tbuckley/cabot-search huggingface dataset:
The Dying Experience
Authors: Michael P. Hahn
Journal: Annals of Internal Medicine (1997)

Letters1 August 1997The Dying ExperienceMichael P. Hahn, RRTMichael P. Hahn, RRTAmerican Society for the Advancement of Palliative Care; Highland, CA 92346Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-3-199708010-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Lynn and colleagues [1] provide further significant confirmatory data on the problems with terminal care. An abundance of medical literature clearly indicates that improvements are needed in end-of-life care. Emphasis should now be focused on implementing the changes necessary to improve this situation. I would like to offer the following suggestions, which may help improve terminal-care practice.First, increase the use of inpatient palliative care on a widespread basis. Centers that have such services available have shown a high degree of overall satisfaction with this type of terminal care [2, 3]. These centers could offer physician and ...References1. Lynn J, Teno JM, Phillips RS, Wu AW, Desbiens N, Harrold J, et al. Perceptions by family members of the dying experience of older and seriously ill patients. Ann Intern Med. 1997; 126:97-106. Google Scholar2. Campbell ML, Frank RR. Experience with end-of-life practice at a university hospital. Crit Care Med. 1997; 25:197-202. Google Scholar3. Kellar N, Martinez J, Finis N, Bolger A, von Gunten CF. Characterization of an acute inpatient hospice palliative care unit in a U.S. teaching hospital. JONA. 1996; 26:16-20. Google Scholar Author, Article, and Disclosure InformationAuthors: Michael P. Hahn, RRTAffiliations: American Society for the Advancement of Palliative Care; Highland, CA 92346 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1997Volume 127, Issue 3Page: 243KeywordsEnd of life careFellowshipsHealth care facilitiesHealth care providersInpatientsMotivationPalliative carePatients ePublished: 15 August 2000 Issue Published: 1 August 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Screening for Drug and Alcohol Abuse in a General Medical Population
Authors: Forest S. Tennant
Journal: JAMA (1979)

One hundred fifty consecutive, first-visit, general medical patients were simply and inexpensively screened by questionnaire, personal inquiry, and physical examination for drug and alcohol abuse. Seventeen (11.3%) currently used psychoactive drugs, excluding alcohol, and ten (6.7%) used drugs or alcohol on a daily basis to the point that the patient considered it an abuse problem. The majority of the drug and alcohol users recognized their problem on a short questionnaire that was part of a medical intake form. Almost all of the recognized abusers of drugs or alcohol subsequently entered treatment of their problem.
Liver fibrosis: The hepatocyte revisited
Authors: Mark D. Gorrell, Kris Kowdley
Journal: Hepatology (2007)

Activated fibroblasts are key contributors to the fibrotic extracellular matrix accumulation during liver fibrosis. The origin of such fibroblasts is still debated, although several studies point to stellate cells as the principal source. The role of adult hepatocytes as contributors to the accumulation of fibroblasts in the fibrotic liver is yet undetermined. Here, we provide evidence that the pro-fibrotic growth factor, TGF- 1, induces adult mouse hepatocytes to undergo phenotypic and functional changes typical of epithelial to mesenchymal transition (EMT). We perform lineage-tracing experiments using AlbCre.R26RstoplacZ double transgenic mice to demonstrate that hepatocytes that undergo EMT contribute substantially to the population of FSP1-positive fibroblasts in CCl4-induced liver fibrosis. Furthermore, we demonstrate that bone morphogenic protein-7 (BMP7), a member of the TGF superfamily, which is known to antagonize TGF signaling, significantly inhibits progression of liver fibrosis in these mice. BMP7 treatment abolishes EMT-derived fibroblasts, suggesting that the therapeutic effect of BMP7 was at least partially due to the inhibition of EMT. These results provide direct evidence for the functional involvement of adult hepatocytes in the accumulation of activated fibroblasts in the fibrotic liver. Furthermore, our findings suggest that EMT is a promising therapeutic target for the attenuation of liver fibrosis.
Doxorubicin delivery by polyamidoamine dendrimer conjugation and photochemical internalization for cancer therapy
Authors: Ping-Shan Lai, Pei-Jen Lou, Cheng-Liang Peng, Chin-Ling Pai, Wei-Nen Yen, Ming-Yi Huang, Tai-Horng Young, Ming-Jium Shieh
Journal: Journal of Controlled Release (2007)
Interaction of the Pseudomonas aeruginosa secretory products pyocyanin and pyochelin generates hydroxyl radical and causes synergistic damage to endothelial cells. Implications for Pseudomonas-associated tissue injury.
Authors: B E Britigan, T L Roeder, G T Rasmussen, D M Shasby, M L McCormick, C D Cox
Journal: Journal of Clinical Investigation (1992)

Pyocyanin, a secretory product of Pseudomonas aeruginosa, has the capacity to undergo redox cycling under aerobic conditions with resulting generation of superoxide and hydrogen peroxide. By using spin trapping techniques in conjunction with electron paramagnetic resonance spectrometry (EPR), superoxide was detected during the aerobic reduction of pyocyanin by NADH or porcine endothelial cells. No evidence of hydroxyl radical formation was detected. Chromium oxalate eliminated the EPR spectrum of the superoxide-derived spin adduct resulting from endothelial cell exposure to pyocyanin, suggesting superoxide formation close to the endothelial cell plasma membrane. We have previously reported that iron bound to the P. aeruginosa siderophore pyochelin (ferripyochelin) catalyzes the formation of hydroxyl free radical from superoxide and hydrogen peroxide via the Haber-Weiss reaction. In the present study, spin trap evidence of hydroxyl radical formation was detected when NADH and pyocyanin were allowed to react in the presence of ferripyochelin. Similarly, endothelial cell exposure to pyocyanin and ferripyochelin also resulted in hydroxyl radical production which appeared to occur in close proximity to the cell surface. As assessed by 51Cr release, endothelial cells which were treated with pyocyanin or ferripyochelin alone demonstrated minimal injury. However, endothelial cell exposure to the combination of pyochelin and pyocyanin resulted in 55% specific 51Cr release. Injury was not observed with the substitution of iron-free pyochelin and was diminished by the presence of catalase or dimethyl thiourea. These data suggest the possibility that the P. aeruginosa secretory products pyocyanin and pyochelin may act synergistically via the generation of hydroxyl radical to damage local tissues at sites of pseudomonas infection.
Aspartame and its effects on health: Independently funded studies have found potential for adverse effects
Authors: John Briffa
Journal: BMJ (2005)

Save the FDAEditor-Abbasi asks whether drug regulation is failing. 1 The US Food and Drug Administration (FDA) performs a thankless task.Patients want new drugs available immediately and agitate to accomplish this.Patients also wish medicines to be guaranteed safe, and blame the FDA when toxicity leads to a drug's withdrawal.Clinical scientists complain that the FDA obstructs their investigations.Pharmaceutical companies see the FDA as an adversary, not a protector.Practising in the USA for 20 years, I encountered many FDA agents.A few revered regulations for their own sake.Such people are irksome, but without strict oversight valueless and toxic agents would be marketed.A prime example is Laetrile (laevo-mandelonitrile-beta-glucuronoside), a useless and poisonous drug promoted for cancer treatment.The FDA, supported by the National Cancer Institute, successfully resisted extreme public pressure to allow its marketing, saving many lives and a multimillion dollar fraud.The FDA faces serious accusations.Attempting to suppress David Graham's whistleblowing on rofecoxib assaults scientific honesty. 2 3 The FDA's refusal to allow non-prescription sales of emergency contraception indicates unacceptable political pressure from the religious right.Unduly close relations between the FDA and pharmaceutical companies may lead to premature marketing approvals.How should the FDA be saved?Firstly, officials ordering withdrawal of a drug should be independent of those who approve marketing.Secondly, making the FDA a quango would protect from political pressures.Thirdly, conflicts of interest involving FDA employees and consultants must be rigorously scrutinised, even more severely than editors scrutinise the interests of contributors.The UK's Medicines and Healthcare products Regulatory Agency is accused of proindustry bias.Housecleaning there and at the FDA will benefit patients, doctors, and the pharmaceutical industry itself.
Natural Killer Cell Cytotoxicity Is Suppressed by Exposure to the Human NKG2D Ligand MICA*008 That Is Shed by Tumor Cells in Exosomes
Authors: Omodele Ashiru, Philippe Boutet, Lola Fernández-Messina, Sonia Agüera-González, Jeremy N. Skepper, Mar Valés-Gómez, Hugh T. Reyburn
Journal: Cancer Research (2010)

Abstract The MHC class I–related chain (MIC) A and MICB ligands for the activating receptor NKG2D can be shed from tumor cells, and the presence of these soluble molecules in sera is related with compromised immune response and progression of disease. Recently, thiol disulphide isomerases and members of the ADAM (a disintegrin and metalloproteinase) gene family were identified as key enzymes in mediating MICA/B shedding from cells. Here, we report shedding of the most frequently expressed MICA allele in human populations (MICA*008) into exosomes, small membrane vesicles that are secreted upon fusion with the plasma membrane. Although similar to other MICA/B molecules in the extracellular domain, the predicted transmembrane and cytoplasmic domains of MICA*008 are quite different, and this difference seemed to be critical for the mode of release from tumor cells. Treatment of natural killer (NK) cells with exosomes containing MICA*008 molecules not only triggered downregulation of NKG2D from the cell surface but also provoked a marked reduction in NK cytotoxicity that is independent of NKG2D ligand expression by the target cell. Our findings reveal a mechanism of NK suppression in cancer that may facilitate immune escape and progression. Cancer Res; 70(2); 481–9
Detection of a Pulmonary Epithelioid Hemangioendothelioma by FDG PET Scan
Authors: Kimberly Fagen, Eugene D. Silverman, Richard L. Cole
Journal: Clinical Nuclear Medicine (2004)

An asymptomatic 66-year-old male smoker was noted to have a right upper lobe opacity on routine chest radiograph. A CT scan confirmed a 2 × 1-cm mass in the right upper lobe. Bronchoscopy and CT-guided biopsy were nondiagnostic. F-18 FDG PET demonstrated uptake in the lesion. Lobectomy and immunohistopathologic examination revealed the mass to be pulmonary epithelioid hemangioendothelioma.
Review: CURB65, CRB65, and Pneumonia Severity Index similarly predict mortality in community-acquired pneumonia
Authors: Andrew Morris
Journal: Annals of Internal Medicine (2011)

Source Citation Chalmers JD, Singanayagam A, Akram AR, et al. Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis. Thorax. 2010;65:878-83. 20729231
Mitigation of Sociocommunicational Deficits of Autism Through Oxytocin-Induced Recovery of Medial Prefrontal Activity
Authors: Takamitsu Watanabe, Osamu Abe, Hitoshi Kuwabara, Noriaki Yahata, Yosuke Takano, Norichika Iwashiro, Tatsunobu Natsubori, Yuta Aoki, Hidemasa Takao, Yuki Kawakubo, Yoko Kamio, Nobumasa Kato, Yasushi Miyashita, Kiyoto Kasai, Hidenori Yamasue
Journal: JAMA Psychiatry (2013)

Sociocommunicational deficits make it difficult for individuals with autism spectrum disorders (ASD) to understand communication content with conflicting verbal and nonverbal information. Despite growing prospects for oxytocin as a therapeutic agent for ASD, no direct neurobiological evidence exists for oxytocin's beneficial effects on this core symptom of ASD. This is slowing clinical application of the neuropeptide.To directly examine whether oxytocin has beneficial effects on the sociocommunicational deficits of ASD using both behavioral and neural measures.At the University of Tokyo Hospital, we conducted a randomized, double-blind, placebo-controlled, within-subject-crossover, single-site experimental trial in which intranasal oxytocin and placebo were administered. A total of 40 highly functioning men with ASD participated and were randomized in the trial.Single-dose intranasal administration of oxytocin (24 IU) and placebo.Using functional magnetic resonance imaging, we examined effects of oxytocin on behavioral neural responses of the participants to a social psychological task. In our previous case-control study using the same psychological task, when making decisions about social information with conflicting verbal and nonverbal contents, participants with ASD made judgments based on nonverbal contents less frequently with longer time and could not induce enough activation in the medial prefrontal cortex. Therefore, our main outcomes and measures were the frequency of the nonverbal information-based judgments (NVJs), the response time for NVJs, and brain activity of the medial prefrontal cortex during NVJs.Intranasal oxytocin enabled the participants to make NVJs more frequently (P = .03) with shorter response time (P = .02). During the mitigated behavior, oxytocin increased the originally diminished brain activity in the medial prefrontal cortex (P < .001). Moreover, oxytocin enhanced functional coordination in the area (P < .001), and the magnitude of these neural effects was predictive of the behavioral effects (P ≤ .01).These findings provide the first neurobiological evidence for oxytocin's beneficial effects on sociocommunicational deficits of ASD and give us the initial account for neurobiological mechanisms underlying any beneficial effects of the neuropeptide.umin.ac.jp/ctr Identifier: UMIN000002241 and UMIN000004393.
Poisons of the Past: Molds, Epidemics, and History
Authors: William K. Beatty
Journal: JAMA (1990)

The breadth of this book quickly becomes evident from a perusal of the list of tables. These range in subject from the symptoms of ergotism through the mortality of English peers' children, 1550-1849, to tree-ring indices in Nancy Brook, NH, 1660-1759. Matossian has attempted to show the relationships between mycotoxins, primarily ergot, and infertility, increased mortality, and mass psychoses, especially witch persecutions. The author clearly states that much of her argument must rely on indirection, since the background statistics and scientific links simply are nonexistent. She has, nevertheless, made a strong case for her hypotheses and has done so in an intriguing and lucid manner. Nor is this a first-shot book: Matossian has been writing on related topics for a decade. Food poisoning has frequently played a role in history, especially in Russia and the rest of Europe north of the Pyrenees and the Alps. Much of the author's supporting
Identification and characterization of mutations in hepatitis B virus resistant to lamivudine
Authors: Marchelle I. Allen, Manon Deslauriers, Webster C. Andrews, Graham A. Tipples, Kathie-Anne Walters, David L. Tyrrell, Nathaniel Brown, Lynn D. Condreay
Journal: Hepatology (1998)

Cirrhosis and hepatocellular carcinoma occur as long-term complications of chronic hepatitis B virus (HBV) infection. Antiviral therapy is potentially a successful approach for the treatment of patients with HBV infection, which includes the nucleoside analog, lamivudine [(-)2′-deoxy-3′-thiacytidine, 3TC]. Although resistance to lamivudine therapy has been reported in several HBV-infected patients, the pattern of resistance-associated mutations in HBV has not been fully characterized. We report a DNA sequence database that includes a 500-base pair region of the HBV polymerase gene from 20 patients with clinical manifestations of lamivudine resistance. Analysis of the database reveals two patterns of amino acid substitutions in the tyrosine, methionine, aspartate, aspartate (YMDD) nucleotide-binding locus of the HBV polymerase. HBV DNA from the sera of patients in Group I exhibits a substitution of valine for methionine at residue 552, accompanied by a substitution of methionine for leucine at residue 528. Patients in Group II had only an isoleucine-for-methionine substitution at position 552. Reconstruction of these mutations in an HBV replication-competent plasmid was performed in a transient transfection cell assay to determine the function/relevance of these mutations to lamivudine resistance. Both Group I and Group II mutations resulted in a substantial decrease in sensitivity to lamivudine treatment (&gt;10,000-fold shift in IC 50 over wild-type [ wt ] IC 50 ), strongly indicating that these mutations were involved in resistance to lamivudine. A hypothetical model of the HBV reverse transcriptase has been generated for further study of the role of these mutations in lamivudine resistance.
Advances in Cutaneous Aesthetic Surgery
Authors: Alexander J. Stratigos
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
Ocular and Cerebellar Defects in Zebrafish Induced by Overexpression of the LIM Domains of the Islet-3 LIM/Homeodomain Protein
Authors: Yutaka Kikuchi, Hiroshi Segawa, Mika Tokumoto, Tatsuya Tsubokawa, Yoshiki Hotta, Keiichi Uyemura, Hitoshi Okamoto
Journal: Neuron (1997)
The Mechanism of Adaptation of Left Atrial Stretch Receptors in Dogs with Chronic Congestive Heart Failure
Authors: Irving H. Zucker, Alvin M. Earle, Joseph P. Gilmore
Journal: Journal of Clinical Investigation (1977)

Chronic congestive heart failure (CHF) was induced in dogs by the construction of an aorto-caval fistula below the level of the renal arteries. Aorto-caval fistula dogs showed signs of CHF which included ascites, hind limb edema, and pulmonary congestion. Ventricular catheterization indicated a significantly higher left ventricular end diastolic pressure and lower maximum velocity of left ventricular pressure development/left ventricular end diastolic pressure in CHF dogs when compared to sham-operated controls. Heart weight/body weight ratios were significantly higher in CHF dogs. Electrophysiological recordings from medullated left atrial type B receptors from the cervical vagus indicated a depressed sensitivity of these receptors in CHF dogs when compared to sham-operated control dogs. For any given change in left atrial pressure, the discharge of left atrial receptors was significantly reduced in CHF dogs compared with sham-operated controls. The mechanism for this depressed sensitivity was investigated. Sonomicrometry of the left atrial appendage indicated a decreased compliance of the left atrial appendage in the dogs with chronic CHF. In addition, microscope examination of the complex unencapsulated receptor endings taken from the left atrial endocardium indicated a marked alteration in receptor morphology. A loss of the end arborization was the most typical finding. It is concluded that chronic CHF brought about by an aorto-caval fistula results in a depressed left atrial stretch receptor response and that both decreased left atrial compliance and structural alterations in the receptor endings may account for this depressed sensitivity.
Lead Content of Calcium Supplements
Authors: Edward A. Ross
Journal: JAMA (2000)

Substantial quantities of lead have been reported in some over-the-counter calcium supplement preparations, including not only bone-meal and dolomite, but also over-the-counter natural and refined calcium carbonate formulations. Examination of this issue is warranted given recent increases in physician recommendations for calcium supplements for prevention and treatment of osteoporosis.To determine the lead content of calcium supplements and to quantify the lead exposure from popular brands of calcium in dosages used for childhood recommended daily allowance, osteoporosis, and phosphate binding in dialysis patients.Analysis of lead content in 21 formulations of nonprescription calcium carbonate (including 7 natural [ie, oyster shell] and 14 refined), 1 brand of prescription-only calcium acetate, and 1 noncalcium synthetic phosphate binder conducted in March 2000.Lead content, assayed using electrothermal atomic absorption, expressed as micrograms of lead per 800 mg/d of elemental calcium, per 1500 mg/d of calcium, and for a range of dosages for patients with renal failure. Six microg/d of lead was considered the absolute dietary limit, with no more than 1 microg/d being the goal for supplements.Four of 7 natural products had measurable lead content, amounting to approximately 1 microg/d for 800 mg/d of calcium, between 1 and 2 microg/d for 1500 mg/d of calcium, and up to 10 microg/d for renal dosages. Four of the 14 refined products had similar lead content, including up to 3 microg/d of lead in osteoporosis calcium dosages and up to 20 microg/d in high renal dosages. No lead was detected in the calcium acetate or polymer products. Lead was present even in some brand name products from major pharmaceutical companies not of natural oyster shell derivation.Despite increasingly stringent limits of lead exposure, many calcium supplement formulations contain lead and thereby may pose an easily avoidable public health concern. JAMA. 2000;284:1425-1429.
Association between coronary heart disease risk factors and physical fitness in healthy adult women.
Authors: L W Gibbons, S N Blair, K H Cooper, M Smith
Journal: Circulation (1983)

We examined associations between physical fitness and risk factors for coronary heart disease in healthy women ages 18-65 years. Physical fitness was objectively determined by the duration of a maximal treadmill exercise test. Six physical fitness categories (very poor to superior), specific within 10-year age increments, were established. Mean risk factor levels varied across categories, but so did potential confounders such as age and weight. Multiple linear regression modeling was used to control for the effects of age, weight and year of exam on coronary risk factors. After adjustment, physical fitness was independently associated with triglycerides (p less than 0.001), high-density lipoprotein cholesterol (HDL-C) (p less than or equal to 0.001), total cholesterol/HDL-C ratio (p less than or equal to 0.001), blood pressure (p less than or equal to 0.001) and cigarette smoking (p less than or equal to 0.001).