tbuckley/cabot-search huggingface dataset:
For Debate: The COMA report: what it left out
Authors: J T Winkler
Journal: BMJ (1985)

<b>Objectives:</b> To use the technique of dermal microdialysis to examine sensitivity of skin vessels to noradrenaline (NA) in patients with familial dysautonomia (FD) and in healthy controls. <b>Methods:</b> In 14 patients with FD and 12 healthy controls, plasma extravasation, local laser Doppler blood flow, and skin blanching were observed before, during, and after application of 10<sup>−6</sup> M NA through a microdialysis membrane, located intradermally in the skin of the lower leg. <b>Results:</b> Maximum local vasoconstriction measured by laser Doppler blood flow did not differ between patients with FD and controls. In contrast, patients with FD had an earlier onset of vasoconstriction (p = 0.02). Moreover, reaction to NA was more prominent and prolonged in FD, shown by a larger zone of skin blanching around the microdialysis membrane (p &lt; 0.001) and delayed reduction of the protein content in the dialysate after termination of NA application (p = 0.03). <b>Conclusion:</b> These data support the hypothesis that peripheral blood vessels of patients with FD show a denervation hypersensitivity to catecholamines. This may be one mechanism contributing to the major hypertension that frequently occurs during “dysautonomic crises” in FD.
COUGH DUE TO REFLEX IRRITATION IN THE UPPER AIR-PASSAGES.
Authors: FRANK S. MILBURY
Journal: JAMA (1901)

In the daily routine of practice, probably there is no affection more frequently met with by physicians than coughs, and in many cases they are puzzling, harassing and stubborn. Even after nearly the whole range of indicated pharmacopeial medicines have been applied, the cough still remains as before, excepting with temporary relief. The patient becomes alarmed, fearing pulmonary complications, although assured by the physician that no lesions or symptoms exist in that region. Mayo Collier<sup>1</sup>says that "cough as a symptom or indication of some irritation in the upper or lower respiratory tract or other parts, is the commonest affection the human frame is subject to." Such cough, however, is oftener extrapulmonary in origin and quite innocent in its nature, and a highly commendable service is rendered and the dignity and scientific value of medicine exhibited when, by thorough and accurate examination, the extraneous cause is discovered, skilfully removed
Children have rights too
Authors: R. Bulford
Journal: BMJ (1997)

I recently had the misfortune to be a hospital outpatient after breaking my leg. My experience made me think about the powers that I have over my own treatment.

There are three main issues in the debate surrounding the young person's right to a say in health care. The first of these is the actual right to a say. This was covered in the Gillick ruling. When they are considered mature enough by their doctor young people can decide on treatment with or without the consent of their parents. The problem is that the maturity of the child has to be decided by the doctors. Some young people would be deemed mature enough to take a decision about their own bodies, whereas others, seen by different doctors, would not.

The process of taking your own decision and being treated like a decent human being relies not only on the permission of the doctors but also on the giving of information necessary to make an informed choice. This is …
Percutaneous Transluminal Coronary Angioplasty
Authors: Robert I. Levy, Michael B. Mock, Vallee L. Willman, Peter L. Frommer
Journal: New England Journal of Medicine (1979)

DR. Andreas Grüntzig and his colleagues are to be congratulated. In this issue of the Journal, they report on their experience with their first 50 patients undergoing percutaneous transluminal coronary angioplasty. The report provides evidence that in carefully selected and prepared patients, and in the hands of an experienced team, balloon angioplasty can effectively dilate highly stenotic coronary vessels and provide immediate improvement in myocardial perfusion and myocardial performance, as measured both subjectively and objectively. Moreover, this improvement can persist for six months or longer. Thus, percutaneous transluminal coronary angioplasty can be seriously considered as a promising new technic. . . .
Autoimmune anti-HIV-1gp120 antibody with antiidiotype-like activity in sera and immune complexes of HIV-1-related immunologic thrombocytopenia.
Authors: S Karpatkin, M Nardi
Journal: Journal of Clinical Investigation (1992)

Autoimmune antiidiotype-like antibody (Ab2) directed against anti-HIV-1gp120 (Ab1) was found in high titer in the sera of 10 consecutive homosexual and 11 narcotic addict HIV-1-related immunologic thrombocytopenia (HIV-1-ITP) patients, was barely detectable in 10 nonthrombocytopenic HIV-1 sero-positive individuals, and was not detectable in 5 normal subjects by use of a solid-phase RIA. Reactivity of autologous Ab2 for Ab1 was 4-120-fold greater than Ab2 for homologous Ab1. Affinity-purified Ab2 did not block the binding of affinity-purified Ab1 to its HIV-1gp120 epitopes on immunoblot, indicating the absence of "internal image" antiidiotype. Both Ab1 and Ab2 are precipitable from sera with polyethylene glycol (PEG) and present in a macromolecular complex that is excluded by gel filtration on G200 and contains IgG, IgM, C3, and the anti-F(ab')2 antiidiotype-like complex. PEG-precipitable complexes bind to platelets in a saturation-dependent manner. Neither affinity-purified Ab1 nor Ab2 binds to platelets. However, the combination of Ab1 and Ab2 (preincubated for 2 h at 22 degrees C) binds to platelets in a saturation-dependent manner at an optimum ratio range of 10-20:1. Ab2 reactivity correlates with serum PEG-precipitable immune complex level (r = 0.91; P less than 0.001) and with thrombocytopenia (r = 0.89; P less than 0.001). We suggest that the anti-HIV-1gp120 antiidiotype-like complex contributes to the markedly elevated platelet Ig and C3 level of HIV-1-ITP patients and propose that this may contribute to their thrombocytopenia.
UK development secretary sets out strategy to tackle global health crisis
Authors: Peter Moszynski
Journal: BMJ (2007)

“A healthy population is essential for poor countries to achieve their true potential,” the UK international development secretary, Hilary Benn, said at this week's launch of Britain's new international health strategy in Central Hall Westminster, calling for coordinated international action to tackle “the global health crisis.”

He was joined by Margaret Chan, director general of the World Health Organization; Joy Phumaphi, vice president for human development of the World Bank; and Michel Kazatchkine, the new head of the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Mr Benn said, “We have seen real progress in …
Lithium in Pregnancy: A Review with Recommendations
Authors: MICHAEL GOLDFIELD, MORTON R. WEINSTEIN
Journal: American Journal of Psychiatry (1971)

The authors' review of studies on the teratogenicity of lithium salts during pregnancy revealed conflicting evidence. They believe lithium therapy should be initiated during pregnancy only in severely manic women who are unresponsive to other therapy and for whom continuing manic behavior would jeopardize their own or their babies' lives. They offer six cautions in the use of lithium during pregnancy, including avoidance of diuretics and of salt restriction. In addition, they announce the formation of an American Registry of Lithium Babies.
The Hands of the Old Métis
Authors: Maurice Kilwein Guevara
Journal: JAMA (1998)

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
The Strangelove Legacy: Children, Parents and Teachers in the Nuclear Age
Authors: Keith Berndtson
Journal: JAMA (1987)

Thinking about nuclear weapons has been a part of growing up for a mere 40 years. Formal research into how awareness of nuclear weapons factors into one's outlook on life began only 20 years ago. The lion's share of analysis and debate on the subject has taken place in the past decade. In that time, a growth in peace and antinuclear activism on the left has spurred reactionary criticism from the right, and ostensibly nonaligned academics have found room for controversy as well. In the process, issues of nuclear awareness have taken on new dimensions. Phyllis La Farge, a contributing editor to Parents magazine, tackles these issues in The Strangelove Legacy .  She has done an admirable job. The book proceeds systematically from considerations of how many children think about nuclear catastrophe and in what ways, to questions of what impact this nuclear awareness has on cognitive and behavioral development at
Hemobilia An Unusual Cause of Segmental Bile Duct Obstruction
Authors: DONALD E. JACKSON, JOHN L. FLOYD
Journal: Clinical Nuclear Medicine (1986)

Hemobilia is reported as an unusual cause of segmental bile duct obstruction. The finding of focal “hot spots” caused by delayed washout of the tracer from the obstructed segments is discussed. Whenever the clinical triad of pain, intermittent jaundice, and gastrointestinal bleeding is associated with the above findings, the diagnosis of hemobilia should be entertained.
Anticoagulant Therapy in Acute Myocardial Infarction
Authors: Charles K. Friedberg
Journal: JAMA (1963)

<h3>To the Editor:</h3> —The letter of Dr. Iversen and associates does not invalidate the fundamental criticism that their treated and untreated cases were not chosen by random selection (alternate case method). This method requires unswerving assignment of successive patients alternately to the treated and untreated groups. Neither the original report from Copenhagen nor the above letter claims to have followed this procedure of random selection. Distribution of patients through a central office, which was unaware of the study, does not denote such selection. Alternate case distribution was impossible unless the central office knew of the study. It is difficult to understand how, over a period of 4 yr, hospital professional staff, other personnel, the patients themselves, and eventually their physicians should not be aware that patients in two departments of two hospitals were not receiving the well-known anticoagulant treatment while such treatment was being administered in the other two departments
Death and the Cigarette
Authors: W. W. Lacey
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The death's head on the cover of the March 28 issue ofThe Journalis supposed, I presume, to link the smoking of cigarettes to fatality. If we are to illustrate the issue in this macabre fashion, why do we perpetuate the lack of ability in the art field? Mr. Van Gogh's picture would convince one that the cause of death was extensive cephalad luxation of the sternal end of the right clavicle with trauma to the cricothyroid structures producing edema of the larynx.
Prospective evaluation of relatives for familial arrhythmogenic right ventricular cardiomyopathy/dysplasia reveals a need to broaden diagnostic criteria
Authors: M.Shoaib Hamid, Mark Norman, Asifa Quraishi, Sami Firoozi, Rajesh Thaman, Juan R Gimeno, Bhavesh Sachdev, Edward Rowland, Perry M Elliott, William J McKenna
Journal: Journal of the American College of Cardiology (2002)
Extracellular Signal–Regulated Kinase Signaling Pathway Regulates Breast Cancer Cell Migration by Maintaining slug Expression
Authors: Haoming Chen, Genfeng Zhu, Yong Li, Ravi N. Padia, Zheng Dong, Zhixing K. Pan, Kebin Liu, Shuang Huang
Journal: Cancer Research (2009)

Cell migration is a critical step in cancer cell invasion. Recent studies have implicated the importance of the extracellular signal-regulated kinase (ERK) signaling pathway in cancer cell migration. However, the mechanism associated with ERK-regulated cell migration is poorly understood. Using a panel of breast cancer cell lines, we detected an excellent correlation between ERK activity and cell migration. Interestingly, we noticed that a 48-hour treatment with U0126 [specific mitogen-activated protein/ERK kinase (MEK)-1/2 inhibitor] was needed to significantly inhibit breast cancer cell migration, whereas this inhibitor blocked ERK activity within 1 hour. This observation suggests that ERK-dependent gene expression, rather than direct ERK signaling, is essential for cell migration. With further study, we found that ERK activity promoted the expression of the activator protein-1 (AP1) components Fra-1 and c-Jun, both of which were necessary for cell migration. Combination of U0126 treatment and Fra-1/c-Jun knockdown did not yield further reduction in cell migration than either alone, indicating that ERKs and Fra-1/c-Jun act by the same mechanism to facilitate cell migration. In an attempt to investigate the role of Fra-1/c-Jun in cell migration, we found that the ERK-Fra-1/c-Jun axis regulated slug expression in an AP1-dependent manner. Moreover, the occurrence of U0126-induced migratory inhibition coincided with slug reduction, and silencing slug expression abrogated breast cancer cell migration. These results suggest an association between ERK-regulated cell migration and slug expression. Indeed, cell migration was not significantly inhibited by U0126 treatment or Fra-1/c-Jun silencing in cells expressing slug transgene. Our study suggests that the ERK pathway regulates breast cancer cell migration by maintaining slug expression.
Platelet characteristics in patients with X-linked macrothrombocytopenia because of a novel GATA1mutation
Authors: Kathleen Freson, Koen Devriendt, Gert Matthijs, Achiel Van Hoof, Rita De Vos, Chantal Thys, Kristien Minner, Marc F. Hoylaerts, Jos Vermylen, Chris Van Geet
Journal: Blood (2001)
Extended Treatment of Venous Thromboembolism
Authors: Jean M. Connors
Journal: New England Journal of Medicine (2013)

Patients with provoked venous thromboembolism caused by transient risk factors can generally stop anticoagulation after 3 months of treatment. For patients with unprovoked venous thromboembolism, for which the risk of recurrence is as high as 40% at 5 years,1 it may be appropriate to consider a longer course of therapy. However, deciding how to balance the risks and benefits of extended anticoagulation is difficult. Warfarin has greater than 90% efficacy in preventing recurrences but carries an associated risk of major bleeding of 1 to 2% per year.2 Warfarin is also a burdensome long-term treatment, with many food and drug interactions . . .
Current Problems in Health Care
Authors: Wilbur J. Cohen
Journal: New England Journal of Medicine (1969)

Abstract American health care is a dynamic, pluralistic mosaic of programs that in spite of certain advantages also faces serious problems. Some, such as shortages of personnel, are not easily corrected, but serious deficiencies in the organization and financing of health care in the United States can be effectively improved. In particular, health insurance, both public and private, must be expanded to provide comprehensive protection for all, and to cover ambulatory as well as hospital services. Special efforts must also be made to contain costs, to reduce excessive use of hospitals, to stimulate economic operation and to eliminate duplication by proper incentive programs, to remove impediments to group practice, and to expand the numbers engaged in health care.
Nitric oxide promotes caspase-independent hepatic stellate cell apoptosis through the generation of reactive oxygen species
Authors: Daniel A. Langer, Amitava Das, David Semela, Ningling Kang-Decker, Helen Hendrickson, Steven F. Bronk, Zvonimir S. Katusic, Gregory J. Gores, Vijay H. Shah
Journal: Hepatology (2008)

Hepatic stellate cells (HSCs) contribute to portal hypertension through multiple mechanisms that include collagen deposition, vasoconstriction, and regulation of sinusoidal structure. Under normal physiologic conditions, endothelial nitric oxide (NO) synthase–derived NO exerts paracrine effects on HSCs; however, in cirrhosis, NO generation is impaired in association with concomitant HSC activation and changes in sinusoidal structure, events that contribute significantly to the development of portal hypertension. These concepts, in combination with recent evidence that induction of HSC-selective apoptosis may represent a useful target for treatment of chronic liver disease, led us to examine if NO may further limit HSC function through apoptosis. Indeed, both NO donors and endothelial NO synthase overexpression promoted HSC apoptotic pathways. HSC death conferred by NO occurred through mitochondrial membrane depolarization and through a caspase-independent pathway. Furthermore, NO-induced apoptosis of HSC did not occur through the canonical pathways of soluble guanylate cyclase or protein nitration, but rather through the generation of superoxide and hydroxyl radical intermediates. Lastly, HSC isolated from rats after bile duct ligation were more susceptible to NO-induced apoptosis. These data indicate that NO promotes HSC apoptosis through a signaling mechanism that involves mitochondria, is mediated by reactive oxygen species, and occurs independent of caspase activation. Conclusion: We postulate that NO-dependent apoptosis of HSCs may maintain sinusoidal homeostasis, and may represent an additional beneficial effect of NO donors for therapy of portal hypertension.
Tumor Cell Repopulation between Cycles of Chemotherapy is Inhibited by Regulatory T-Cell Depletion in a Murine Mesothelioma Model
Authors: Licun Wu, Zhihong Yun, Tetsuzo Tagawa, Katrina Rey-McIntyre, Masaki Anraku, Marc de Perrot
Journal: Journal of Thoracic Oncology (2011)
Predictive value of reactive hyperemic response on reperfusion on recovery of regional myocardial function after coronary angioplasty in acute myocardial infarction.
Authors: H Suryapranata, F Zijlstra, D C MacLeod, M van den Brand, P J de Feyter, P W Serruys
Journal: Circulation (1994)

BACKGROUND The objective of the study was to determine the coronary vasodilatory reserve in reperfused myocardium in patients with acute myocardial infarction and its relation to regional myocardial function. METHODS AND RESULTS The study population consisted of 22 patients with acute myocardial infarction who underwent successful coronary angioplasty. The vasodilatory reserve in the reperfused myocardium was assessed quantitatively using computer-assisted digital subtraction cine-angiography immediately after angioplasty and at follow-up angiography before hospital discharge. Myocardial contrast medium appearance time and density were determined before and after pharmacological hyperemia induced by an intracoronary injection of 12.5 mg papaverine. Global and regional left ventricular functions were determined from contrast angiography. After papaverine, the mean contrast medium appearance time decreased significantly from 3.5 +/- 0.7 to 2.7 +/- 0.7 cardiac cycles (P &lt; .000005) immediately after successful coronary angioplasty and from 3.8 +/- 0.7 to 2.7 +/- 0.9 cardiac cycles (P &lt; .000005) at angiography before hospital discharge. The mean contrast medium density increased significantly from 48.7 +/- 13.8 to 61.0 +/- 19.0 pixels (P &lt; .003) and from 49.6 +/- 19.7 to 80.3 +/- 29.6 pixels (P &lt; .000005), respectively. As a consequence, the calculated coronary flow reserve increased significantly from 1.8 +/- 0.7 to 2.6 +/- 1.0 (P &lt; .0008). The global ejection fraction increased significantly from 52 +/- 12% to 58 +/- 14% (P &lt; .03), primarily because of a significant improvement in the regional myocardial function of the infarct zone from 20.8 +/- 9.0% to 26.0 +/- 10.5% (P &lt; .001). Coronary flow reserve correlated well with regional myocardial function both during the acute phase (R = .79, P &lt; .002) and at follow-up angiography (R = .82, P &lt; .000004). Interestingly, coronary flow reserve measurement on reperfusion, immediately after angioplasty, correlated significantly with regional myocardial function at follow-up angiography (R = .81, P &lt; .00003). CONCLUSIONS The results indicate that there is a pharmacologically inducible vasodilatory reserve in reperfused ischemic myocardium after successful coronary angioplasty in patients with acute myocardial infarction and that this is increased at 10-day follow-up angiography. More important, the degree of reactive hyperemic response on reperfusion has a predictive value regarding the ultimate degree of recovery of regional myocardial function. Quantitative assessment of reperfusion may be useful in investigating the role of coronary reperfusion and salvage of myocardial function.
Deficiency of the iron-sulfur clusters of mitochondrial reduced nicotinamide-adenine dinucleotide-ubiquinone oxidoreductase (complex I) in an infant with congenital lactic acidosis.
Authors: R W Moreadith, M L Batshaw, T Ohnishi, D Kerr, B Knox, D Jackson, R Hruban, J Olson, B Reynafarje, A L Lehninger
Journal: Journal of Clinical Investigation (1984)

We report the case of an infant with hypoglycemia, progressive lactic acidosis, an increased serum lactate/pyruvate ratio, and elevated plasma alanine, who had a moderate to profound decrease in the ability of mitochondria from four organs to oxidize pyruvate, malate plus glutamate, citrate, and other NAD+-linked respiratory substrates. The capacity to oxidize the flavin adenine dinucleotide-linked substrate, succinate, was normal. The most pronounced deficiency was in skeletal muscle, the least in kidney mitochondria. Enzymatic assays on isolated mitochondria ruled out defects in complexes II, III, and IV of the respiratory chain. Further studies showed that the defect was localized in the inner membrane mitochondrial NADH-ubiquinone oxidoreductase (complex I). When ferricyanide was used as an artificial electron acceptor, complex I activity was normal, indicating that electrons from NADH could reduce the flavin mononucleotide cofactor. However, electron paramagnetic resonance spectroscopy performed on liver submitochondrial particles showed an almost total loss of the iron-sulfur clusters characteristic of complex I, whereas normal signals were noted for other mitochondrial iron-sulfur clusters. This infant is presented as the first reported case of congenital lactic acidosis caused by a deficiency of the iron-sulfur clusters of complex I of the mitochondrial electron transport chain.