tbuckley/cabot-search huggingface dataset:
Malignant Pericardial Effusion: a Case for Treatment
Authors: A. G. Hocken
Journal: BMJ (1964)

Vitamins (I)Vitamins are organic substances essential for normal body metabolism and for the maintenance of health.While some vitamins are synthesized within the human body, the amounts produced and -utilized are in general not sufficient to meet metabolic requirements.Vitamins are effective, however, in small amounts; though intimately concerned with metabolism, they are not a source of energy.The term " vitamine " was first applied over 50 years ago to substances known previously as "accessory food factors."The latter description is in many ways more satisfactory, for the vitamins are of widely different chemical structures, physical properties, and physiological actions, and are grouped together mainly by reason of their similar modes of discovery. General ConsiderationsThe principal use of vitamins is the prevention or correction of deficiency states.Primary dietetic deficiency is still prevalent in many of the underdeveloped areas of the world, but is uncommon in this country; it still occurs, however, in states of poverty or neglect, in mental defectives, and in food faddists.Secondary deficiency is more common and usually results from disorders of the alimentary tract.Single vitamin deficiency is well known to occur, but multiple deficiency should always be suspected, especially in relation to the "B " group, as multi- vitamin therapy is often required. Prevention of DeficiencyPrevention of primary deficiency is usually achieved simply by the consumption of a good mixed diet.Deficiency is more likely to occur from an ill-balanced diet of adequate caloric content than from a balanced diet of low caloric content as may be prescribed for obese patients.In the prevention of secondary deficiency it is necessary to recognize the potential dangers not only in gastro-intestinal disorders but also in the increased requirements of growth, pregnancy, and lactation.The prophylactic use of vitamins has abolished much ill-health and physical disability, but this provides no justification for their indiscriminate use, which may on occasion carry some danger.
THE MORON AND THE STUDY OF ALIEN DEFECTIVES
Authors: HOWARD A. KNOX
Journal: JAMA (1913)

In no branch of the science of medicine does a lay diagnosis have weight in a court of law as it does in mental aberration. In most types of active insanity there are manifest and obvious symptoms which brand the as "crazy" in the eyes of the laity. For instance, the testimony of a lay person has been admitted to substantiate the sanity of a person making a will on his death-bed. In many cases of the systematized delusions (paranoia) without deterioration, the interval manic-depressive and certain alcoholic hallucinosis cases of a mild type there may be external evidence of insanity to the layman, but in some cases this is lacking. There is one great class of defectives of tremendous importance from a eugenic, social and economic point defectives. view that is not ordinarily recognized by laymen as defectives. This class comprises the morons and constitutional inferior types. These terms
Lung water and vascular permeability in sheep. Newborns compared with adults.
Authors: K L Brigham, H Sundell, T R Harris, Z Catterton, I Kovar, M Stahlman
Journal: Circulation Research (1978)

To compare vascular permeability and water content in the lungs of newborn lambs with those in adult sheep, we measured extravascular water and permeability surface area products (PS) for >4 C-urea and 14 Csucrose in nine 3-to 5-day-old lambs and 13 yearling sheep.In normal, unanesthetized animals, we injected a mixture of "Cr-erythrocytes, ""I-albumin, 3 H-water, and either "C-sucrose or "C-urea as a bolus into the right atrium and sampled blood from the thoracic aorta, calculating extravascular water and PS for urea and sucrose from the time-concentration curves of the tracers.We also measured extravascular lung water and dry bloodless lung weight postmortem.Normalized to dry lung weight, extravascular lung water by both techniques was similar in newborns and adults (indicator dilution values = 3.2 ± 0.03 (SEM) ml/g for lambs and 3.2 ± 0.03 for sheep; postmortem values = 4.07 ± 0.26 g/g for lambs and 4.03 ± 0.17 for sheep).In newborn lambs, PS calculated by integral extractor!was 0.28 ± 0.04 (SEM) g/g dry lung for "C-urea and 0.18 ± 0.04 for l4 C-sucrose.These values were not significantly different from those for adult sheep ("C-urea PS = 0.26 ± 0.05; l4 C-sucrose PS = 0.08 ± 0.03).We conclude that, when normalized to dry lung weight, newborn and adult sheep have similar lung water and vascular permeability to small hydrophilic molecules and that indicator methods for measuring PS and lung water are feasible in newborns.PULMONARY edema is a prominent pathological finding in hyaline membrane disease.'Since the edema fluid is rich in large proteins, 2 at least part of the lesion may involve increased microvascular permeability.Techniques for measuring permeability in newborns could help to clarify the pathogenesis of this disease.There have been
Fluconazole levels in human expidermis and blister fluid
Authors: E. Haneke
Journal: British Journal of Dermatology (1990)

Journal Article Fluconazole levels in human expidermis and blister fluid Get access E. Haneke E. Haneke Department of Dermatology, Ferdinand‐Sauerbruch‐Klinikum, Arrenbergerstr 20, 5600 Wuppertal 1, F.R.G. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 123, Issue 2, 1 August 1990, Pages 273–274, https://doi.org/10.1111/j.1365-2133.1990.tb01870.x Published: 01 August 1990
Getting health professionals to work together
Authors: C. Davies
Journal: BMJ (2000)

Microtubules, a critical component of the cytoskeleton, carry combinations of post‐translational modifications (PTMs), which are critical for the regulation of key cellular processes. Long‐lived microtubules, in neurons particularly, exhibit both detyrosination of α‐tubulin as well as polyglutamylation. Dysregulation of these PTMs results in disease, including developmental defects and neurodegeneration. Despite their importance, the mechanisms governing the emergence of such PTM patterns are not well understood, mostly because tools to dissect the function and regulation of tubulin PTMs have been lacking. Here, we report a chemical method to produce fully functional tubulin carrying precisely defined PTMs within its C‐terminal tail. Using a sortase‐ and intein‐mediated tandem transamidation strategy, we ligate synthetic α‐tubulin tails, which are site‐ specifically glutamylated to specific extents, to recombinant human tubulin heterodimers. Using microtubules reconstituted with such designer tubulins, we show that polyglutamylation of α‐tubulin promotes its detyrosination by enhancing the activity of the tubulin tyrosine carboxypeptidase vasohibin/SVBP in a manner dependent on the length of polyglutamyl chains. Moreover, modulating polyglutamylation levels in cells results in corresponding changes in detyrosination. Together, using synthetic chemistry to produce tubulins carrying defined PTMs, we can directly link the detyrosination cycle to polyglutamylation, connecting two key regulatory systems that control tubulin function.
Asymptomatic pulmonary involvement in RA
Authors: G Provenzano
Journal: Thorax (2002)

Tattersfield et al 1 and Walsh et al 2 offer important information about the possible adverse affects of corticosteroids on bone mineral density (BMD).Tattersfield and her colleagues reported no change in BMD with inhaled corticosteroids for mild asthma, while Walsh et al found a dose related increase in the incidence of fractures in those taking oral corticosteroids.We would like to report our study of BMD in patients with airways disease, which reinforces these findings and highlights men as being particularly at risk.We prospectively studied 100 consecutive outpatients (44 men) with steroid responsive airways disease.The formulation and cumulative dose of corticosteroid was recorded in each individual, together with all prescribed prophylaxis for osteoporosis.Bone mineral density was measured in the non-dominant forearm.We found no relationship between inhaled corticosteroid dose and BMD.Mean BMD was significantly reduced in those on oral as opposed to inhaled steroids.In men the mean Z scores for those on inhaled and oral corticosteroids were 0.1 and -0.6, respectively (p=0.07), while women had mean Z scores of 0.5 and -0.3 for inhaled and oral corticosteroids, respectively (p=0.016).Our patient numbers were insufficient to confirm a dose response.The surprising result was that men were more likely to meet the WHO criteria for osteoporosis than women (25% v 12.5%).This result is explained at least in part by the use of prophylaxis which was prescribed to 21 women but to only two men.Of those on regular oral steroids, only 5.5% of men received prophylaxis compared with 62.5% of women.Similar results have been reported in other chronic diseases, with a greater reduction in BMD being reported in men with cystic fibrosis. 3 Unfortunately it appears to have been assumed that men are protected from osteoporosis by virtue of their gender.When chronic disease is treated with oral corticosteroids, both men and women are equally at risk of osteoporosis and all should be considered for prophylaxis.
Hyperscalcemia of Thyrotoxicosis
Authors: JOHN D. BAXTER
Journal: Annals of Internal Medicine (1966)

Excerpt Hypercalcemia has been reported as an uncommon or rare occurrence with thyrotoxicosis (1-18), and except for reports by Rose and Boles (15), three cases; Bortz, Eisenberg, Bowers, and Pont (2), nine cases; and Koenig, Scholz, and Salassa (8), five cases; most investigators have emphasized that the serum calcium concentration in hyperthyroid patients is abnormal only in exceptional cases (10, 19-24). We have reviewed the serum calcium concentrations in thyrotoxicosis and have found that a mild, but significant degree of hypercalcemia was commonly present. These data are presented, together with clinical features of 19 patients who had hypercalcemia while hyperthyroid. METHODS
The diagnosis of art: Diastrophic dysplasia and Hephaistos
Authors: R. Arnott
Journal: Journal of the Royal Society of Medicine (2007)

By couching the discussion of Blair and Bush in terms of hubris and nemesis, Lord Owen 1 has avoided the pitfall of diagnosis from afar while still highlighting serious problems with the two world leaders (JRSM November 2006).He does dip his toe into psychodynamics citing Freud and Justin Frank, but, by and large, he sticks to discussing behaviour and its relation to hubris and power.As a politician, Lord Owen is qualified to discuss the political leaders he has encountered.As a physician, should he be making medical judgments on political leaders?Simon Wessely has questions about this and about whether or not psychiatrists should venture beyond the consulting room. 2 Should psychiatrists limit their judgments to patients they have examined?The American Psychiatric Association says 'yes' and Dr Wessely cites data to support that view.But the question remains, can psychiatrists and neuroscientists, with the help of philosophers, provide useful insights that contribute to the understanding of leaders and their followers?I believe that we should try.We should bring whatever scientific data there may be to counter ideology, blind faith and the intoxicating effects of power.It is true hubris often comes with power.Even though we do not have a psychiatric diagnosis for hubris, it is a psychological entity and as such should potentially be understood by science, as are other psychological phenomena.We do not diagnose those that we have not personally examined and we cannot diagnose an entire population, but perhaps we can bring clinical and scientific insights to help understand destructive behaviour As scientists and clinicians, we too must guard against hubris.Hopefully our colleagues will help us with that.JRMS should be applauded for exploring the issue.
Pectoralis Muscle Uptake of Thallium-201 After Arm Exercise Ergometry Possible Confusion with Lung Thallium-201 Activity
Authors: RICHARD J. CAMPEAU, OLGA M. GARCIA, OLGA A. CORREA, JED E. MACE
Journal: Clinical Nuclear Medicine (1990)

Pectoralis muscle uptake of thallium-201 was noted in 8 (73%) out of 11 patients after exercise arm ergometry. Uptake varied from mild to marked and potentially could be confused with pulmonary TI-201 activity with a resulting false-positive diagnosis of exercise-induced left ventricular dysfunction. The three patients exhibiting negative or trace TI-201 uptake had suboptimal exercise efforts. The characteristics of pectoralis muscle TI-201 uptake are illustrated, and differentiation from true lung TI-201 activity is discussed.
A hospital study of community acquired pneumonia in the elderly.
Authors: P Venkatesan, J Gladman, J T Macfarlane, D Barer, P Berman, W Kinnear, R G Finch
Journal: Thorax (1990)

Studies on community acquired pneumonia in the United States in patients over the age of 65 years have shown that Gram negative bacilli account for an appreciable proportion of cases, in addition to usual pathogens such as Streptococcus pneumoniae and Haemophilus influenzae. There have been no reports of community acquired pneumonia in the elderly in the United Kingdom. We undertook such a study to determine the clinical features, aetiology, and outcome. Seventy three patients (38 men) with ages ranging from 65 to 97 (median 79) years were studied prospectively. Pneumonia was defined as an acute lower respiratory tract infection with new, previously unrecorded shadowing on a chest radiograph. Patients with severe chronic illness in whom pneumonia was an expected terminal event were excluded. Nearly all the patients (96%) had respiratory symptoms or signs but many had features that might obscure the true diagnosis of pneumonia. Over half the patients had non-respiratory symptoms and over a third had no systemic signs of infection. A pathogen was identified in 43% of patients, most commonly Streptococcus pneumoniae, Haemophilus influenzae and influenza B virus. Gram negative bacilli were not seen. The mortality rate was high (33%). Early deaths were due to infection whereas later deaths were associated with other factors, such as stroke (two patients) and pulmonary embolism (two patients). Prognostic indicators for mortality were apyrexia, systolic hypotension, increasing hypoxaemia, and new urinary incontinence. As the range of pathogens causing pneumonia was the same in the elderly in this study as in other age groups it is suggested that initial antibiotic treatment for patients in this age group should always cover S pneumoniae and H influenzae.
Australian study shows how to get best value from preventive measures
Authors: M. Sweet
Journal: BMJ (2010)

Huge health gains could be achieved by a few key preventive interventions, including taxing unhealthy foods, higher taxes on tobacco and alcohol, and limiting salt in bread, cereals, and margarine, a new Australian study concludes.

The evaluation of preventive measures to improve health, published by the University of Queensland, Brisbane, and Deakin University, Melbourne, also recommends stopping prostate specific antigen testing to screen for prostate cancer and other measures that it says are not cost effective, including aspirin for primary prevention of cardiovascular disease (www.sph.uq.edu.au/bodce-ace-prevention).

It recommends disinvesting from most approaches to promoting fruit and vegetable intake, weight loss programmes, and school based interventions against illicit drug use.

It advises what “may seem like a radical approach” of encouraging laparoscopic gastric banding for severely obese people, saying that this would be far better value than dietary and exercise interventions, which tend not to lead to long term weight loss.

One of its major recommendations is to use cost effective generic drugs or a low cost polypill to treat …
Amoxicillin conjugates to HLA class I molecules and interferes with signalling through the ILT2/LIR‐1/CD85j inhibitory receptor
Authors: E. Morel, T. Bellón
Journal: Allergy (2007)

Background: Drugs behave as haptens and are recognized by specific T‐cell receptors in the context of major histocompatibility complex (MHC) molecules in allergic subjects. Natural killer cell receptors (NKRs) are MHC class I‐specific receptors that modulate the threshold of activation of immunocompetent cells. Amongst them, ILT2/LIR‐1/CD85j is an inhibitory NKR widely distributed in several cell lineages and with a broad spectrum of recognition of human leucocyte antigen (HLA) class I ligands. Methods: We have evaluated, at the biochemical and cellular level, the ability of amoxicillin (AX) conjugate to HLA class I molecules and to interfere with the inhibitory signal delivered by the HLA class I receptor ILT2/LIR‐1/CD85j. Results: We have detected AX bound to cell membrane proteins and in particular to HLA class I molecules. Preincubation with AX rendered target cells susceptible to NK cell‐mediated lysis. In conjugation experiments, target cell‐bound AX hampered tyrosine phosphorylation of ILT2/LIR‐1/CD85j upon ligand recognition and the subsequent recruitment of SHP‐1 phosphatase. Conclusion: Conjugation of AX to HLA class I molecules may mask HLA recognition by inhibitory receptors and attenuate the negative signal delivered by SHP‐1 phosphatase, thus lowering the threshold of activation of effector cells.
SMILE A WHILE
Authors: John Cullen
Journal: JAMA (1966)

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
Adenomatous Polyps of the Colon
Authors: Richard H. Marshak
Journal: JAMA (1976)

THE MANAGEMENT of adenomatous polyps of the colon is a controversial subject. We have taken an approach that utilizes the points of agreement among clinicians, radiologists, and pathologists to offer a rational basis for the diagnosis and treatment of these lesions. Pathologists agree that an adenomatous polyp on a long stalk is at most a lesion of low-grade<i>clinical</i>malignancy. Even if the head of the polyp histologically harbors carcinoma cells, these cells rarely traverse the pedicle into adjacent lymph nodes. Grinnell and Lane,<sup>1</sup>in a series of 2,000 patients, did not find a single patient who had a polyp on a long stalk with a head measuring less than 1.5 cm in whom metastasis had occurred. Enterline<sup>2</sup>recently restated this view, noting that he had never seen metastasis when a carcinoma is confined to the head of a polyp on a stalk. Ackerman and Spratt,<sup>3</sup>Castleman
Effects of Pericardial Constraint on Left Ventricular Mechanoreceptor Activity in Cats
Authors: Steven Y. Wang, Robert S. Sheldon, Dale W. Bergman, John V. Tyberg
Journal: Circulation (1995)

The purpose of this study was to assess the effect of pericardial constraint on the activity of left ventricular (LV) mechanoreceptors with nonmyelinated vagal afferents.Single-unit activity of cervical vagal afferents (conduction velocity, 1.6 +/- 0.5 m/s) was recorded in six cats anesthetized with alpha-chloralose. Discharge frequency during diastole (DFdiastole) and systole (DFsystole) was determined after correction for conduction delay of the nerve action potential. When the pericardium was closed and LV end-diastolic pressure (LVEDP) was approximately 5 mm Hg, DFdiastole and DFsystole were 1.3 +/- 1.0 and 0.3 +/- 0.1 impulses per second, respectively. Volume expansion increased LVEDP, LV transmural LVEDP, and segment length and was associated with a significant increase in DFdiastole. At a given LVEDP, DFdiastole was significantly greater in the absence of the pericardium than with the pericardium closed. Removal of the pericardium increased the slope of the relation between DFdiastole and intracavitary LVEDP but did not alter the slope of the relations between DFdiastole and transmural LVEDP and LV segment length.These results suggest that, rather than the absolute value of intracavitary LVEDP, transmural LVEDP and distension appear to be more important determinants of diastolic LV mechanoreceptor activity and that pericardial constraint may attenuate mechanoreceptor activity by limiting cardiac distension.
Foreign Objects in the Spinal Canal
Authors: Henry D. Messer
Journal: JAMA (1979)

To the Editor.—  Although it is generally believed, as stated by Nino et al (240:1173, 1978), that foreign objects should always be removed from the spinal canal, demonstration that removal of bone or lead fragments is actually of benefit remains unproved. Many patients, especially those with partial cord function, will show improvement without surgery. While I agree with Nino and associates, that late deterioration of cord function may be associated with syringomyelia or fibrous scarring, I know of no evidence that early surgery will prevent such worsening. Also, one should keep in mind the possibility that the presence of copper (a jacketing on many bullets) can lead to progressive cyst formation and deterioration in the CNS. 1   Many of us with much experience in the management of gunshot wounds of the spine have certainly seen patients made worse or even die after laminectomy. Therefore, I would urge conservatism and disagree