tbuckley/cabot-search huggingface dataset:
Development of Congestive Heart Failure in Type 2 Diabetic Patients With Microalbuminuria or Proteinuria
Authors: Laurent Vaur, Pascal Gueret, Michel Lievre, Sylvie Chabaud, Philippe Passa
Journal: Diabetes Care (2003)

OBJECTIVE—The DIABHYCAR (type 2 DIABetes, Hypertension, CArdiovascular Events and Ramipril) study allowed investigators to analyze factors leading to the development of congestive heart failure (CHF) in type 2 diabetic patients with abnormal urinary albumin concentration. RESEARCH DESIGN AND METHODS—Type 2 diabetic subjects of both sexes aged ≥50 years who had a urinary albumin concentration ≥20 mg/l were randomly allocated to 1.25 mg/day ramipril or placebo in addition to their usual treatment and treated for 3–6 years in a double-blind fashion. Major outcomes including hospitalization for CHF were recorded during the follow-up. RESULTS—Of the 4,912 included patients, 187 developed CHF during the study. There was no significant difference in the incidence of CHF between the two treatment groups. Using a multivariate analysis, independent risk factors for the occurrence of CHF were age, history of cardiovascular disease, baseline urinary albumin concentration, baseline HbA1c, and smoking habits. A total of 68 of the 187 patients (36.4%) died during the 12 ± 11-month period after the first hospitalization for CHF, whereas the annual mortality rate of the population who did not develop CHF was 3.2%. CONCLUSIONS—Presence of atherosclerotic disease, baseline urinary albumin concentration, and HbA1c level were indicators for further development of CHF. Occurrence of CHF is a major prognostic turn in a diabetic patient’s life.
Routine Depression Screening for Patients With Diabetes—Reply
Authors: Lee J. Ducat, Louis H. Philipson, Barbara J. Anderson
Journal: JAMA (2014)

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
TOTAL REMOVAL OF STOMACH FOR CARCINOMA OF PYLORUS—RECOVERY.
Authors: G. CHILDS MACDONALD
Journal: JAMA (1898)

J. Patritti, Italian; aged 38 years; occupation, dairyman; admitted to St. Mary's Hospital on June 15, 1898, suffering from a tumor of the pyloric end of the stomach. The usual symptoms associated with that condition were present; as the patient was unable to speak English but imperfectly, no definite history was obtainable, but so far as we could gather, he had been ill, probably unable to work, for two and one-half months prior to entering the institution. He stated he never had any previous illness; moreover his immediate relatives were free from cancers or tumors. He complained of pain in the epigastric region, paroxysmal in character, vomiting and weakness. The physical examination revealed marked general emaciation, a distinct movable tumor in the right hypochondrium; the stomach was dilated and on stimulation of the epigastrium by rubbing could be made to contract violently, attempting to pass its contents on to the
The Evolving Field of Tyrosine Kinase Inhibitors in the Treatment of Endocrine Tumors
Authors: Lei Ye, Libero Santarpia, Robert F. Gagel
Journal: Endocrine Reviews (2010)

Abstract Activation of tyrosine kinase receptors (TKRs) and their related pathways has been associated with development of endocrine tumors. Compounds that target and inactivate the kinase function of these receptors, tyrosine kinase inhibitors (TKIs), are now being applied to the treatment of endocrine tumors. Recent clinical trials of TKIs in patients with advanced thyroid cancer, islet cell carcinoma, and carcinoid have shown promising preliminary results. Significant reductions in tumor size have been described in medullary and papillary thyroid carcinoma, although no complete responses have been reported. Case reports have described significant tumor volume reductions of malignant pheochromocytomas and paragangliomas. In addition, these compounds showed an initial tumoricidal or apoptotic response followed by long-term static effects on tumor growth. Despite the promising preliminary results, this class of therapeutic agents has a broad spectrum of adverse effects, mediated by inhibition of kinase activities in normal tissues. These adverse effects will have to be balanced with their benefit in clinical use. New strategies will have to be applied in clinical research to achieve optimal benefits. In this review, we will address the genetic alterations of TKRs, the rationale for utilizing TKIs for endocrine tumors, and current information on tumor and patient responses to specific TKIs. We will also discuss the adverse effects related to TKI treatment and the mechanisms involved. Finally, we will summarize the challenges associated with use of this class of compounds and potential solutions.
Peter Edward Morris
Authors: P. Palfrey
Journal: BMJ (2003)

Former general practitioner Wednesbury, West Midlands, and Hayle and Carbis Bay, Cornwall (b Wednesbury 1914; q Birmingham 1937), died from a heart attack on 28 August 2003.

After qualification Peter joined his father's general practice in Wednesbury. In 1947, partly out of his affection for sailing, he bought a practice in Hayle, where he worked as a singlehanded practitioner. Peter was well known both for his manual skills and for his inquiring mind, and this was manifest in his interest and practice in acupuncture and manipulative medicine. He retired from full time practice in 1983 and moved to Carbis Bay. Divorced from his first wife, Mollie, and predeceased by his second wife, Vivienne, he leaves two children and six grandchildren.
Differential ventilation in unilateral pulmonary artery occlusion
Authors: C. S. Darke, T. W. Astin
Journal: Thorax (1972)

A case is reported of complete isolated occlusion of the right pulmonary artery resulting in underperfusion of the right lung; this was confirmed radiographically and at thoracotomy. Bronchospirometry showed that there was a reduction of ventilation to the right lung. When this lung alone was supplied with a carbon dioxide rich mixture there was a shift of ventilation towards the normal pattern with reversion to the initial distribution when air breathing was resumed. Ventilation of the right lung with a low oxygen mixture failed to cause any shift of ventilation. The results confirm that the effects of pulmonary artery occlusion on differential ventilation which have been shown in animals also occur in man and provide further evidence that carbon dioxide can have a bronchodilator action in man.
Autoimmune Pancreatitis With F-18 Fluoro-2-deoxy-D-Glucose PET Findings
Authors: YUJI NAKAMOTO, HARUMI SAKAHARA, TATSUYA HIGASHI, TSUNEO SAGA, NORIKO SATO, KAZUICHI OKAZAKI, MASAYUKI IMAMURA, JUNJI KONISHI
Journal: Clinical Nuclear Medicine (1999)

Two cases of pancreatitis induced by autoimmunity with PET images using F-18 fluoro-2-deoxy-D-glucose (FDG) are reported. The patients had abdominal pain and were thought to have possible pancreatic neoplasms. In one patient, PET showed intense uptake of the entire pancreas, but a Ga-67 scan yielded a negative result. Because the serum immunoglobulin G level was high, autoimmune pancreatitis was diagnosed in this patient. He underwent steroid therapy and fully recovered. In another patient with positive antinuclear antibodies and hyperglobulinemia, focal intense uptake was found in the head of the pancreas on the FDG PET. She also recovered with steroid therapy. Autoimmune pancreatitis is a relatively new form of chronic pancreatitis and should be kept in mind when making a differential diagnosis of pancreatic cancer with the assistance of FDG PET.
Antiplatelet vs. anticoagulation treatment after intracoronary Palmaz-Schatz stent placement in acute myocardial infarction — A prospective randomized trial
Authors: Hanna Walter, Franz-Josef Neumann, Gert Richardt, Eckhard Alt, Claus Schmitt, Rudolf Blasini, Helmut Schühlen, Martin Hadamitzky, Eva Zitzmann, Albert Schömig
Journal: Journal of the American College of Cardiology (1996)
Mechanisms underlying atriopeptin-induced increases in hematocrit and vascular permeation in rats.
Authors: J R Williamson, S W Holmberg, K Chang, J Marvel, S P Sutera, P Needleman
Journal: Circulation Research (1989)

Infusion of atriopeptin into humans and animals induces diuresis, natriuresis, hemodynamic changes, and an increase in arterial hematocrit. The objective of the present study was to elucidate the mechanism(s) responsible for the increase in hematocrit in rats given atriopeptin-24 (AP-24). Infusion of AP-24 for 30 minutes increased large vessel and total vascular hematocrits by 10-15% while decreasing microvascular hematocrits by 9-26% in numerous tissues. Regional vascular permeation by [131I] bovine serum albumin was markedly increased (2-5.6-fold) in many tissues, consistent with a 16% decrease in plasma volume. AP-24 infusion had no effect on extracellular fluid volume or the volume of circulating red cells. Vascular resistance was decreased and was associated with a significant increase in blood flow in many, but not all, tissues. In the atrium and in the small and large intestine the percentage decrease in microvascular hematocrit exceeded the increase in blood flow. These observations indicate that the increase in large vessel hematocrit induced by AP-24 infusion 1) is accompanied by a decrease in (microvascular) hematocrit in many tissues, 2) reflects an increase in overall (i.e., total vascular hematocrit), and 3) is the consequence of a decrease in plasma volume resulting from a marked increase in the rate of vascular permeation by plasma constituents in multiple tissues.
Long-Term Therapy of Myoclonus and Other Neurologic Disorders with L-5-Hydroxytryptophan and Carbidopa
Authors: Melvin H. Van Woert, David Rosenbaum, John Howieson, Malcolm B. Bowers
Journal: New England Journal of Medicine (1977)

We evaluated the therapeutic effect of L-5-hydroxytryptophan (L-5HTP), the precursor of serotonin (5-hydroxytryptamine), combined with carbidopa, a peripheral decarboxylase inhibitor, in patients with intention myoclonus and examined the serotonin metabolites in spinal fluid, blood and urine before and during therapy. In 18 patients with intention myoclonus due to anoxia or other brain damage, 11 derived more than 50% overall improvement during treatment with L-5HTP and carbidopa. Spinal-fluid 5-hydroxyindoleacetic acid was 35% lower in patients with intention myoclonus than in controls (P less than 0.05). Therapy with L-5HTP and carbidopa increased the concentration of serotonin metabolites in urine and spinal fluid. We postulate that a deficiency of brain serotonin is causally related to intention myoclonus and that the therapeutic effect of L-5HTP and carbidopa may be due to the repletion of serotonin in regions of the brain where serotoninergic neurons have degenerated.
FATE AND FUNCTION OF THE OVARIES AFTER HYSTERECTOMY
Authors: ALICE FREELAND MAXWELL
Journal: JAMA (1924)

The diverging views concerning the fate and function of ovaries that are retained after hysterectomy indicate that there are important problems still to be met in gynecology. Radicals and conservatives cite in support of their opinions the physiology of the ovary, its influence on metabolism and the normality of the individual, and its functional value at different periods in the woman's existence.  Radicals claim that the ovaries are essential for proper growth and development only during infancy and childhood, when they serve as glands of internal secretion. They state that, at puberty, the ovaries assume their specific and important role of reproduction, menstruation being only a physiologic mechanism related to this process. After sexual maturity is reached, they hold that the ovary is without somatic influence and that it is concerned only with procreation. The radicals advocate the removal of the glands when hysterectomy is necessary in adult life, since
Meigs's Syndrome
Authors: A. C. Clay, R. N. Johnston, L. Samson
Journal: BMJ (1944)

JCURNALactual rupture, and that rupture may occur with only weak contractions.(5) That the prognosis depends upon the time elapsing between rupture and laparotomy.Early diagnosis of impending rupture should reduce the mortality to a minimum.In the case reported only a few minutes elapsed between rupture and the delivery of the child.A little earlier and the uterus might have been saved; a little later and two lives might have been lost.
Tracheobronchial FDG Uptake in Primary Amyloidosis Detected by PET/CT
Authors: Michael Soussan, Matthieu-John Ouvrier, Gabriel Pop, Jean-Louis Galas, Alain Neuman, Pierre Weinmann
Journal: Clinical Nuclear Medicine (2011)

Tracheobronchial amyloidosis is a rare manifestation of the disease and has never been described with FDG PET/CT. In this study, we report a case of a 70-year-old man with increasing dyspnea, a right pleural effusion, a tracheobronchial circumferential wall thickening, and a mediastinal fat infiltration on CT scan. FDG PET/CT revealed intense tracheobronchial uptake associated with mediastinal and intra-abdominal fat uptake. Bronchoscopy and mediastinoscopy with biopsies confirmed the diagnosis of primary amyloidosis and excluded malignancy. FDG PET/CT could be useful for the evaluation of tracheobronchial amyloidosis metabolic activity and follow-up.
Accumulation of oxidized LDL in human semilunar valves correlates with coronary atherosclerosis
Authors: M Mehrabi
Journal: Cardiovascular Research (2000)

Objective: Recent data indicate that oxidized low-density lipoprotein (ox-LDL) has several proatherogenic effects, e.g. induction of macrophage chemoattractants, adhesion molecules, cytokines, type-1 plasminogen activator inhibitor and platelet-derived growth factor A-chain by smooth muscle cells. Therefore, ox-LDL has been utilized as a marker of oxidative modification of proteins in atherosclerosis. Because heart valves consist of smooth muscle cells, fibroblasts and endothelial cells, and because valvular disease and coronary atherosclerosis could result from similar biological processes, we investigated ox-LDL accumulation in isolated aortic and pulmonary valves and coronary arteries from patients with angiographically proven coronary heart disease (CHD, n=19), patients with idiopathic congestive heart failure (IDCM=idiopathic dilated cardiomyopathy, n=20), and transplant donors. Methods: Masson–Goldner staining and immunohistochemistry utilizing anti ox-LDL and CD68 were performed on paraffin sections of freshly isolated semilunar valves. Data were analyzed by digital image planimetry and by visual scoring of staining intensity. Results: Ox-LDL immunoreactivity was identified in the vascular aspect of the attachment line, in the deep valve stroma, and in the ventricular and vascular endothelium of the semilunar valves, colocalizing with macrophages. Valvular ox-LDL area was significantly increased in CHD-patients (P<0.03) and IDCM-patients (P<0.04) compared with controls. More ox-LDL was accumulating in the pulmonary valves than in the aortic valves (P=0.04) as assessed by area and staining intensity. Valvular ox-LDL area in pulmonary valve and aortic valve was significantly correlated with ox-LDL accumulation in the intimal layer (P<0.001) and medial layer (P<0.001) of coronary arteries from the same patients. Conclusion: The data suggest that the biological process leading to ox-LDL accumulation in coronary atherosclerosis also involves heart valves. Therefore, accumulation of the oxidative stress marker ox-LDL in heart valves illustrates atherosclerosis as an additional mechanism accelerating valvular degeneration in these patients.
Defective waste disposal: does it induce autoantibodies in SLE?
Authors: P J Charles
Journal: Annals of the Rheumatic Diseases (2002)

Considerable evidence points to a dysregulated or dysfunctional clearance of apoptotic cells in human SLE

Apoptosis, or programmed cell death is central in the normal physiological function of multicellular organisms and is implicated in developmental and homoeostatic mechanisms. It is a complex process that seeks to limit the ability for cellular constituents to leak from a cell and cause damage to surrounding tissues, and to prevent intracellular material from being recognised by the immune system. Phagocytosis of apoptotic cells is critical in their disposal and occurs before membrane degradation, thus ensuring the rapid and safe elimination of potentially inflammatory or immunogenic material from the circulation.

Since the pioneering work by Rosen and colleagues first demonstrated that an autoantigen associated with systemic rheumatic diseases could be located in the blebs of apoptotic cells,1 there has been a growing interest in the role of apoptosis in the production of autoantibodies. It has subsequently been shown that many such autoantigens can be found in macromolecular structures in cell surface vesicles during apoptosis.2,3 These possess the antigenic determinants that bind to autoantibodies from patients with a variety of autoimmune diseases.4,5 However, it must be appreciated that because apoptosis is a normal physiological event, exposure to potential autoantigens is likely to be common in healthy subjects without the induction of autoimmunity. As more is understood about the process of apoptosis, the potential for dysregulation at multiple levels leading to the induction of autoimmune diseases is suggested (fig 1). It is likely that further research will uncover more of these links.

One area of research which has attracted interest is concerned with …
Variability in Radiologists' Interpretations of Mammograms
Authors: Joann G. Elmore, Carolyn K. Wells, Carol H. Lee, Debra H. Howard, Alvan R. Feinstein
Journal: New England Journal of Medicine (1994)

Despite the proved value of mammography in screening for breast cancer, its efficacy depends on radiologists' interpretations. The variability in such interpretations is not well understood.
TV show House helped doctors spot cobalt poisoning
Authors: J. Wise
Journal: BMJ (2014)

The US television series House helped doctors in Germany diagnose cobalt intoxication from a hip replacement in a patient with severe heart failure.

A 55 year old man was referred to a clinic at Philipps-University Marburg in Germany after presenting with hypothyroidism, oesophagitis, fever of unknown origin, increasing deafness, and loss of sight and eventually severe heart failure. Heart catheterisation had ruled out coronary artery disease, said the case report in the Lancet .1

The doctors …
Diagnosis of Neonatal Infection With Herpes Simplex Virus—Reply
Authors: Barry Ladizinski, Kachiu C. Lee
Journal: JAMA (2014)

In Reply Even though rapid DFA testing is not the reference standard test for diagnosing HSV, it was the best option among those given in the answer choices, and the most rapid diagnostic test available because PCR was not an option at the hospital during the weekend when the infant presented.
Homosexual Yout
Authors: Gary Remafedi
Journal: JAMA (1987)

DURING the 1980s, health professionals and laypersons alike have confronted the subject of homosexuality on a daily basis in journals and books, on radio and television, primarily in the context of the acquired immunodeficiency syndrome (AIDS) pandemic. Despite an unprecedented public awareness of adult homosexuality and its relevance to a variety of individual and public health issues, disproportionately little attention has been focused on the antecedents of homosexuality in childhood and adolescence. Although the prevalence of adolescent homosexual behavior is well recognized, some authorities<sup>1</sup>"clearly reject"<sup>2</sup>the notion that a homosexual orientation can be established prior to adulthood. Unlike other cultures, including Native American communities,<sup>3</sup>modern American society views heterosexuality as the only possibility for its young. The homosexual adult, as if by parthogenesis, springs from the heterosexual child at the age of 18 years. Not only does this perspective preclude understanding the origins and development of
Phase I Study of Single-Agent Anti–Programmed Death-1 (MDX-1106) in Refractory Solid Tumors: Safety, Clinical Activity, Pharmacodynamics, and Immunologic Correlates
Authors: Julie R. Brahmer, Charles G. Drake, Ira Wollner, John D. Powderly, Joel Picus, William H. Sharfman, Elizabeth Stankevich, Alice Pons, Theresa M. Salay, Tracee L. McMiller, Marta M. Gilson, Changyu Wang, Mark Selby, Janis M. Taube, Robert Anders, Lieping Chen, Alan J. Korman, Drew M. Pardoll, Israel Lowy, Suzanne L. Topalian
Journal: Journal of Clinical Oncology (2010)

Purpose Programmed death-1 (PD-1), an inhibitory receptor expressed on activated T cells, may suppress antitumor immunity. This phase I study sought to determine the safety and tolerability of anti–PD-1 blockade in patients with treatment-refractory solid tumors and to preliminarily assess antitumor activity, pharmacodynamics, and immunologic correlates. Patients and Methods Thirty-nine patients with advanced metastatic melanoma, colorectal cancer (CRC), castrate-resistant prostate cancer, non–small-cell lung cancer (NSCLC), or renal cell carcinoma (RCC) received a single intravenous infusion of anti–PD-1 (MDX-1106) in dose-escalating six-patient cohorts at 0.3, 1, 3, or 10 mg/kg, followed by a 15-patient expansion cohort at 10 mg/kg. Patients with evidence of clinical benefit at 3 months were eligible for repeated therapy. Results Anti–PD-1 was well tolerated: one serious adverse event, inflammatory colitis, was observed in a patient with melanoma who received five doses at 1 mg/kg. One durable complete response (CRC) and two partial responses (PRs; melanoma, RCC) were seen. Two additional patients (melanoma, NSCLC) had significant lesional tumor regressions not meeting PR criteria. The serum half-life of anti–PD-1 was 12 to 20 days. However, pharmacodynamics indicated a sustained mean occupancy of &gt; 70% of PD-1 molecules on circulating T cells ≥ 2 months following infusion, regardless of dose. In nine patients examined, tumor cell surface B7-H1 expression appeared to correlate with the likelihood of response to treatment. Conclusion Blocking the PD-1 immune checkpoint with intermittent antibody dosing is well tolerated and associated with evidence of antitumor activity. Exploration of alternative dosing regimens and combinatorial therapies with vaccines, targeted therapies, and/or other checkpoint inhibitors is warranted.