tbuckley/cabot-search huggingface dataset:
High-resolution manometry alters the diagnosis in patients diagnosed with diffuse oesophageal spasm by conventional manometry: resurgence of achalasia cardia
Authors: D. Majumdar, P. Saunders, Y. Yiannakou, A. Dhar
Journal: Gut (2011)

<h3>Introduction</h3> Oesophageal manometry is the gold standard for the diagnosis of oesophageal dysmotility, a common clinical problem. Advances in manometric techniques by high-resolution manometry (HRM) and oesophageal pressure topography have revolutionised the interpretation of oesophageal physiology. There are reports of the impact of HRM to a change in manometric diagnosis. <h3>Aim</h3> To study the change in the diagnosis of diffuse oesophageal spasm by HRM and its impact on clinical management of oesophageal dysmotility. <h3>Patients and methods</h3> Between 2009 and 2010, all patients with a diagnosis of diffuse oesophageal spasm on conventional manometry referred for endoscopic botulinum toxin treatment were offered HRM at a tertiary referral centre. Case notes review was done for clinical symptoms at presentation, initial and final manometric diagnosis and outcomes of treatment. <h3>Results</h3> 10 patients were referred for botulinum toxin treatment of diffuse oesophageal spasm. Presenting symptoms were dysphagia, chest pain, regurgitation and weight loss; 6 patients had more than one symptom. Mean age = 57.6 years with M: F = 1:2. Mean duration between onset of symptoms and referral to specialist service was 20.6 months. All had a normal gastroduodenoscopy. Seven patients had barium swallow showing: hiatus hernia (n=1), oesophageal dysmotility (n=3), probable achalasia (n=2) and normal study (n=1). On conventional manometry, 7 were diagnosed as diffuse oesophageal spasm (DES), 2 were diagnosed with hypertensive oesophageal contractions and one had diffuse dysmotility. Five of these patients had HRM at a tertiary centre. Three patients had features of classic achalasia, one revealed DES and one had functional oesophago-gastric junction (OGJ) obstruction. The patients with achalasia were treated with 100 units of Botulinum toxin injection at the OG junction. 2 of them had complete symptom resolution and remained symptom free at 1 year follow-up. 1 patient with achalasia did not respond and was referred for a laparoscopic cardiomyotomy. Of the 5 patients with DES and hypertensive contractions 2 were treated successfully with Botulinum toxin injection to the OG junction and in the lower body of oesophagus. 3 patients had calcium channel blocker therapy with good symptom resolution. <h3>Conclusion</h3> HRM alters the diagnosis of diffuse oesophageal spasm on conventional manometry to achalasia in a third of patients, and therefore has a significant impact on their treatment options. Based on this initial observation, a larger prospective study is planned to investigate this change to diagnosis.
The "Acne" of Tuberous Sclerosis
Authors: Kenneth M. Halprin
Journal: JAMA (1967)

The next patient you see with juvenile "acne" may have adenoma sebaceum—one of the manifestations of the inherited disease, tuberous sclerosis. This particular "acne" will be centrally clustered, dome-shaped instead of conical, rather vascular, will lack blackheads and pustules, and most importantly will occur in a child who is prepubertal and therefore too young to have true acne (Fig 1). These hamartomatous growths are composed of vascular, epithelial, glandular, and collagenous elements and have characteristic histologic elements. Mental retardation and seizures develop in most patients with tuberous sclerosis during early childhood. Some, however, do not show central-nervoussystem signs, and their condition, therefore, is not recognized before the appearance of their cutaneous lesions. Many adults with this disease lead normal lives and are not aware of the serious portent of their skin lesions. Unfortunately, there is no guarantee that cerebral calcifications, mental retardation, and all the manifestations of tuberous sclerosis will
Letting intrauterine devices lie.
Authors: M Pollock
Journal: BMJ (1982)

A detailed study of the Lippes loop over 10 years and 27,954 woman-months showed that the pregnancy rate was highest during the 1st 2 years, after which it fell to an annual average of 0.5. The rate of removals for bleeding and pain was also highest during the 1st 2 years, after which it fell more slowly. All expulsions occurred during the 1st 3 years. Women using IUDs are more likely to develop pelvic inflammatory disease than other women. Infection is most common during the 1st year after fitting but may occur at any time. All devices tend to accumulate small deposits of calcium, and this may be associated with some corrosion of the underlying plastic. There is debate as to how long an IUD should remain in the uterus. Clearly it should be removed if it is causing symptoms. The woman who has been wearing her device symptom-free for many years and shows nothing abnormal on pelvic and cytological examination should be allowed to continue as she is, provided that she agrees to return for routine medical examination. This should include a cervical smear at yearly intervals, and immediate reporting if she develops any gynecological symptoms. The IUD should eventually be removed 1-2 years after the menopause; in most cases this will be accomplished without difficulty.
Trade Unionism for Doctors
Authors: Sanford A. Marcus
Journal: New England Journal of Medicine (1984)

WE are currently passing through the most drastic socioeconomic transformation in the history of the American medical profession.1 The traditional relationship with the patient that physicians have always guarded so jealously is now under attack by two forces, the success of either of which will change irrevocably most of the premises and attitudes on which we have based our careers as physicians.The first of these forces — and the one on which we have focused the most attention in the past — is socialized medicine, the assertion by government that access to health care is a right conferred by . . .
A Case of Periarteritis Nodosa
Authors: L. M. Shorvon
Journal: BMJ (1947)

A Case of Periarteritis NodosaPeriarteritis nodosa is a rare and generally fatal disease.Perilman (1946) thinks that every case deserves special atten- tion, therefore I record the following case. CASE REPORTAn Army driver aged 31 was taken ill with malaise, aches and pains, especially in the left side of the chest, and cough while in Greece.He was admitted to 53 General Hospital on April 24, 1946.
The Treatment of Metastatic Spinal Cord Tumors
Authors: Surendra Bansal
Journal: JAMA (1967)

Sixty cases of metastatic extramedullary tumors of the spinal cord have been analyzed regarding tumor type, level of involvement, degree of paresis, and the role of surgery and radiation therapy in management. In general, the more rapid the rate of progression, and the longer the duration and the more severe the degree of neurological deficit, the less favorable is the prognosis concerning return of motor function. The best mode of treatment appears to be surgery followed by postoperative radiation therapy. When pressure symptoms develop and the position of the defect can be established, immediate decompressive laminectomy should be performed to lessen the chances of permanent cord damage. This should be followed by radiation therapy to the area of involvement.
Seeing what isn't there
Authors: Barbara J. Bain, Bella Patel
Journal: American Journal of Hematology (2008)

The photograph shows the blood film of a patient who was hospitalized with renal failure.At first glance there appeared to be a number of unusually shaped red cells.Initially a haemolytic anaemia was suspected and investigation was commenced but on further reflection it was realized that the apparent holes in the red cells were likely to represent overlying cryoglobulin.This possibility was confirmed and was found to be due to type II cryoglobulinaemia in a patient with hepatitis C infection.The hepatitis C infection was, in turn, the cause of the renal failure.Cryoglobulin may be weakly basophilic, in which case it is easily recognised on a blood film.However, it is also necessary to recognize the negative image of unstained cryoglobulin, which can be an important clue to the diagnosis of hepatitis C infection (Image 1).Image 1.
Antibody producing human-human hybridomas. II. Derivation and characterization of an antibody specific for human leukemia cells.
Authors: L Olsson, R B Andreasen, A Ost, B Christensen, P Biberfeld
Journal: The Journal of Experimental Medicine (1984)

Human-human hybridoma technology was used to immortalize human B lymphocytes from patients with acute myeloid leukemia (AML) to study the antigenic repertoire of the humoral immune response against the patients' own leukemia cells and against leukemic cells from other patients. Nine fusions were done with lymphocytes from seven AML patients, and all with the human RH-L4 B lymphoma line as malignant fusion partner. A total of 305 Ig-producing hybrids were obtained. 26 reacted with cell surface components on AML cells, but 21 were found not to be specific for leukemia cells, when screened for reactivity against a panel of normal and malignant cells of both human and murine origin. Five hybridomas secreted Ig with high specificity for human leukemia cells, but only one hybridoma culture, aml-18, was stable in respect to Ig-production and growth upon repeated clonings and expansion in liquid cultures. A method was developed to grow human hybridomas as ascites tumors in nude mice, but the ascites fluid did not contain increased amount of antibody. The reactivity of the aml-18 antibody (gamma, kappa) was analyzed against samples of mononuclear cells from peripheral blood of 63 patients with leukemia and with cytologically verified leukemia cells in the blood. 22 of 54 AML samples reacted with aml-18. The reactivity pattern was not correlated to any categories of the French-American-British (FAB) classification; two of four ALL were positive. Moreover, a pronounced intratumoral antigenic heterogeneity in regard to aml-18 reactivity was seen and indicates a high degree of diversity in the immunological phenotype within individual AML cell populations. The study demonstrates that some patients with AML generate an immune response against their autologous malignant cells, and that the antigenic determinant in the case of aml-18 is also expressed specifically on leukemic cells from other patients.
NHS trusts urge caution over BMA finance survey
Authors: Lynn Eaton
Journal: BMJ (2005)

<h3>Abstract</h3> Next-generation risk assessment for environmental chemicals and ingredients in consumer products involves a weight of evidence (WoE) framework integrating a suite of new approach methodologies (NAMs) based on points of departure (PoD) obtained from <i>in vitro</i> assays. Omics techniques provide broad coverages of the molecular toxicity pathway space. Transcriptomics assays especially play a leading role by providing relatively conservative PoDs in comparison with apical endpoints. However, it is unclear whether and how parameters measured using other omics technicquesparticipate in the cellular response to chemical perturbations, especially at exposure levels below the transcriptomically defined PoD. Multi-omics coverage may provide additional sensitive or confirmative biomarkers to complement and reduce the uncertainty in safety decisions made using targeted and transcriptomics assays. In the present study, we compared changes in transcriptomics, proteomics and phosphoproteomics with two prototype compounds, coumarin, as a main study and doxorubicin, as a complementary study to understand the sensitivity of the three omics techniques in response to chemically-induced changes in HepG2 and AC16 cells. With measurements obtained for multiple chemical concentrations and time points, we demonstrated that, compared with proteomics and transcriptomics, phosphoproteomics alterations occur not only earlier in time as expected, but also at much lower chemical concentrations and hence are proximal to the very early effects induced by chemical exposure. The phosphoproteomics changes appear to approach maximum when the transcriptomics alterations begin to be initiated. The results are consistent with a tiered framework of cellular response to chemical insults, where posttranslational modification of preexisting proteins is first seen before transcriptomics induction is engaged to launch a more energy-expensive defense that defines a useful PoD. We conclude that as the cost becomes more affordable, proteomics covering posttranslational modifications can be utilized to provide a more complete coverage of chemical-induced cellular alteration and supplement transcriptomics-based health safety decision making.
The Retinal Atlas
Authors: Felipe de Alba
Journal: JAMA (2011)

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
Plato on social inequality
Authors: G R Fraser
Journal: BMJ (1995)

<h3>Background</h3> Obesity is an epidemic in pediatric patients. The purpose of this study was to review the results of a unique program to facilitate pediatric health and weight loss. <h3>Methods</h3> All patients ≤ 18 years old enrolled in the program. At enrolment and discharge, body measurements were recorded. The program was composed of 12 weeks of participation in activities encouraging weight loss/maintenance such as weight training, cardioexercises, and dietary consultation for family. Weight and height measurements were compared pre- and postprogram. In addition, comparisons between Katrina and non-Katrina enrollees were made. The hypothesis was that patients lost weight and grew significantly taller. <h3>Results</h3> Eighty participants, with 53 completing the program. The average age was 10.9 years, with 64% female. The mean weight change for the entire group was + 1 pound (range −12 to 23) (<i>p</i> = .26), whereas mean height increased 0.65 inches (range 0-2.5) (<i>p</i> &lt; .001). Simple regression analysis of weight change versus height change showed that height did not predict weight change. In a multiple regression of weight change on group (Katrina versus non-Katrina) were significant with the Katrina group, height-/weight-adjusted change was 11.7 pounds greater than non-Katrina (<i>p</i> &lt; .0001). In the non-Katrina group, the mean weight change was −0.214 pounds (range −12 to +13.5), the mean height change was 0.7 inches (range 0-2.5) (<i>p</i> &lt; .0001). In this non-Katrina group, using simple regression, height change did predict weight change. For every inch change in height, a change in weight of 3.8 pounds would be predicted (<i>p</i> &lt; .0016). <h3>Conclusions</h3> This program9s goal of facilitating pediatric weight loss has yet to be achieved. Children affected by Katrina gained significantly more weight than controls. Children do grow taller during the study, potentially adding weight. Further longitudinal studies are needed on this patient population to see if goals are achieved later.
Determination of Blood Volume in the Heart and Lungs and the Cardiac Output through the Injection of Radiophosphorus
Authors: GUSTAV NYLIN, HJÖRDIS CELANDER
Journal: Circulation (1950)

The dilution curve of the specific activity of the erythrocytes in the arterial blood after intravenous injection of labeled erythrocytes with P 32 has been treated mathematically. It is possible with the help of the dilution curve to calculate the minute volume of the heart and the thoracic pool (the residual blood of the heart + the blood content of the lungs). The values of the thoracic pool amount to about 30 per cent of the total circulatory blood-volume.
Multicenter study of percutaneous transluminal angioplasty for right coronary artery ostial stenosis
Authors: Eric J. Topol, Stephen G. Ellis, Jodi Fishman, Pierre Leimgruber, Richard K. Myler, Simon H. Stertzer, William W. O’Neill, John S. Douglas, Gary S. Roubin, Spencer B. King
Journal: Journal of the American College of Cardiology (1987)
Systemic oxidative stress in asthma, COPD, and smokers.
Authors: I Rahman, D Morrison, K Donaldson, W MacNee
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

An imbalance between oxidants and antioxidants is proposed in smokers and in patients with airways diseases. We tested this hypothesis by measuring the Trolox equivalent antioxidant capacity (TEAC) of plasma and the levels of products of lipid peroxidation as indices of overall oxidative stress. The plasma TEAC was markedly reduced (0.66 +/- 0.07 mmol/L; mean +/- SEM; n = 11), with increased levels of lipid peroxidation products, in healthy chronic smokers as compared with healthy nonsmokers (1.31 +/- 0.10 mmol/L, n = 14, p < 0.001), an effect that was exaggerated in those who had smoked 1 h before the study. Plasma TEAC was also low in patients presenting with acute exacerbations of chronic obstructive pulmonary disease (COPD) (0.46 +/- 0.10 mmol/L, n = 20, p < 0.001) or asthma (0.61 +/- 0.05 mmol/L, n = 9, p < 0.01) with increases in plasma lipid peroxidation products. There was a negative correlation between superoxide anion release by stimulated neutrophils and plasma antioxidant capacity (r = -0.73, p < 0.001) in patients with acute exacerbations of COPD. The profound decrease in TEAC was associated with a decreased plasma protein sulfhydryl concentrations in acute exacerbations of COPD but not in smokers or in asthmatic subjects. Therefore smoking, acute exacerbations of COPD, and asthma are associated with a marked oxidant/antioxidant imbalance in the blood, associated with evidence of increased oxidative stress. The decreased antioxidant capacity in plasma may result from different mechanisms in these conditions.
MEDICAL TREATMENT OF ACTINOMYCOSIS.
Authors: J. L. SAWYERS
Journal: JAMA (1901)

In presenting the following cases of actinomycosis I have selected, with one exception, only those in which I have been able to verify the diagnosis with the microscope. My chief object in reporting them is to call the attention of the profession: 1, to the frequency of the disease, especially in agricultural communities; 2, to direct attention to a mode of treatment that has proved very satisfactory in all the cases coming under my observation for the past two years: <h3>Case 1.</h3> —Mrs. D., aged 29, a farmer's wife; had good health prior to her present illness, but for two years hard lumps or swellings had from time to time appeared about the lower jaw. Four times the swellings had been incised and cleaned out with a sharp spoon. After this procedure the disease would be quiescent for a month or two, and then the swellings would recur. At the
CORTICOTROPIN AND CORTISONE IN BLOOD DISEASES IN CHILDREN
Authors: J. M. Stickney
Journal: JAMA (1952)

The effect of corticotropin and cortisone on the blood and bone marrow of normal human beings and persons with diseases not primarily of the hematopoietic system is fairly consistent.<sup>1</sup>There is a temporary decrease in circulating eosinophils and lymphocytes, with a sustained increase in neutrophils. The lymphocyte count usually returns to normal with continued administration of the hormones. There may be transient reticulocytosis. A rise in the erythrocyte count, concentration of hemoglobin, hematocrit reading, and red blood cell volume occurs only in patients in whom an underlying disease that produces anemia is favorably affected. The blood platelet count is not altered. Significant changes in the bone marrow are not seen. The response may be more rapid to corticotropin than to cortisone, but there are no essential differences if adrenal function is intact. <h3>LEUKEMIA</h3> The observations by Dougherty and White<sup>2</sup>of the effects of the pituitary adrenotropic hormones on
Immunologic Aspects of Lung Diseases and Cystic Fibrosis
Authors: Paul A. Greenberger
Journal: JAMA (1997)

Immunologic lung disorders are accompanied by an array of laboratory abnormalities, some of which contribute to disease pathogenesis. Allergic bronchopulmonary aspergillosis, which complicates asthma and cystic fibrosis, causes mucous plugging of airways, eosinophilic pneumonia, and bronchiolitis obliterans. Aspergillus fumigatus, growing saprophytically in bronchial mucus, is responsible for most cases, and prednisone, not antifungal agents, is the drug of choice because it controls the immunologic responses of the lung. In cystic fibrosis, epithelial surface fluid from the lung does not kill Pseudomonas aeruginosa, in part because antibodies to P aeruginosa are plentiful but ineffective in opsonizing bacteria. Neutrophil-derived elastase cleaves immunoglobulins and digests the C3b receptor on neutrophils, which limits phagocytosis of pathogens. In helminth infections and infestations, pulmonary and peripheral blood eosinophilia can be accompanied by increases in total and antiparasite IgE concentrations and generate T(H)2 CD4+ T-lymphocyte responses. Understanding the immunologic abnormalities of lung disorders may lead to more effective therapies.
Transient and persistent photosensitivity due to musk ambrette. Clinical and photobiological studies
Authors: C.A. RAMSAY
Journal: British Journal of Dermatology (1984)

Musk ambrette caused contact photosensitivity in five patients. One patient showed transient light reactivity and four showed persistent light reactivity. Tests with artificial radiation were performed on normal skin without musk ambrette being added. All patients reacted abnormally to UV-B and three to UV-A. In particular the patient with transient light reactivity showed abnormal responses to UV-B and UV-A. The patients were not always aware of the role of sunlight in the development of their eruption and the clinical features were not always typical of a photodermatitis.
Leptospirosis — Time for a Booster
Authors: Jay P. Sanford
Journal: New England Journal of Medicine (1984)

The term "leptospirosis" is now applied to diseases that may have multiple clinical presentations and are caused by any of the more than 170 serotypes of leptospires, of which at least 27 occur naturally in the United States. Leptospirosis occurs throughout the world, especially in the tropics. In Thailand and Vietnam, 15 to 27 per cent of persons tested have antibodies. Studies to define the causes of "fevers of unknown origin" in U.S. troops in Vietnam demonstrated that 1 to 17 per cent were associated with leptospirosis.1 , 2 In military units in Panama, attack rates ranging from 2 to 8 per . . .