96 out of 101 general practitioners chosen at random from the list held by a family practitioner committee were interviewed. The results provided little evidence of regular attendance at local postgraduate centre meetings, though practice based educational meetings were common. Thirty one of the general practitioners worked in practices that held one or more practice based educational meetings each month at which the doctors provided the main educational content. Performance review was undertaken in the practices of 51 of the general practitioners, and 80 of the doctors recognised its value. The general practitioners considered that the most valuable educational activities occurred within the practice, the most valued being contact with partners. They asked for increased contact with hospital doctors. The development of general practitioners9 continuing medical education should be based on the content of the individual general practitioner9s day to day work and entail contact with his or her professional colleagues.