tbuckley/cabot-search huggingface dataset:
Additional Steps Proposed to Ensure Antiacne Drug Used Only in Appropriate Patient Population
Authors: Charles Marwick
Journal: JAMA (1990)

FURTHER STEPS are being taken to prevent pregnant women from taking the antiacne drug isotretinoin (Accutane, Hoffman-La Roche, Inc). The measures include a videocassette movie for patients to see in the physician's office, warning of the teratogenic effects of the drug, and expansion of patient referral to obstetrician-gynecologists for pregnancy testing at the time of prescribing the drug. In hearing about these steps, two Food and Drug Administration (FDA) advisory committees also heard a proposal from the American Academy of Dermatology to develop a special prescription form, indicating to the pharmacist that the patient has been counseled about the risks of the drug and has had a pregnancy test. These moves represent further efforts by the manufacturer, medical organizations, and the FDA to reduce still further the fetal malformations that are likely to occur if a women being treated with the drug is, or becomes, pregnant. The drug has been
Evaluation of Bone Pain in Carcinoma of the Lung
Authors: Henry D. Covelli
Journal: JAMA (1980)

False-negative bone scans localized to the vertebral column were detected in ten patients with primary carcinoma of the lung. All patients had macroscopic vertebral metastases at autopsy despite recent normal technetium Tc 99m bone scans and skeletal roentgenograms. Bone scans were 96% accurate in detecting nonvertebral metastases that were grossly visible at postmortem, with seven patients demonstrating multiple skeletal defects. False-negative studies of the vertebral column apparently prevented both the clinician and radiotherapist from treating symptomatic metastases in eight patients despite the administration of radiotherapy to other scan-positive symptomatic areas or to the primary tumor site.
The composition of ileostomy fluid
Authors: T. Kanaghinis, M. Lubran, N. F. Coghill
Journal: Gut (1963)

The paper presents data on the sodium, potassium, and water content of ileostomy dejecta from 12 patients with new ileostomies and six patients with established ones. The effects of administration of electrolytes and codeine on these parameters are described. The literature on the chemistry of ileostomy is critically reviewed.
HISTOLOGICAL STUDIES ON HOG CHOLERA
Authors: Oskar Seifried
Journal: The Journal of Experimental Medicine (1931)

1. A more or less marked encephalomyelitis and meningitis was found in 33 out of 39 cases of virus hog cholera which had been infected either intramuscularly or by contact and killed between 6 and 49 days after infection. 2. This hog cholera encephalitis is characterized by a varying amount of vascular and perivascular infiltration with small lymphocytes, mononuclear elements, a few plasma cells, and occasionally a few eosinophilic leucocytes. The glia shows a proliferation surrounding infiltrated vessels or forming small nodules or more diffuse foci. Satellitism and in a few instances true neuronophagia have been observed. Both microglia and macroglia participate in this process. There is no essential increase of glia fibers. In nearly all parts of the central nervous system degenerating lesions of the nerve cells such as tigrolysis and degeneration of the nucleus, including a slight atrophy of endocellular neurofibers, are encountered. No demyelinization has been observed. Specific inclusion bodies in the nerve cells are absent. In addition, in a certain number of cases microscopic and macroscopic hemorrhages are present in the brain, spinal cord, and meninges. 3. These lesions in varying degrees have been found in swine infected with four different strains of hog cholera virus. Two were laboratory strains and two were obtained from fresh field outbreaks. 4. Histological changes in the central nervous system were found as early as 6 days after infection before the animal showed central nervous system symptoms. In two cases which were paralyzed no lesions in the central nervous system could be demonstrated. 5. The lesions in the central nervous system are considered to be the anatomical substratum for the various nervous symptoms commonly found in hog cholera.
Primary Sensitization to Inhalant Allergens
Authors: PATRICK G. HOLT, CLAUDIA MACAUBAS, SUSAN L. PRESCOTT, PETER D. SLY
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Evidence suggests that allergen-specific helper T (Th) cell memory, which underlies expression of atopy in adulthood, is programmed during very early life. Predisposition to primary allergic sensitization per se may be related to the function of discrete gene(s) that regulate responses to microbial stimuli, particularly during early infancy, whereas a second set of genes may control tissue expression of atopic disease.
The Possible Inter-Relation of Psoriasis and<i>Streptococcus faecalis</i>
Authors: Jacob H. Swartz
Journal: New England Journal of Medicine (1945)

MUCH has been learned about psoriasis, but none of the numerous theories have been substantiated by evidence that warrants a definite conclusion concerning its etiology.Of particular interest is the fact that some cases have responded temporarily to a diet low in proteins, others to one low in carbohydrates, and still others to a low-fat intake. In many cases, however, if the patient continued on such a diet for any length of time, the improvement ceased. A change to another type of diet frequently resulted in further improvement.It is noteworthy that there is a strong family history of psoriasis . . .
Bottle feeding and the sudden infant death syndrome
Authors: E A Mitchell, A W Stewart, R P K Ford
Journal: BMJ (1995)

EDITOR,--R E Gilbert and colleagues report that bottle feeding is not a significant independent risk factor for the sudden infant death syndrome.1 We believe that they may have made a type 2 error (stating that there is no difference when in fact there is one). They report that the risk of the syndrome in breast fed infants was almost half that seen in bottle fed infants after adjustment for a small number of potential confounders. As the reduction in risk did not reach significance, however, they conclude that bottle feeding was not an independent risk factor.

The New Zealand cot death study, …
Bone SPECT in Baastrupʼs Disease
Authors: LOUISE MICHELLE HAMLIN, CALVIN B. DELAPLAIN
Journal: Clinical Nuclear Medicine (1994)

A 29-year-old man with chronic back pain not associated with any neuropathy was imaged with planar and SPECT bone scintigraphy. Increased uptake of the radiopharmaceutical was noted in the posterior elements of L4. Plain film radiographs demonstrated abnormal contact of the apposing spinous processes (“kissing spines”), which results in reactive sclerosis causing increased uptake on the bone scintigrams.
Inhibition of endothelial cell activation by adenovirus-mediated expression of I kappa B alpha, an inhibitor of the transcription factor NF-kappa B.
Authors: C J Wrighton, R Hofer-Warbinek, T Moll, R Eytner, F H Bach, R de Martin
Journal: The Journal of Experimental Medicine (1996)

During the inflammatory response, endothelial cells (EC) transiently upregulate a set of genes encoding, among others, cell adhesion molecules and chemotactic cytokines that together mediate the interaction of the endothelium with cells of the immune system. Gene upregulation is mediated predominantly at the transcriptional level and in many cases involves the transcription factor nuclear factor (NF) kappa B. We have tested the concept of inhibiting the inflammatory response by overexpression of a specific inhibitor of NF-kappaB, I kappa B alpha. A recombinant adenovirus expressing I kappa B alpha was constructed (rAd.I kappa B alpha) and used to infect EC of human and porcine origin. Ectopic expression of IkappaBalpha resulted in marked, and in some cases complete, reduction of the expression of several markers of EC activation, including vascular cell adhesion molecule 1, interleukins 1, 6, 8, and tissue factor. Overexpressed I kappa B alpha inhibited NF-kappa B specifically since (a) in electrophoretic mobility shift assay, NF-kappa B but not AP-1 binding activity was inhibited, and (b) von Willebrand factor and prostacyclin secretion that occur independently of NF-kappa B, remained unaffected. Functional studies of leukocyte adhesion demonstrated strong inhibition of HL-60 adhesion to I kappa B alpha-expressing EC. These findings suggest that NF-kappa B could be an attractive target for therapeutic intervention in a variety of inflammatory diseases, including xenograft rejection.
Hypernatremia and Lactulose Therapy
Authors: Donald C. Nelson
Journal: JAMA (1983)

Lactulose is used in the treatment of portal-systemic encephalopathy. Although it is usually safe, a case of hypernatremia has been reported. To evaluate further the association of lactulose therapy and hypernatremia, records of patients with hepatic failure treated with lactulose for encephalopathy were analyzed. In 20 of 75 courses of lactulose treatment, serum sodium level exceeded 145 mEq/L. Mortality was 41% in patients in whom hypernatremia developed as compared with 14% in those who remained normonatremic. In persons who died, hypernatremia persisted; in patients who eventually recovered, the serum sodium level returned to normal. The precise mechanism of hypernatremia in these cases is not clearly defined. As an osmotic cathartic, however, lactulose may cause fecal water loss in excess of sodium, resulting in contraction of extracellular fluid volume and, therefore, hypernatremia.
Faecal calprotectin (FC) in secondary care: unnecessarily complex or definitely helpful?
Authors: M. Srinivas, R. Eyre, M. Walsh, P. Basumani, B. Hoeroldt, P. Willemse, K. Bardhan
Journal: Gut (2011)

<h3>Introduction</h3> Faecal calprotectin (FC) is a protein complex released from degraded neutrophils exuded through the gut wall into the lumen. Its levels are therefore likely to better reflect the presence and intensity of gut inflammation than our conventional inflammatory markers: C reactive protein (most commonly used by us), platelets, albumin, endoscopy, histopathology and imaging. FC values (mg/kg) suggest inflammatory status as &lt;50:Nil; 50–100: possible; &gt;100: likely; &gt;1000: definite. The factors limiting its routine use include need for spot stool collection, which many patients dislike and the time involved for manual assay, hence higher cost. Is the ‘help’ in decision making worth the effort and cost? <h3>Aim</h3> To test the utility of FC in the routine clinical setting of a gastroenterology unit in a UK DGH. <h3>Methods</h3> Retrospective study of consecutive new and follow up patients who had FC (PhiCal ELISA test) done in our clinics between 10/2007 and 2/2009 (n = 200). Patients were categorised into IBD-flare (relapse), IBD-active (persistent activity), IBD-remission and non-IBD (eg, IBS, abdominal pain, weight loss). The spot FC values are tabulated as median and range according to presence or absence of inflammation by conventional markers as above (≤ 1 test done within 2 weeks in majority). <h3>Results</h3> See table 1. <h3>Conclusion</h3> FC levels &gt; 500 correlate well with flare and active IBD. Very low levels (&lt; 7.8) reliably indicate lack of significant GI inflammation. Levels &gt; 7.8 in non-IBD patients (majority of new referrals) may indicate ongoing GI inflammation in a few and hence the need to investigate fully rather than assume functional GI disease as the FC levels are within the published “normal” range. Raised FC in IBD-remission may signify ongoing silent inflammation with potentially significant influence on long-term prognosis (an area to be explored). <h3>Discussion</h3> This retrospective pilot study in our unit suggests that the effort and cost of FC is exceeded by the help it offers. It is of definite help when levels are very high or very low. We need to assess systematically the disease correlation with moderate FC elevation to develop local normal values.
Pulmonary Embolism
Authors: Benson B. Roe, Joel C. Goldthwait
Journal: New England Journal of Medicine (1949)

CONSIDERABLE interest has been manifested in the subject of thromboembolism during the past few years, and numerous reports have appeared in the literature on the various preventive measures. As far as we know, however, no long-range mortality statistics following an extended trial of one method of treatment have been reported, and it is our purpose here to analyze the possible effects of femoral-vein interruption on the mortality of pulmonary embolism at the Massachusetts General Hospital.Interruption of the femoral veins was introduced in this hospital in 1939 as a measure hoped to be of value in the prevention of fatal . . .
Mesenteric panniculitis following colonoscopy, polypectomy, and epinephrine injection
Authors: K. Lee, E. Ehrenpreis, J. Greenberg, G. Yang, J. Horowitz
Journal: Endoscopy (2010)

A 47-year-old woman with irritable bowel syndrome and family history of colon cancer underwent an elective colonoscopy. During the procedure, two sigmoid polyps were removed via hot biopsy. This was complicated by arterial bleeding and controlled with an injection of 6 mL of 1 : 10 000 epinephrine and placement of an endoscopic clip. Immediately following the procedure, the patient developed severe abdominal pain and irregular bowel habits leading to hospitalization. She was treated with intravenous levofloxacin, metronidazole, and oral 5-aminosalicylic acid for 7 days without relief.
Med School: A Collection of Stories About Medical School 1951-1955
Authors: A. W. Gotta
Journal: JAMA (2004)

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
Cutaneous Melanoma: Clinical Management and Treatment Results Worldwide
Authors: Kirby I. Bland
Journal: JAMA (1985)

This comprehensive textbook is edited by two international authorities experienced in the natural history and clinical management of cutaneous melanoma. The volume enlists the contributions of the authors, three additional surgeons, and two pathologists involved with the clinical care of over 4,000 patients with melanoma within a 25-year interval. Additional contributors include 79 authorities in surgery, dermatology, pathology, medical oncology, and biostatistics. This review of the comprehensive approach to malignant melanoma presents a unique approach to data presentation, which collectively incorporates the clinical experience of the authors in the management of over 20,000 patients treated at major melanoma centers throughout the world. An organized, concise, yet exhaustive review of this neoplasm from its in situ phase to the more advanced stages is presented in a readable format that allows one to formulate objective opinions with regard to the natural history and therapeutic options for this neoplasm. The book is organized
Lupus anticoagulant associated with primary malignant lymphoplasmacytic lymphoma of the spleen: A report of four patients
Authors: M. Ciaudo, M. H. Horellou, C. De Carbonnieres, J. Conard, M. Samama, J. Audouin
Journal: American Journal of Hematology (1991)

Abstract Primary lymphoma of the spleen is characterized by predominant splenomegaly. Lymphoplasmacytic malignant lymphoma of the spleen, of low malignancy in the Kiel classification, low and intermediate grade in the National Cancer Institute Working Formulation (NCIWF), is rare. It is often associated with a monoclonal immunoglobulin M (IgM). Four patients presenting with primary splenic lymphoma of plasmacytic type associated with a high level of monoclonal IgM and a lupus anticoagulant (LA) are described. This association has not previously been reported. In contrast with the usual heterogeneity of LA, this LA is relatively homogeneous with an important prolongation of the prothrombin time (&gt;18 see for a control of 12), more prolonged partial thromboplastin time (PTT) of the mixture patient + control plasma than PTT of the patient plasma. Despite the important coagulation abnormalities, none of these four patients has presented any hemorrhagic or thrombotic complications, even during major surgery such as splenectomy. The lupus‐like anticoagulant effect ran parallel with the monoclonal IgM. Survival, after splenectomy and chemotherapy, appears to be favourable: three patients are alive with survivals of ≧7 years. The follow‐up is as yet too short for the last patient.
Charlotte Emma Hall
Authors: G. Kinghorn
Journal: BMJ (2010)

Phosphodiesterase-4 (PDE4) plays a critical role in the regulation of β-adrenergic receptor–stimulated cyclic adenosine monophosphate cell signaling in the heart. (<i>R</i>)-rolipram, a PDE4-selective inhibitor, has been studied previously as a radiotracer for the quantification of PDE4 levels. The aim of this study was to characterize (<i>R</i>)-<sup>11</sup>C-rolipram binding in the rat myocardium in vivo, using small-animal PET. <b>Methods:</b> Male Sprague–Dawley rats (<i>n</i> = 30) were administered (<i>R</i>)-<sup>11</sup>C-rolipram and imaged for 60 min to evaluate tracer binding and reproducibility, quantified using Logan slope analysis of the distribution volume. Dynamic <sup>13</sup>N-ammonia imaging was performed to quantify myocardial blood flow and assist in cardiac regional analysis. Saturation studies evaluated the sensitivity of (<i>R</i>)-<sup>11</sup>C-rolipram to PDE4 blocking by unlabeled cold (<i>R</i>)-rolipram (0.0001–1.0 mg/kg), for estimation of the median effective dose (ED<sub>50</sub>) in the heart. (<i>R</i>)-<sup>11</sup>C-rolipram response to enhanced norepinephrine stimulation of the β-adrenergic receptor with desipramine (20 mg/kg, intravenous) was also studied. Intrarat variability studies (<i>n</i> = 5) were conducted with test–retest imaging at 16 ± 7 d. <b>Results:</b> A reduction of Logan slope was observed with increasing cold mass coadministered with the tracer, with an ED<sub>50</sub> of 0.0019 mg/kg (95% confidence interval, 0.0014–0.0052) estimated from the saturation studies. This ED<sub>50</sub> predicted less than 10% enzyme occupancy at 0.0002 mg of cold (<i>R</i>)-rolipram per kilogram (mass/body weight). Low-occupancy imaging at 0.00018 ± 0.00002 mg/kg produced a mean Logan slope of 5.5 ± 0.85 mL/cm<sup>3</sup>. Enzyme saturation of more than 90%, compared with low-occupancy conditions, occurred at more than 0.02 mg/kg, with a complete blocking dose (&gt;1 mg of (<i>R</i>)-rolipram per kilogram) resulting in a Logan slope of 3.3 ± 0.1 mL/cm<sup>3</sup>, representing a 40% reduction. Compared with baseline, a Logan slope of 6.8 ± 0.7 mL/cm<sup>3</sup> in desipramine-challenged animals was observed, representing a 30% increase due to acute norepinephrine stimulation, despite a reduction in myocardial blood flow. Intrarat and intraoperator variability was less than 5% between repeated measures. <b>Conclusion:</b> (<i>R</i>)-<sup>11</sup>C-rolipram shows the ability to monitor increases and decreases in PDE4 availability in the rat myocardium, with good reproducibility.
Hospital accused of experiments on pregnant women
Authors: J Roberts
Journal: BMJ (1994)

A major American medical centre has been accused of violating the rights of its pregnant patients. The Medical University of South Carolina was accused last week of testing pregnant patients for drug use without their consent, collecting confidential information and turning it over to police, and conducting illegal experiments on humans.

The programme of drug testing began in 1989 to try to stop women from using drugs such as cocaine and heroin during pregnancy. Local government and hospital officials hoped that the threat of prison …
Adam Neil Smith
Authors: Katy McIntyre
Journal: BMJ (2005)

In 1982, when the AIDS epidemic was in its infancy, it took an unusually prescient person to recognise that this was a disease like no other.One such person was Alvin Novick, professor of biology at Yale University and a former clinician.The term AIDS had only just been coined.President Reagan had not mentioned the word in public (that took him a further three years), though his press secretary had joked about AIDS in a press briefing.The virus had yet to be identified; the first AIDS drug, AZT (zidovudine), was not to reach the marketplace for another five years.Alvin Novick, then aged 58, ended his 30 year study of bat sonar systems to confront the crisis.He ceased doing laboratory science and devoted the rest of his life-a further 20 years-to tackling AIDS.Insightful, decisive, compassionate, and rigorous in everything he did, Novick was ahead of his time on almost every issue.From the beginning, he pressed for safeguards at blood banks.He researched the legal, ethical, public policy, and community development aspects of HIV/AIDS, and he was interested in every aspect of the disease, including AIDS education and prevention; risk reduction for people who injected drugs; the ethical issues surrounding ethnographic research; surveillance; confidentiality; testing; the conduct of clinical trials; tuberculosis and AIDS; the behavioural epidemiology of AIDS; and home and terminal care for patients-he founded Connecticut's AIDS hospice.Novick wanted drug users included in clinical trials, not least to enhance their access to health care.He also researched post-exposure prophylaxis, the use of law to regulate behaviour, the systematic oppression of people who were vulnerable to AIDS infection or were infected; drug adherence; and vertical transmission.
Risk Factors and Risqué Humor
Authors: Samuel Vaisrub
Journal: JAMA (1976)

Prohibition in any form, be it the sixth commandment, the governmental ban on sale of alcoholic drinks, or the medical proscription of cholesterol-rich foods, stokes the furnaces of humor. Restrictions, particularly medical enjoinders, generate jokes. Some, like Mark Twain's memorable: "It's easy to give up smoking. I did it hundreds of times" have become classics of the stage comic. Others, among them jests about fat women cheating on their diet, are best forgotten. One of the less memorable jocular takeoffs on a medical restraint occurred recently when a renowned television emcee based his humor on the risks of sexual activity after myocardial infarction. The speed—a matter of hours—with which the television program followed the presentation of a paper on this topic at the annual meeting of the American Heart Association attested to the popular interest in matters pertaining to heart disease. Whether the humor was in good taste is, of