tbuckley/cabot-search huggingface dataset:
"Myanesin" in the Treatment of Tetanus
Authors: M. H. A. Davison, A. B. Ward, E. A. Pask
Journal: BMJ (1949)

Failure was attributed to the low blood levels of sulphamezathine, and it was decided to repeat the course, using sulphamerazine in place of sulphamezathine, since it allowed higher blood concentrations to be reached without excessive dosage.For various non-medical reasons nearly two months elapsed before starting the second course on Feb. 2, 1948.Sulphamerazine, 2 g., was given orally at eight-hourly inter- vals for two doses, and subsequently 1 g.eight-hourly for seven days, to a total of 25 g.Penicillin, 400,000 units intramuscularly, was given concurrently three-hourly night and day, to a total of 24,000,000 units for the same time.Assay of the blood for penicillin, tested three hours after an injection, yielded a concentration of 3.2 units of penicillin per 100 ml. of blood.Assay of the blood for sulpharnerazine, tested at eight hours after an oral dose-i.e., just before the next dose-yielded a concentration of 12 mg. of total sulphamerazine and 7 mg. of free sulphamerazine.Stools were cultured daily for fourteen days after cessation of the course, and all were negative for Salni.typhi.Stool examinations were continued for the next nine months; three daily specimens were pooled and examined each week, making a total of 117 stools cultured.All cultures were negative for Salm.typhi, and it seems probable that the patient has been freed from the carrier state, though he will remain under observation for a further three months to complete a year's observation.It is noteworthy that his agglutination titre against a VI suspension of Salm.typhi had fallen from 1 in 20 to nil.
The Thalassaemia Syndromes
Authors: William R. Best
Journal: JAMA (1966)

The thalassemias constitute a group of inherited anemias characterized by defective hemoglobin synthesis, without obvious structural change in the preponderant type of circulating hemoglobin. Different defects in hemoglobin synthesis may be responsible in different families. The author delineates 11 varieties of thalassemia, and suggests that there may be more. Clinical severity ranges from increased red blood cell count and no clinical manifestations, to fetal death with hydrops. There is often an increase in minor hemoglobin components. The globin of normal hemoglobin, type A, contains two alpha and two beta chains, α2β2. Fetal (type F) and A2 hemoglobins, normal minor components, are similarly designated α2γ2 and α2δ2, and in some thalassemias, elevations of one or both may be found. In others there may be abnormal chain combinations, H (β4), Bart's (δ4), or Lepore (fusion or crossing-over of portions of β and δ chains). While these syndromes are more common in Mediterranean
The NHS and Community Care Act 1990: is it a success for elderly people?
Authors: V. Ajayi, F. G Miskelly, I. G Walton
Journal: BMJ (1995)

The NHS and Community Care Act 1990 signified a controversial change in the government's health and social policy.1 Phase 3 of the act was implemented on 1 April 1993, transferring the responsibility for funding of patients in the voluntary sector and in private residential and nursing homes from the Department of Social Security to local authority social services departments. We studied the effects of this reform on hospital practice.

From 1 April 1992 to 31 March 1994 we observed all patients aged >65 in the general medical, geriatric, and orthopaedic wards of our hospital who had been inpatients for >28 days. We observed these 766 patients weekly until discharge and noted the date when the patients became “medically stable”—that is, no longer benefiting from acute hospital care or rehabilitation—where they were discharged …
Combined-System Disease
Authors: Carl B Heilman, Vasilios A Zerris
Journal: New England Journal of Medicine (2009)

A 76-year-old woman presented with a 3-month history of bilateral numbness and tingling in her hands and feet. She also noted tingling along her spine on forward flexion of the neck (Lhermitte's sign). Her gait was unsteady, particularly when walking in the dark. She noted progressive difficulty with memory. She reported no changes in her bowel and bladder habits, vision, speech, or hearing. On examination, there were areas of hypoesthesia to light touch, extending from the wrist to the fingertips, the palmar surfaces of both hands, and over the toes in both feet. Vibratory and joint-position sensations were decreased bilaterally . . .
Blair promises to raise spending on NHS to European average
Authors: A. Ferriman
Journal: BMJ (2000)

Britain's prime minister, Tony Blair, pledged more money for the NHS this week, promising on television to raise the proportion of the UK gross domestic product spent on health from the present 6.8%to the European national average, 8%If he carries out his pledge, spending on the NHS will rise by at least £9bn ($14.4bn).

Mr Blair was forced to take the initiative on health following a week of …
Systematic review of mini-implant displacement under orthodontic loading
Authors: Manuel Nienkemper, Jörg Handschel, Dieter Drescher
Journal: International Journal of Oral Science (2013)

A growing number of studies have reported that mini-implants do not remain in exactly the same position during treatment, although they remain stable. The aim of this review was to collect data regarding primary displacement immediately straight after loading and secondary displacement over time. A systematic review was performed to investigate primary and secondary displacement. The amount and type of displacement were recorded. A total of 27 studies were included. Sixteen in vitro studies or studies using finite element analysis addressed primary displacement, and nine clinical studies and two animal studies addressed secondary displacement. Significant primary displacement was detected (6.4–24.4 µm) for relevant orthodontic forces (0.5–2.5 N). The mean secondary displacement ranged from 0 to 2.7 mm for entire mini-implants. The maximum values for each clinical study ranged from 1.0 to 4.1 mm for the head, 1.0 to 1.5 for the body and 1.0 to 1.92 mm for the tail part. The most frequent type of movement was controlled tipping or bodily movement. Primary displacement did not reach a clinically significant level. However, clinicians can expect relevant secondary displacement in the direction of force. Consequently, decentralized insertion within the inter-radicular space, away from force direction, might be favourable. More evidence is needed to provide quantitative recommendations. Mini-implants provide stable anchorage for orthodontics, despite secondary movement over time, report dental researchers in Germany. When teeth are damaged due to misalignment, they must be rebuilt and carefully anchored to the jaw. Recently, developed mini-implants are useful for such anchorage, but they may move over time with use. Manuel Nienkemper and colleagues at Heinrich-Heine University in Düsseldorf reviewed 27 recent research studies about the displacement of mini-implants. They found that movement during the initial placement was insignificant, but secondary movement caused by dental forces over time could cause problems for the patient. The team emphasizes that mini-implants require a suitable bone site with a thin mucosal covering. They also suggest that implant failure could be avoided by inserting the implant slightly off-centre, leaving space in the opposite direction from the main orthodontic forces.
Limited Efficacy of a<i>Haemophilus influenzae</i>Type b Conjugate Vaccine in Alaska Native Infants
Authors: J. Ward, G. Brenneman, G.W. Letson, W.L. Heyward
Journal: New England Journal of Medicine (1990)

The prevention of invasive Haemophilus influenzae type b disease requires a vaccine that is effective when administered during the first six months of life. The infants of Alaska Natives are at particularly high risk of invasive H. influenzae type b disease.
Complement Factor H Gene Abnormalities in Haemolytic Uraemic Syndrome: From Point Mutations to Hybrid Gene
Authors: Marina Noris, Giuseppe Remuzzi
Journal: PLoS Medicine (2006)

A typical haemolytic uraemic syndrome (aHUS) is a rare disease involving haemolytic anaemia, thrombocytopenia, and renal failure. There is growing evidence that the disease is associated with defective control of the alternative pathway of complement [1].

Genetic abnormalities in complement regulatory proteins, including complement factor H (CFH), membrane cofactor protein, and complement factor I, have been reported in 30%, 10%, and 5% of patients with aHUS, respectively [2–4]. CFH is a plasma protein produced by the liver that acts as a central regulator in the alternative pathway of complement activation. CFH acts as a cofactor for complement factor I in the inactivation of the central complement protein C3b to form iC3b. CFH also accelerates the decay of the C3 convertase C3bBb of the alternative pathway, and competes with factor B for binding to C3b [5].
ECHOCARDIOGRAPHIC PREDICTORS OF DECLINING EXERCISE PERFORMANCE IN CHILDREN WITH SICKLE CELL DISEASE
Authors: Niti Dham, Gregory Ensing, Mehdi Nouraie, Lori Luchtman-Jones, Andrew D. Campbell, Manuel Arteta, Sohail R. Rana, Caterina Minniti, Gregory J. Kato, Mark Gladwin, Oswaldo L. Castro, Victor R. Gordeuk, Craig A. Sable
Journal: Journal of the American College of Cardiology (2010)
A Clinical Trial of Iron-fortified Bread
Authors: P. C. Elwood
Journal: BMJ (1963)

Analyses of human body fat obtained from 131 necropsies performed in Southern England have shown that D.D.T.-derived material and 1,2,3,4,10,10-hexachloro -6,7 -epoxy -1,4,4a,5,6,7,8,8a -octahydro-exo-1,4endo-5,8-dimethanonaphthalene (H.E.O.D.) are present.The mean content in the fat of the general population is 2.21 p.p.m. equivalent-D.D.T. and 0.21 p.p.m.H.E.O.D.The results compare favourably, as regards amounts of insecticidal material present, with those found in the general population in West Germany, and more than favourably with those found in the general population cf the United States.There are indications that equili-brium levels in the fat have been reached, reflecting the current exposures to these materials.We express our gratitude to Dr. Francis Camps and
Interventional Thrombectomy for Major Stroke — A Step in the Right Direction
Authors: Werner Hacke
Journal: New England Journal of Medicine (2014)

Intravenous thrombolytic therapy is the only proven treatment for acute ischemic stroke, but its use is limited by a brief time window of up to 4.5 hours after the onset of symptoms1 and a recanalization rate of less than 50%. Large clots in vessels such as the distal internal carotid artery or the first segment of the middle cerebral artery respond poorly to intravenous thrombolysis.2 The need for a treatment for patients who do not have a good response to intravenous treatment alone remains pressing.On the basis of compelling anecdotal experience, stroke specialists had hoped that transvascular recanalization would . . .
Operating Characteristics of Prostate-Specific Antigen and Verification Bias
Authors: R. S. Punglia
Journal: JAMA (2005)

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
Crebbp haploinsufficiency in mice alters the bone marrow microenvironment, leading to loss of stem cells and excessive myelopoiesis
Authors: Stephanie N. Zimmer, Qing Zhou, Ting Zhou, Ziming Cheng, Sherry L. Abboud-Werner, Diane Horn, Mike Lecocke, Ruth White, Andrei V. Krivtsov, Scott A. Armstrong, Andrew L. Kung, David M. Livingston, Vivienne I. Rebel
Journal: Blood (2011)
The effect of nitroglycerin and nitroprusside on intramural carbon dioxide tension during acute experimental myocardial ischemia in dogs.
Authors: L D Hillis, C Davis, S F Khuri
Journal: Circulation Research (1981)

There is continuing controversy over the effects of nitroglycerin and nitroprusside on myocardial ischemia. In 36 open-chest, anesthetized dogs with normal left ventricular filling pressures, intramural carbon dioxide tension (PmCO2) was measured directly with a mass spectrometer during repeated 10-minute coronary artery occlusions separated by 45-minute periods of reflow. Simultaneously, regional myocardial blood flow (RMBF) in the ischemic area was quantified by the microsphere technique. In all dogs the increase in PmCO2 from before to 10 minutes after the first occlusion (delta PmCO2) exceeded that during subsequent occlusions. In those dogs not receiving an intervention (controls), delta PmCO2 during the third occlusion was similar to that during the second occlusion. When nitroglycerin was administered before the third occlusion, it caused a significantly smaller elevation in delta PmCO2 than that which occurred during the control second occlusion, and transmural RMBF to the ischemic region was not altered. In contrast, sodium nitroprusside sufficient to reduce mean systemic arterial pressure to the same extent as nitroglycerin caused no change in delta PmCO2 and a significant decrease of transmural RMBF to the ischemic region. Thus, in the dog with normal left ventricular filling pressures, nitroglycerin reduces myocardial carbon dioxide tension, but nitroprusside given to produce similar hemodynamic alterations exerts not effect on intramural PCO2.
Abstract 531: Is Earlier Hepatitis A Associated with Abnormal Hepatic Response to Statin Therapy?
Authors: Helmut Sinzinger, Simona Marchesi, Graziana Lupattelli
Journal: Circulation (2007)

Hepatic enzyme elevation is low (&lt; 3%) in large statin trials. Elevations are reversible after dose reduction or statin withdrawal. Very rare cases of hepatitis have been reported. No data are available how predisposing risk factors /diseases might influence hepatic statin response. Among the patients suffering from hepatic side effects during statin therapy 896 (477 m, 419 f; aged 31–76 years) admitted with (one or more) elevated hepatic enzyme, anamnestic data on hepatitis A, B, C, hepatic steatosis, alcohol abuse, hepatobiliary problems, abnormal enzymes (GOT, GPT, γGT) were assessed. The prevalence (% vs. % statin use in Austria) was for lovastatin n= 4; 0,2 (0,7), fluvastatin n = 111; 12,4 (14,0), simvastatin n = 297; 33,1 (34,8), pravastatin n = 82; 9,2 (11,8), rosuvastatin n = 69; 7,9 (1,5), atorvastatin n = 333; 37,2 (37,2). Only 41 patients (4,27%) had concomitant muscle complaints (21 cramps, 16 aches, 3 stiffness, 1 weakness), 12 (1,33%) CK elevation, 261 (29,13%) elevated isoprostane 8epiPGF 2α . Those with muscle complaints had normal CK levels and vice versa. Pretherapeutic findings (more than one possible) were hepatitis A 326 (36,4% !!), hepatitis B 7 (0,8%), hepatitis C 3 (0,3%), hepatic steatosis 141 (15,7%), alcohol abuse 104 (11,6%) and /or hepatobiliary problems 17 (1,9%). Abnormal enzymes GOT 116 (12,9%), GPT 113 (12,6%), γGT 147 (16,4%) persisted for &lt; 1 week. Patients after hepatitis A had significantly (p &lt; 0,001) higher transaminases as compared to the other patients. Withdrawal of the respective statin normalized transaminases within 4 weeks in 129 patients (14,4%), in only 7 elevation persisted for a longer period (up to 7 months). After 1 year all were in the normal range. Transaminase levels due to steatosis hepatis even sometimes showed improvement after statin therapy (mean: −12,7% GOT; −14,1 GPT; −16,0 γGT). Reexposure to another statin compound after a 4 weeks drug free interval caused recurrence of side effects in 87 patients (49 with earlier hepatitis A = 56,3%). Hepatitis A seems to represent a high risk for abnormal liver function response on statin therapy and reexposure to other compounds of this family. The combination of abnormal hepatic response with muscle complaints is very rare.
Contribution of endothelium-derived nitric oxide to exercise-induced vasodilation.
Authors: D M Gilligan, J A Panza, C M Kilcoyne, M A Waclawiw, P R Casino, A A Quyyumi
Journal: Circulation (1994)

BACKGROUND Endothelium-derived nitric oxide is an important modulator of resting vascular tone in animals and humans. However, the contribution of nitric oxide to exercise-induced vasodilation is unknown. METHODS AND RESULTS The effect of NG-monomethyl-L-arginine (L-NMMA), an inhibitor of nitric oxide synthesis, on exercise-induced vasodilation was studied in 18 healthy subjects (mean +/- SD, 40 +/- 10 years; 10 women). Acetylcholine was used to test the efficacy of L-NMMA in inhibiting stimulation of nitric oxide synthesis and sodium nitroprusside to test the specificity of L-NMMA in inhibiting endothelium-dependent vasodilation. Intermittent handgrip exercise and infusions of acetylcholine and sodium nitroprusside were performed during intra-arterial infusion of 5% dextrose (control) and L-NMMA (4 to 16 mumol/min). Forearm blood flow was determined by strain-gauge plethysmography. Forearm oxygen extraction was measured from arterial and venous oxygen saturations. In a separate study, 10 subjects performed exercise during infusions of 5% dextrose, L-arginine (the substrate for nitric oxide production), and D-arginine (the stereoisomer that is not a substrate for nitric oxide production). L-NMMA reduced exercise blood flow by 7 +/- 13% (P = .04), increased exercise resistance by 18 +/- 20% (P = .02), and increased exercise oxygen extraction by 16 +/- 17% (P &lt; .001). The degree of inhibition of acetylcholine-induced vasodilation with L-NMMA correlated positively with the degree of reduction in exercise blood flow (r = .55, P = .02). The highest dose of L-NMMA (16 mumol/min) produced the greatest effect; exercise blood flow was reduced by 11 +/- 14% (P = .03), and vascular resistance increased by 26 +/- 23% (P = .005). L-NMMA did not affect the forearm vasodilation produced by sodium nitroprusside. Exercise blood flow, resistance, and oxygen extraction were not significantly modified by infusions of either L- or D-arginine. CONCLUSIONS Inhibition of nitric oxide synthesis reduces exercise-induced vasodilation in the human forearm, indicating that nitric oxide plays a role in exercise-induced vasodilation. Increased availability of nitric oxide substrate does not enhance exercise-induced vasodilation in healthy subjects. These findings have important implications for disease states in which endothelium-derived nitric oxide production is impaired.
Reducing the risk of major elective surgery
Authors: T. Treasure, D. Bennett
Journal: BMJ (1999)

Papers p 1099 

In this week's BMJ Wilson and colleagues report a randomised controlled trial in high risk surgical patients admitted to an intensive care unit at least four hours before elective operation for optimisation of cardiac output and oxygen delivery to >600 ml/min/m2. This pre-emptive strategy was compared with usual practice, which is to monitor the cardiovascular system intraoperatively and to respond to changes in arterial and filling pressures. They showed a reduction in mortality from 17% (95% confidence interval 8% to 31%) to 3% (0.7% to 9%) and reduction of bed use by up to 40% (p 1099).1 By the usual criteria their patients were high risk: about a third had known ischaemic heart disease and half of them were aged over 70. This finding is not unexpected, and the question now is what we should do about it.

Control of the circulation is one of the first tutorials in cardiovascular physiology. We teach how baroreceptors sense the resulting pressure between the force of the contracting heart and the resistance …
SOME OF THE USES OF IODIN IN SURGICAL PRACTICE.
Authors: JOHN EGERTON CANNADAY
Journal: JAMA (1906)

At the present day I think I may truthfully state that the most decided tendency in the use of drugs is clearly a return to the simple life. The profession is at least partially freed from the bondage of an empirical authority, and one by one is dropping the complex and respectable myths and legends of medicine. Inasmuch as it has been clearly shown by careful and painstaking laboratory workers that a 1-200 solution of iodin will kill the staphylococcus pyogenes in five minutes, that two minutes' exposure of the streptococcus (most virulent of pathogenic germs) to a 1-500 solution of iodin will destroy its life, that it requires thirty minutes' exposure to a 1-1,000 solution of bichlorid of mercury, the hitherto acknowledged chief of antiseptics, to accomplish the same results and that while iodin is much less toxic it is a far more powerful antiseptic than either carbolic acid
Red blood cell transfusion affects microdialysis-assessed interstitial lactate/pyruvate ratio in critically ill patients with late sepsis
Authors: Petros Kopterides, Maria Theodorakopoulou, Nikitas Nikitas, Ioannis Ilias, Dimitra Argiro Vassiliadi, Stylianos E. Orfanos, Iraklis Tsangaris, Nikolaos A. Maniatis, Argirios E. Tsantes, Anthi Travlou, George Dimitriadis, Apostolos Armaganidis, Urban Ungerstedt, Ioanna Dimopoulou
Journal: Intensive Care Medicine (2012)
'I'm Not a Doctor, but I Play One on TV'
Authors: Gabriela Radulescu
Journal: JAMA (1985)

Television commercials often make intentionally outrageous claims, some humorous, others annoying, as a ploy to capture our attention. Some of these claims are clearly stated, others only implied. In the former category I place the one about the man whose life was a complete disaster until he started eating prunes. Then he promptly became charming, successful, and happy. This one is benign and mildly humorous. Then there is the one in which Steve Landesberg debates whether happiness can be more easily attained through the pursuit of artistic expression or by eating a particular snack and, of course, opts for the latter. Perhaps we more readily find humor in absurdities that are explicitly stated because of the presumed conspiratorial wink on the part of the advertiser, who, we feel, is joking<i>with</i>us. When the absurd premise is taken as an axiom, the joke seems turned<i>on</i>us, and hence the
US Health Policy—Expectations and Realities
Authors: Eli Ginzberg
Journal: JAMA (1988)

THE YEAR 1988 is an auspicious time to take stock of US health policy. It is just 25 years since the federal government acted vigorously to expand the number of medical school graduates by an order of magnitude. It is 20 years since the Congress first became aware that the costs of Medicare would far exceed the original estimates with which it had reckoned and accordingly eliminated the 2% override in reimbursements to hospitals. And 1988 saw the first significant increase in Medicare entitlements when the President signed into law the catastrophic insurance bill. This longer retrospective emphasizes the extent to which earlier expectations have been fulfilled or, alternatively, undermined by later events. The increase of more than 60% in the ratio of physicians to population, from 140 to 233 per 100 000 (1960 to 1988) (Bureau of Health Professions, Health Resources and Services Administration, US Department of Health and