tbuckley/cabot-search huggingface dataset:
Treatment of Chronic Lead-poisoning with Calcium Disodium Versenate
Authors: A. C. Markus, A. G. Spencer
Journal: BMJ (1955)

All authors agree that treatment with versenate gives prompt relief from the distressing symptoms of lead- poisoning.Calcium disodium versenate is a synthetic chelating agent that removes lead from the body by the formation of a soluble non-ionized lead complex which is excreted in the urine.The pharmacology and mode of action of versenate are described in detail by Karpinski et al. (1953).In chronic lead-poisoning lead is stored in the bones, and this may subsequently be released by infection or metabolic stress and cause acute lead-poisoning (Aub et al., 1925).It has been shown that lead can be mobilized by the administration of ammonium chloride or "para-thor-mone" (Hunter and Aub, 1927).How- ever, such treatment may also cause a recurrence of the symptoms of lead-poisoning,and opinion is divided, therefore, on the wisdom of attempts to de-lead the skeleton (Cantarow and Trumper, 1944).It is possible that during treatment with versenate most of the lead excreted in the urine is derived from the body fluids and soft tissues, and that lead deposited in the skeleton is less readily accessible.For this reason, Giles et al.(1955) have tried treatment with versenate and ammo- nium chloride, but they did not obtain an increase in the rate of excretion of lead in the urine above that produced by versenate alone.This paper describes the excellent results obtained by the use of versenate in three patients with chronic leadpoisoning.In addition, an attempt was made to mobilize lead stored in the bones and to increase its rate of excretion in the urine by the simultaneous use of para-thor-mone and versenate.Case 1 A man aged 33, employed as a vitreous enameller for seven years, was referred to U.C.H. with complaints of anorexia, constipation, and headaches over the past year, and recently of repeated attacks of abdominal pain which
Subconjunctival Swelling — Prolapse of Orbital Fat
Authors: Mohammad Tahir Masoud, M Yusuf Shaikh
Journal: New England Journal of Medicine (2007)

A 59-year-old nonobese man presented with a 7-year history of gradually progressive swelling over the left eye. He had no other clinically significant medical history or history of trauma. There was a soft, yellowish mass in the outer temporal subconjunctival region (Panel A). The patient's vision was normal. Among the disorders in the differential diagnosis, orbital lymphoma was a particular concern. Characteristic features of an orbital lymphoma typically include a lesion of salmon color that is firm on palpation, that has a solid appearance on computed tomography (CT), and that follows the contour of the orbit without bony erosion. The . . .
Abstract P5-13-06: Survival Benefit of Bisphophonates in Early Breast Cancer: A Meta-Analysis
Authors: Y Lin, X Ying, F Wang, P. He
Journal: Cancer Research (2010)

Abstract Objectives: Bone is one of the most common metastatic sites of breast cancer. Recent date from randomized clinical studies suggested that the use of bisphophonates affect bone metastasis and survival in early breast cancer patients. Results from some of these trials are encouraging but somewhat contradictory. We conducted a meta analyses to assess the effect of bisphosphonates on bone metastasis and survival in primary breast cancer patients. Methods: Trials were retrieved by searching the PubMed database, Cochrane Library and major cancer scientific conferences up to January 2010. All tirals randomized patients to receive any bisphosphonate versus non-use or placebo. Hazard ratios (HR) and its 95% CIs for bone metastasis free survival and overall survival were estimated. Results: 8 eligible trials including 6132 patients entered the analysis. 3049 patients were treated with bisphosphonates and 3083 received either placebo or no treatment. Compared with no use, bisphophonates in the adjuvant setting improved the overall survival (HR=0.808; 95%CI 0.708-0.923; P = 0.022). However, the reduction of bone metastasis was failure to be seen (HR = 1.011; 95% CI 0.996-1.027; P = 0.667). Conclusion: Our meta-analysis provides additional evidence that adjuvant breast cancer treastment with bisphosphonates brought a survival benefit. However, the result should be carefully interpreted for that the statistical significance was not consistent in the bone benefit. Results of new clinical trials were awaited. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-13-06.
Pandemic obesity in Europe
Authors: Trish Groves
Journal: BMJ (2006)

A new charter from WHO promises concerted action to prevent and treat obesity

The threats to public health from widespread obesity are well known. So are the main solutions—we all need to move more and eat less. Evidence is still sparse, however, on the effectiveness, and, importantly, the cost effectiveness of large scale public health interventions to prevent and treat obesity. But a fifth of Europe's population is already obese, and obesity in adults accounts for up to 6% of direct health costs and more than 12% in indirect costs of shortened lives, reduced productivity, and lowered incomes.1 Can Europe afford to wait for better evidence? The World Health Organization does not think so. 

This month in Istanbul, WHO brought together from all corners of Europe ministers of health; ministers from other sectors such as education, sport, environment, transport, and agriculture; the food industry; public-private partners; and non-governmental organisations with the aim of taking real and immediate action on obesity. The meeting was more than a high level talking shop. The …
Crooke-Mellgren Cells
Authors: N. G. B. McLetchie
Journal: BMJ (1945)

<h3>Abstract</h3> High frequency oscillations (HFO) are receiving increased attention for their role in health and disease. Ketamine-dependent HFO have been identified in cortical and subcortical regions in rodents, however, the mechanisms underlying their generation and whether they occur in higher mammals is unclear. Here, we show under ketamine-xylazine anesthesia, classical gamma oscillations diminish and a prominent &gt; 80 Hz oscillation emerges in the olfactory bulb of rats and cats. In cats negligible HFO was observed in the thamalus and visual cortex indicating the OB was a suitable site for further investigation. Simultaneous local field potential and thermocouple recordings demonstrated HFO was dependent on nasal airflow. Silicon probe mapping studies spanning almost the entire dorsal ventral aspect of the OB revealed this rhythm was strongest in ventral areas of the bulb and associated with microcurrent sources about the mitral layer. Pharmacological microinfusion studies revealed HFO was dependent on excitatory-inhibitory synaptic activity, but not gap junctions. Finally, we showed HFO was preserved despite surgical removal of the piriform cortex. We conclude that ketamine-dependent HFO in the OB are driven by nasal airflow and local dendrodendritic interactions. The relevance of our findings to ketamine’s model of psychosis in awake state are also discussed.
Jan van Riemsdyk
Authors: John W. Huffman
Journal: JAMA (1969)

Jan van Riemsdyk's work has been hailed as the acme of the medical illustrator's art. His unusual contributions to the development of modern obstetrics and his special relationship to American medical education set him apart from other medical artists. Hence, it is ironic that we know so little about him. He lived during the 18th century when men were prolific letter writers and chronologists, but his confreres, and particularly those most indebted to him, tell us few of the things we would like to know about him. Although he is wraith-like as a person, his work is anything but ghostly. Its impact on obstetric teaching was, in its own way, as forceful as the impact which Calcar's drawings for the<i>De Fabrica</i>had on the teaching of anatomy. Riemsdyk's skillful use of perspective and his manipulation of lights and shadows strongly suggest that he was either trained by Wandelaer (who
Sepsis stimulates nonlysosomal, energy-dependent proteolysis and increases ubiquitin mRNA levels in rat skeletal muscle.
Authors: G Tiao, J M Fagan, N Samuels, J H James, K Hudson, M Lieberman, J E Fischer, P O Hasselgren
Journal: Journal of Clinical Investigation (1994)

We tested the role of different intracellular proteolytic pathways in sepsis-induced muscle proteolysis. Sepsis was induced in rats by cecal ligation and puncture; controls were sham operated. Total and myofibrillar proteolysis was determined in incubated extensor digitorum longus muscles as release of tyrosine and 3-methylhistidine, respectively. Lysosomal proteolysis was assessed by using the lysosomotropic agents NH4Cl, chloroquine, leupeptin, and methylamine. Ca(2+)-dependent proteolysis was determined in the absence or presence of Ca2+ or by blocking the Ca(2+)-dependent proteases calpain I and II. Energy-dependent proteolysis was determined in muscles depleted of ATP by 2-deoxyglucose and 2.4-dinitrophenol. Muscle ubiquitin mRNA and the concentrations of free and conjugated ubiquitin were determined by Northern and Western blots, respectively, to assess the role of the ATP-ubiquitin-dependent proteolytic pathway. Total and myofibrillar protein breakdown was increased during sepsis by 50 and 440%, respectively. Lysosomal and Ca(2+)-dependent proteolysis was similar in control and septic rats. In contrast, energy-dependent total and myofibrillar protein breakdown was increased by 172% and more than fourfold, respectively, in septic muscle. Ubiquitin mRNA was increased severalfold in septic muscle. The results suggest that the increase in muscle proteolysis during sepsis is due to an increase in nonlysosomal energy-dependent protein breakdown, which may involve the ubiquitin system.
Fibrin Resistance to Lysis in Patients with Pulmonary Hypertension Other Than Thromboembolic
Authors: Massimo Miniati, Claudia Fiorillo, Matteo Becatti, Simonetta Monti, Matteo Bottai, Carlo Marini, Elisa Grifoni, Bruno Formichi, Carolina Bauleo, Chiara Arcangeli, Daniela Poli, Paolo Antonio Nassi, Rosanna Abbate, Domenico Prisco
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Reportedly, fibrin isolated from patients with chronic thromboembolic pulmonary hypertension (CTEPH) is resistant to lysis. Persistence of regions within the fibrin beta chain, which mediate cell signaling and migration, could trigger the organization of pulmonary thromboemboli into chronic intravascular scars.Ascertain whether fibrin resistance to lysis occurs in patients with pulmonary hypertension (PAH) other than CTEPH, and in those with prior pulmonary embolism (PE) and no pulmonary hypertension.Fibrinogen was purified from 96 subjects (17 with CTEPH, 14 with PAH, 39 with prior PE, and 26 healthy control subjects) and exposed to thrombin to obtain fibrin clots. Plasmin-mediated cleavage of fibrin beta chain was assessed hourly over a 6-hour period by polyacrylamide gel electrophoresis. Fibrin band intensity was measured by densitometry of stained gels. Data were normalized to the band intensity of the undigested protein.By 1 hour of digestion, fibrin band intensity had decreased by a median of 25% (interquartile range [IQR], 20 to 27%) in control subjects, and by 15% (IQR, 11 to 18%) in patients with prior PE (P < 0.0001). The 1-hour median reduction in band intensity was 2% (IQR, 1 to 3%) in CTEPH, and 4% (IQR, 2 to 7%) in PAH (P < 0.0001 vs. control subjects and PE). The decline in fibrin band intensity remained significantly different among the four groups up to 6 hours (P < 0.0001).Fibrin resistance to lysis occurs in pulmonary hypertension other than CTEPH and, to a smaller extent, in patients with prior PE and no pulmonary hypertension.
The Doctors' Tale: Professionalism and Public Trust
Authors: L. E. Ferris
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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Class III Antiarrhythmic Effects of Zatebradine
Authors: Carmen Valenzuela, Eva Delpo´n, Laura Franqueza, Pilar Gay, One´sima Pe´rez, Juan Tamargo, Dirk J. Snyders
Journal: Circulation (1996)

Background Zatebradine is a bradycardic agent that inhibits the hyperpolarization-activated current (I f ) in the rabbit sinoatrial node. It also prolongs action potential duration in papillary muscles in guinea pigs and in Purkinje fibers in rabbits. The underlying mechanism by which zatebradine induces this effect has not been explored, but it is likely to involve K + channel block. Methods and Results Cloned human cardiac K + delayed rectifier currents (hKv1.5) were recorded in Ltk − cells transfected with their coding sequence. Zatebradine 10 μmol/L did not modify the initial activation time course of the current but induced a subsequent decline to a lower steady-state current level with a time constant of 109±16 ms. Zatebradine inhibited hKv1.5 with an apparent K D of 1.86±0.14 μmol/L. Block was voltage dependent (electrical distance δ=0.177±0.003) and accumulated in a use-dependent manner during 0.5- and 1-Hz pulse trains because of slower recovery kinetics in the presence of the drug. Zatebradine reduced the tail current amplitude, recorded at −30 mV, and slowed the deactivation time course, which resulted in a “crossover” phenomenon when control and zatebradine tail currents were superimposed. Conclusions These results indicate that (1) zatebradine is an open-channel blocker of hKv1.5, (2) binding occurs in the internal mouth of the ion pore, (3) unbinding is required before the channel can close, and (4) zatebradine-induced block is use dependent because of slower recovery kinetics in the presence of the drug. These effects may explain the prolongation of the cardiac action potential and could be clinically relevant.
Importance of Subvalvular Preservation and Early Operation in Mitral Valve Surgery
Authors: Evelyn M. Lee, Leonard M. Shapiro, Francis C. Wells
Journal: Circulation (1996)

Background Mitral valve replacement (MVR) has a high mortality and morbidity. It has been suggested that preservation of the subvalvular apparatus and more optimal timing of surgery might improve outcome. Methods and Results We performed a retrospective study of 612 consecutive patients who underwent mitral valve repair or replacement: 226 patients had repair, 68 had replacement with subvalvular preservation (MVR/SVP), and 318 had replacement without subvalvular preservation (MVR/NoSVP). Baseline characteristics were most unfavorable in the repair group with respect to age ( P =.002) and in the repair and MVR/SVP groups with respect to NYHA functional class and left ventricular function ( P =.044). Thirty-day mortality was lower in the repair (1.8%, P =.046) and MVR/SVP (1.5%, P =NS) groups than the MVR/NoSVP group (5.0%). Overall survival at 7 years was better in the repair (71.2±5.6%, P =.022) and MVR/SVP (66.2±12.4%, P =.017) groups than the MVR/NoSVP group (63.5±3.4%). Myocardial failure caused 66 of 107 complication-related deaths. Multivariate analysis confirmed independent beneficial effects of repair on 30-day mortality (odds ratio, 0.27, P &lt;.05) and of repair and MVR/SVP on overall mortality (hazard ratios, 0.43, P &lt;.001 and 0.40, P &lt;.05, respectively) and complication-related death (hazard ratios, 0.38, P &lt;.001 and 0.35, P &lt;.05, respectively). Preoperative NYHA class III or IV symptoms and left ventricular impairment were independent risk factors for death and myocardial failure. Conclusions Mitral valve repair is superior to replacement. If repair is not feasible, the subvalvular apparatus should be preserved. Early surgery before the development of severe symptoms and demonstrable left ventricular impairment is also needed to optimize outcome.
Our Ubiquitous Technology
Authors: Caroline Wellbery
Journal: JAMA (2012)

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
OSTEITIS OF THE COCCYX
Authors: Frank K. Boland
Journal: JAMA (1927)

The report of cases of osteitis and osteomyelitis of the coccyx seems to be exceedingly rare. Monnier<sup>1</sup>describes a case of acute osteomyelitis of the coccyx in a girl, aged 17 years, which ran the course of an acute infectious process and which at first was diagnosed as typhoid, a mistake not infrequently made in acute osteomyelitis of other bones. The case of chronic osteitis of the coccyx here recorded seems of unusual interest, as it was responsible for an entirely different condition; viz., stricture of the rectum. Indeed, when I first saw the patient, stricture of the rectum was the predominating lesion. <h3>REPORT OF CASE</h3> A man, aged 35, first noticed "soreness and sensitiveness" at the tip of the spine in December, 1923, and was more comfortable standing than sitting. He could not remember having received a blow on this part of his body, but recalled having slipped and fallen on
Review of the usefulness of contacting other experts when conducting a literature search for systematic reviews
Authors: R J McManus, S Wilson, B C Delaney, D A Fitzmaurice, C J Hyde, R S Tobias, S Jowett, F D R Hobbs
Journal: BMJ (1998)

Identifying relevant studies is “the most fundamental challenge” when compiling a systematic review.1 Electronic databases, such as Medline, may detect only about half of papers identified by the gold standard of hand searching journals.1 Hand searching requires a focus, usually the specialist literature,2 which may not exist for newly developed fields or those that cross boundaries with other areas. We examined the usefulness of contacting other experts when searching for relevant references for a systematic review of a field where such a specialist focus does not exist.

View this table:

Results of various types of search



As part of a systematic review undertaken in 1996, all published literature relating to “near patient testing” (any investigation performed in a clinical setting where the result is available without a sample being sent to a laboratory for analysis) in primary care was identified for 1986-95.3 Electronic databases were searched and secondary citations were collected from identified publications (see table). The search strategy is reported elsewhere.3 Indexes of abstracts from major international …
Shifting Work, Sleep Cycles Are on the Way to Becoming Another Public Health Issue
Authors: Chris Anne Raymond
Journal: JAMA (1988)

GETTING A LITTLE SHUT-EYE used to be no more than a personal concern. Now it's becoming a public health issue. One of four American workers is engaged in shift work, according to a 1977 study from the National Institute of Occupational Safety and Health. The effects of this phenomenon now are at issue among police officers and power plant workers alike, in industries as diverse as medicine and manufacturing. Experts in sleep research hope that concrete changes in work schedules will be made, enabling workers to function in good health. Their concerns were outlined in a recent report warning of threats to public safety if policymakers ignore the impact of shift work (<i>Sleep</i>1988;1:101-109). And a recently completed first-of-its-kind study indicates that such changes can benefit both workers and employers. Investigators acknowledge that it will be difficult to implement changes without a clear-cut mandate and considerable agreement between labor and
Multivariate prediction of coronary heart disease in the Western Collaborative Group Study compared to the findings of the Framingham study.
Authors: R J Brand, R H Rosenman, R I Sholtz, M Friedman
Journal: Circulation (1976)

The Western Collaborative Group Study (WCGS) is a prospective epidemiological study of 3,154 initially well men, aged 39059 years at intake in 1960-61, who were employed in ten participating companies in California. Clinical coronary heart disease (CHD) occurred in 257 men during a follow-up period of eight and one-half years. Coronary heart disease risk is predicted using the additive multiple logistic model with the risk factors: age, cholesterol, systolic blood pressure, hematocrit, ECG status, smoking at intake, and relative body weight. The predicted individual CHS risk levels, using the logistic results derived from the WCGS data, are highly correlated with predicted risk levels using a Framington study (FS) equation for these same risk factors with 12-year follow-up. The observed number of CHS events in the WCGS is not significantly different from the expected number of events derived from the FS logistic equation, after correction of length of follow-up. Multiple logistic analysis of the direct association between CHD incidence and behavior pattern gives an approximate relative risk of 1.9 (P = 0.0006) and 2.1 (P = 0.0015) for Type A compared to Type B men aged 39-49 and 50-59 years, respectively. It is estimated that removal of the excess risk associated with Type A behavior would correspond to a 31% (standard error = 6.6%) reduction of coronary heart disease incidence in the Western Collaborative Group Study population.
Use of the nicotine metabolite ratio as a genetically informed biomarker of response to nicotine patch or varenicline for smoking cessation: a randomised, double-blind placebo-controlled trial
Authors: Caryn Lerman, Robert A Schnoll, Larry W Hawk, Paul Cinciripini, Tony P George, E Paul Wileyto, Gary E Swan, Neal l Benowitz, Daniel F Heitjan, Rachel F Tyndale
Journal: The Lancet Respiratory Medicine (2015)