tbuckley/cabot-search huggingface dataset:
Association Between Postoperative Troponin Levels and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery
Authors: P. J. Devereaux, M. T. Chan, P. Alonso-Coello, M. Walsh, O. Berwanger, J. C. Villar, C. Y. Wang, R. I. Garutti, M. J. Jacka, A. Sigamani, S. Srinathan, B. M. Biccard, Clara K Chow, V. Abraham, M. Tiboni, S. Pettit, W. Szczeklik, G. Lurati Buse, F. Botto, G. Guyatt, D. Heels-Ansdell, D. I. Sessler, K. Thorlund, A. X. Garg, M. Mrkobrada, S. Thomas, R. N. Rodseth, R. M. Pearse, L. Thabane, M. J. McQueen, T. VanHelder, M. Bhandari, J. Bosch, A. Kurz, C. Polanczyk, G. Malaga, P. Nagele, Y. Le Manach, M. Leuwer, S. Yusuf
Journal: JAMA (2012)

Of the 200 million adults worldwide who undergo noncardiac surgery each year, more than 1 million will die within 30 days.To determine the relationship between the peak fourth-generation troponin T (TnT) measurement in the first 3 days after noncardiac surgery and 30-day mortality.A prospective, international cohort study that enrolled patients from August 6, 2007, to January 11, 2011. Eligible patients were aged 45 years and older and required at least an overnight hospital admission after having noncardiac surgery.Patients' TnT levels were measured 6 to 12 hours after surgery and on days 1, 2, and 3 after surgery. We undertook Cox regression analysis in which the dependent variable was mortality until 30 days after surgery, and the independent variables included 24 preoperative variables. We repeated this analysis, adding the peak TnT measurement during the first 3 postoperative days as an independent variable and used a minimum P value approach to determine if there were TnT thresholds that independently altered patients' risk of death.A total of 15,133 patients were included in this study. The 30-day mortality rate was 1.9% (95% CI, 1.7%-2.1%). Multivariable analysis demonstrated that peak TnT values of at least 0.02 ng/mL, occurring in 11.6% of patients, were associated with higher 30-day mortality compared with the reference group (peak TnT ≤ 0.01 ng/mL): peak TnT of 0.02 ng/mL (adjusted hazard ratio [aHR], 2.41; 95% CI, 1.33-3.77); 0.03 to 0.29 ng/mL (aHR, 5.00; 95% CI, 3.72-6.76); and 0.30 ng/mL or greater (aHR, 10.48; 95% CI, 6.25-16.62). Patients with a peak TnT value of 0.01 ng/mL or less, 0.02, 0.03-0.29, and 0.30 or greater had 30-day mortality rates of 1.0%, 4.0%, 9.3%, and 16.9%, respectively. Peak TnT measurement added incremental prognostic value to discriminate those likely to die within 30 days for the model with peak TnT measurement vs without (C index = 0.85 vs 0.81; difference, 0.4; 95% CI, 0.2-0.5; P < .001 for difference between C index values). The net reclassification improvement with TnT was 25.0% (P < .001).Among patients undergoing noncardiac surgery, the peak postoperative TnT measurement during the first 3 days after surgery was significantly associated with 30-day mortality.
The Physiology of Disease
Authors: Harry B. Greenberg
Journal: JAMA (1975)

Designed for the medical student who is completing his preclinical studies and who is beginning his clinical training,<i>The Physiology of Disease</i>will also appeal to the busy practitioner. Its authors, Roddie and Wallace, have the knack for expressing concepts of normal and disordered physiology so clearly and succinctly that the reader comes away from their text with the impression of having learned a good deal about the subject. Among the topics they treat in a particularly interesting fashion are the effects of gravity and the disorders of immunity. Increased gravitational (g) forces may well limit man's ability to visit the larger planets. A man weighing 70 kg on earth weighs 700 kg when subjected to the 10 g forces experienced shortly after rocket launch. The problem may be mitigated if he lies transversely in the plane of gravity so that his blood does not pool in his head or
Cancers coinciding with childbearing: delayed diagnosis during pregnancy?
Authors: M. Lambe, A. Ekbom
Journal: BMJ (1995)

Cancers associated with childbearing pose extremely difficult questions for the patient and her physician. Population based registry data gave us the opportunity to examine the incidence of this uncommon occurrence.

Cases were identified following a linkage between the Swedish Cancer Registry and a nationwide fertility registry. Nearly all diagnosed cancers are recorded in the cancer registry.1 The fertility registry contains information on number and dates of live births for more than 2.3 million Swedish women born in 1925 and thereafter.2

Among women born from 1925 to 1972 more than 2.7 million live births and 32848 cancers were recorded during reproductive ages (15-44 years) in 1960-90. Of all cancers, 428 (1.3%) were diagnosed during pregnancy (date of a live birth-9 months) and 1425 (4.3%) during the lactation period (date of birth+12 months). The overall incidences during pregnancy and lactation, respectively, were 15.6 and 51.6 …
Rest and exercise hemodynamics after the Fontan procedure.
Authors: G B Shachar, B P Fuhrman, Y Wang, R V Lucas, J E Lock
Journal: Circulation (1982)

Sixteen consecutive patients (12 with tricuspid atresia) underwent a Fontan procedure, with no operative deaths. There were three late deaths. Eleven of the survivors were electively catheterized 4-25 months postoperatively. Rest and exercise hemodynamics were measured in five patients, and resting hemodynamics alone were measured in three. All exercised patients were New York Heart Association class I Cardiac index was low at rest (2.3 +/- 0.61/min/m2) and during exercise (4.9 +/- 1.11/min/m2) due to a low stroke index both at rest (28 ml) and exercise (35 ml). Accordingly, mixed venous oxygen saturations were decreased (66% at rest and 31% during exercise). These values are significantly lower than those at rest and during exercise from 23 control patients of similar age and size. Heart rates, pulmonary vascular resistances, and left ventricular filling pressures appeared normal both at rest and during exercise. High right atrial pressure at rest (15 mm Hg) was associated with minimal conduit gradient (2 mm Hg). However, exercise increased the mean conduit gradient to 8 mm Hg, demonstrating significant functional conduit obstruction. As expected, the cardiovascular response to exercise is abnormal after the Fontan procedure, even in asymptomatic patients. This abnormal response may be exacerbated by conduit obstruction, and conduit obstruction may not be apparent during resting studies.
Gene Therapy Based on Gemcitabine Chemosensitization Suppresses Pancreatic Tumor Growth
Authors: Fabienne Vernejoul, Laurent Ghénassia, Anny Souque, Hubert Lulka, Daniel Drocourt, Pierre Cordelier, Lucien Pradayrol, Stéphane Pyronnet, Louis Buscail, Gérard Tiraby
Journal: Molecular Therapy (2006)

Excepting surgical resection, there is no efficient treatment against pancreatic cancer. The chemotherapeutic agent gemcitabine improves the patient's clinical status but survival is not prolonged. The aim of this study was to design a new strategy to render gemcitabine more efficient in the treatment of pancreatic cancer using gene therapy. We have generated a fusion gene (DCK::UMK) combining deoxycytidine kinase (DCK) and uridine monophosphate kinase (UMK), which converts gemcitabine into its toxic phosphorylated metabolite. Antitumor effects of DCK::UMK gene expression were tested in vitro and in vivo in an orthotopic transplantable model of pancreatic cancer established in hamsters. DCK::UMK sensitizes pancreatic cancer cells to gemcitabine by reducing dramatically both in vitro cell viability and in vivo tumor volume. We found that in vivo expression of DCK::UMK resulted in an antitumor bystander effect due to apoptosis of untransduced cells. In vivo intratumoral gene transfer of DCK::UMK using the synthetic carrier PEI induced a potent tumor regression. Taken together, the results show that the fusion gene DCK::UMK sensitizes pancreatic cancer cells to gemcitabine treatment to induce cell death by apoptosis and tumor regression. Intratumoral delivery of the DCK::UMK gene in combination with gemcitabine might be of high interest for pancreatic cancer management.
A CHRISTMAS STORY.
Authors: E. S. McKEE
Journal: JAMA (1905)

About eighteen years ago I was called to see a patient, a recent arrival from Russia, whom we will call Mrs. Blankstein. She was very ill, indeed, and I found it necessary to see her every day for a month, commencing December 15. She recovered, and in due time I sent my bill. In somewhat overdue time her husband came to my office to pay it. The following was his plea: "Mr. Doctor: dat bill you zendt mein vife, he's all dright, but vone dem visits you make mein vife you makes him on a Grisdmas day, and I vandt you make me a bresent dat visit you makes mein vife ond Grisdmas day." The request was so original, coming from the source it did, so different from the usual demand of a per cent. off, that I threw off the visit, made him a "bresent" of it, instead of
NHS laboratories are infringing DNA patents with cheap "home brew" tests, says Human Genetics Commission
Authors: I. Torjesen
Journal: BMJ (2011)

NHS hospital pathology services are at increasing risk of being sued for infringing intellectual property rights if they carry out diagnostic tests using patented genetic technology without paying royalties to the patent holders, warns a new report from the Human Genetics Commission.

Since the 1980s thousands of patents relating to human DNA sequences and their use have been granted. Patents are held on specific sequences, biomarkers, and platform technologies, all of which have a vital role in the diagnosis and treatment of serious and rare diseases.

Laboratories buy diagnostic kits where a patent licence is included in the purchase price, but many produce their own tests without considering intellectual rights. These “home brews” vary in …
Bench and Bedside
Authors: Lawrence D. Grouse
Journal: JAMA (1981)

Clinicians at the bedside and researchers at the bench make the discoveries that shape the future of medicine. With this issue (p 1562),<i>JAMA</i>inaugurates a column of clinically oriented, basic science research in review. The column will permit physicians to glimpse the future of medicine and to gain a better understanding of the scientific basis of their practice. This new department, entitled BENCH AND BEDSIDE, reflects the relevance of basic science research to medical practice. It acknowledges the vital contributions that clinical and basic science research make to medicine. The following editorial principles will apply to all articles published in BENCH AND BEDSIDE: Columns will be focused reviews of important basic science work. The articles will emphasize highlights and major trends in medical research. They will not assume exhaustive archival functions that would make them unwieldy or impenetrable for the physician-reader. They will not attempt to cover vast expanses
The effect of zinc and erythromycin on the growth of erythromycin-resistant and erythromycin-sensitive isolates of Propionibacterium acnes: an in-vitro study
Authors: K.T. HOLLAND, R.A. BOJAR, W.J. CUNLIFFE, A.G. CUTCLIFFE, E.A. EADY, L. FAROOQ, A.M. FARRELL, E.M. GRIBBON, D. TAYLOR
Journal: British Journal of Dermatology (1992)

The effect of zinc and erythromycin on cultures inoculated with mixtures of different ratios of erythromycin sensitive (ES) and resistant (ER) Propionibacterium acnes cells was studied in vitro. Propionibacterium acnes ES outgrew P. acnes ER in the absence of erythromycin and zinc. At low levels of erythromycin ES outgrew ER, whilst the addition of 600 pg/ml zinc further reduced the growth of ER compared to ES. Growth of ER and ES were similar at levels of erythromycin near the minimum inhibitory concentration (MIC) of ES cells. Concentrations above the MIC for ES cells inhibited ES but not ER cells. At the higher concentrations of erythromycin, the addition of 96 ng/ml zinc delayed the growth of ER cells, whilst the addition of 300 micrograms/ml zinc prevented the growth of ER cells. The combination of erythromycin and zinc, at appropriate concentrations, inhibits both ES and ER.
PWE-172 Micronutrient-Antioxidant Supplementation has no Impact on Gastric Atrophy in Zambian Adults: A Randomised Controlled Trial
Authors: V Kayamba, M S Chomba, P Kelly
Journal: Gut (2013)

<h3>Introduction</h3> With the increasing number of gastric cancer cases in young patients in Zambia, we set out to investigate the possibility of reversing gastric atrophy, a precancerous lesion, using micronutrient-antioxidant supplementation in a retrospective analysis of a published randomised controlled trial. We recently reported that low antioxidant levels were associated with gastric cancer in Zambia. In an earlier study, we had demonstrated that people with the HIV infection tend to have higher gastric pH than those without HIV. <h3>Methods</h3> Archival samples from a randomised controlled trial, (Kelly <i>et al</i><i>Trans R Soc Trop Med Hyg.</i> 2008; 102:194–9) were used in this study. These were collected from healthy volunteers in Misisi, a densely populated and impoverished township in Lusaka, and carefully stored at –80oC in a secure laboratory at the University Teaching Hospital, the largest referral hospital in Zambia. In this controlled trial, 500 volunteers were randomly allocated to either a micronutrient-antioxidant supplementation or placebo. The supplements contained vitamins, A, B1, B2, B6, B12, C, D3, E, niacin, folic acid, iron, zinc, copper and selenium. We analysed 215 samples collected in 2005, from subjects who had taken either supplementation or placebo for a median of 19 (range 14 to 27) months. Gastric atrophy was determined using pepsinogen 1 to 2 ratio of less than 3.0 using BIOHIT ELISA kits, Helsinki, Finland, according to the manufacturer’s instructions. Fasting gastric pH was available on 121 participants. The presence of atrophy was compared between the intervention and the placebo groups. Other factors analysed included the effect of HIV infection, age, body mass index (BMI), smoking, alcohol intake and gastric pH. <h3>Results</h3> Gastric atrophy was found in 8 (7.8%) of 103 subjects on supplementation, and 7 (6.3%) of 112 on placebo (RR 1.24; 95%CI 0.47–3.3; <i>P</i> = 0.22). HIV infection was diagnosed in 5 participants with atrophy and 61 without (RR 1.07; 95%CI 0.37–3.2; <i>P</i> = 1.0). The lack of effect of supplementation on atrophy was not changed after stratification for HIV status (M-H OR 2.0; <i>P</i> = 09.20). Gastric atrophy was found to be more prevalent in those above the age of 40 years. In univariate and multivariate analysis, BMI, smoking, alcohol intake showed no impact on gastric atrophy. Gastric pH and pepsinogen 1:2 ratio were inversely correlated (Spearman’s r = –0.34; <i>P</i> = 0.0001). <h3>Conclusion</h3> An average of nine months of micronutrient-antioxidant supplementation has no impact on gastric atrophy in Zambian healthy adults. The high gastric pH seen in HIV patients can not be attributed to gastric atrophy. <h3>Disclosure of Interest</h3> None Declared.
Pediatric Readmissions as a Hospital Quality Measure
Authors: Rajendu Srivastava, Ron Keren
Journal: JAMA (2013)

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
Muscarinic receptor modulation of basal and beta-adrenergic stimulated function of the failing human left ventricle.
Authors: G E Newton, A B Parker, J S Landzberg, W S Colucci, J D Parker
Journal: Journal of Clinical Investigation (1996)

The objective of this study was to evaluate the effect of muscarinic receptor modulation on basal and beta-adrenergic stimulated left ventricular function in patients with heart failure. 21 heart failure patients and 14 subjects with normal ventricular function were studied. In Protocol 1 intracoronary acetylcholine resulted in a 60+/-8% inhibition of the left ventricular +dP/dt response to intracoronary dobutamine in the normal group, and a similar 70+/-13% inhibition in the heart failure group. Acetylcholine also attenuated the dobutamine-mediated acceleration of isovolumic relaxation (Tau) in both groups. Acetylcholine alone had no effect on Tau in the normal group, while it prolonged Tau in the heart failure group. In Protocol 2 intracoronary atropine resulted in a 35+/-10% augmentation of the inotropic response to dobutamine in the normal group, versus a non-significant 12+/-15% augmentation of the dobutamine response in the heart failure group. In Protocol 3, in 6 heart failure patients, both effects of acetylcholine, the slowing of ventricular relaxation and the inhibition of beta-adrenergic responses, were reversed by the addition of atropine. Therefore, in the failing human left ventricle muscarinic stimulation has an independent negative lusitropic effect and antagonizes the effects of beta-adrenergic stimulation.
The Implications of Increased Pulmonary Arterial Resistance in Mitral Stenosis.
Authors: James J. Morris
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970The Implications of Increased Pulmonary Arterial Resistance in Mitral Stenosis.James J. Morris Jr., M.D., F.A.C.P., Abe Walston, M.D., Robert H. Peter, M.D., Victor S. Behar, M.D., Yihong Kong, M.D.James J. Morris Jr., M.D., F.A.C.P.Search for more papers by this author, Abe Walston, M.D.Search for more papers by this author, Robert H. Peter, M.D.Search for more papers by this author, Victor S. Behar, M.D.Search for more papers by this author, Yihong Kong, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-782_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe pulmonary artery pressure in some patients with mitral stenosis may be elevated out of proportion to the rise in left arterial pressure. This elevation, indicating an increase in pulmonary arteriolar resistance, has been traditionally regarded as a "protective reflex constriction" of the pulmonary arterioles. The danger in accepting this as a reflex mechanism is that other causes may be overlooked. The prevalence and specific cause for an increased pulmonary arteriolar resistance was investigated in a series of 117 patients with hemodynamically pure mitral stenosis.Complete right- and left-heart catheterizations were performed in all patients and resistance was calculated from... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: James J. MorrisJr., M.D., F.A.C.P.; Abe Walston, M.D.; Robert H. Peter, M.D.; Victor S. Behar, M.D.; Yihong Kong, M.D.Affiliations: Durham, N.C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 782-782KeywordsArteriolesBlood pressureCatheterizationMitral stenosisPulmonary arteriesReflexesStenosis ePublished: 1 December 2008 Issue Published: 1 May 1970 PDF downloadLoading ...
RAIDING OF BODY TISSUE PROTEIN TO FORM PLASMA PROTEIN AND HEMOGLOBIN
Authors: G. H. Whipple, L. L. Miller, F. S. Robscheit-Robbins
Journal: The Journal of Experimental Medicine (1947)

Dogs with sustained anemia and hypoproteinemia due to bleeding and a continuing low protein or protein-free diet with abundant iron will continue to produce much new hemoglobin and plasma protein for many weeks. The stimulus of double depletion (anemia and hypoproteinemia) leads to raiding of body and tissue protein to fill the demand for new hemoglobin and plasma protein. The blood proteins in these experiments take priority over the organ and tissue proteins. This is another illustration of the "ebb and flow" or dynamic equilibrium between organ or tissue protein and blood proteins. The average dog cannot tolerate this drain of double depletion for more than 7 to 11 weeks and during this time may lose 30 to 40 per cent of body weight. Some dogs are much more resistant to this raiding than others. Some dogs show a high blood protein output during every week up to the danger point. With the largest blood protein output one usually observes the most rapid weight loss. For every kilogram of weight loss we observe 50 to 140 gm. blood protein output. The weekly blood protein production ranges from 40 to 66 gm. These experiments make heavy demands on the body protein and we expected to record a "premortal rise" in urinary nitrogen. No such observations are noted, rather a most frugal use of all protein and minimum figures for urinary nitrogen. We suspect that "premortal rise" in many experiments means a terminal infection with the related catabolism of tissue protein and high urinary nitrogen.
Ten years' experience with an elemental diet in the management of Crohn's disease.
Authors: K Teahon, I Bjarnason, M Pearson, A J Levi
Journal: Gut (1990)

The immediate and longterm outcome of treating patients with acute Crohn9s disease with an elemental diet was studied retrospectively. Successful diet induced remission was achieved in 96 of 113 patients (85%) regardless of age, sex, site or severity of disease, or associated complications of strictures, fistula, or perianal disease. Treatment was unsuccessful in 17 patients (15%), but there were no features at the outset of treatment that distinguished these patients from those who had successful remission. The longterm outcome of treatment was assessed over a five year period by analysis of life tables and survival curves. Twenty two per cent of the patients relapsed within six months of treatment and thereafter the annual relapse rate was 8-10%. Patients with disease complicated by fistula or perianal involvement had early relapse, approaching 100% for the latter. A further retrospective comparison of longterm outcome of diet v steroid induced remissions showed no significant difference in the relapse rates between the two groups at one, three, and five years.