tbuckley/cabot-search huggingface dataset:
Demeclocycline in congestive cardiac failure.
Authors: R R Ghose, R Bonser
Journal: BMJ (1978)

2-36 mmol/l (1-6 mg/100 ml) if the 12-hour steady-state serum lithium level was main- tained at 1 mmol/l."i The mean dosage of Priadel required to maintain this level would be 1643 mg.Comparison of these results suggests that the peak serum lithium level would be certainly above 2 mmol/l (1-4 mg/100 ml) and probably considerably above this in the patient described, as the patient was receiving a higher dosage of lithium.If the blood samples were taken just before administration of the whole dose of lithium, the peak serum lithium level would be even higher than this.We still do not know how best to give lithium to maintain prophylaxis, but in view of the recent reports of renal damage following lithium toxicity7 8 it is prudent to give lithium in such a way as to avoid levels in the toxic range.The majority of patients should receive lithium in at least a divided dose schedule.
RISK ASSESSMENT AND VALIDATION OF DESTINATION THERAPY RISK SCORE (DTRS) IN RECIPIENTS OF CONTINUOUS FLOW LEFT VENTRICULAR ASSIST DEVICES (LVADS) AT A SINGLE CENTER
Authors: Manreet Kanwar, Stephen Bailey, Amresh Raina, George Sokos, Srinivas Murali, Robert Moraca, Brian Staub, Raymond Benza
Journal: Journal of the American College of Cardiology (2012)
Graves Hyperthyroidism After Stopping Immunosuppressive Therapy in Type 1 Diabetic Islet Cell Recipients With Pretransplant TPO Autoantibodies
Authors: Pieter Gillard, Volkert Huurman, Bart Van der Auwera, Brigitte Decallonne, Kris Poppe, Bart O. Roep, Frans Gorus, Chantal Mathieu, Daniel Pipeleers, Bart Keymeulen
Journal: Diabetes Care (2009)

OBJECTIVE After an initially successful islet cell transplantation, a number of patients return to C-peptide negativity, and therefore immunosuppressive therapy is discontinued. Some are then found to have developed Graves disease. We examined the risk of Graves disease after immunosuppression. RESEARCH DESIGN AND METHODS Immunosuppressive therapy was stopped in 13 type 1 diabetic islet cell recipients who had received one course of antithymocyte globulin and maintenance doses of mycophenolate mofetil and a calcineurin inhibitor. None had a history of thyroid disease. RESULTS In four patients, clinical Graves hyperthyroidism was observed within 21 months after discontinuation and 30–71 months after the start of immunosuppressive therapy. All four patients exhibited a pretransplant positivity for thyroid peroxidase (TPO) autoantibodies, while the nine others were TPO negative pre- and posttransplantation. CONCLUSIONS Type 1 diabetic recipients of islet cell grafts with pretransplant TPO autoantibody positivity exhibit a high risk for developing Graves hyperthyroidism after immunosuppressive therapy is discontinued for a failing graft.
Getting the hump
Authors: Trisha Greenhalgh
Journal: BMJ (2005)

If you cross our road, you can access five primary schools, two nurseries, a playground, and a home for elderly mentally infirm people. We used to have the best speed bumps in London: elegant little terracotta tables with gently sloping tarmac either side. Ninety-nine per cent of cars slowed down. Boy racers did predictable damage to their undercarriages. Nobody got killed.

The boy racers got together and lobbied the local council. They claimed that …
Truthfulness and Personal Disclosure in the Physician–Patient Relationship
Authors: David R. Fulp
Journal: Annals of Internal Medicine (2008)

Letters21 October 2008Truthfulness and Personal Disclosure in the Physician–Patient RelationshipDavid R. Fulp, MDDavid R. Fulp, MDFrom Chesapeake, VA 23322.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-8-200810210-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Regarding the recent article by Agrawal (1), I understand the short-term benefit of her lie, but if the patient ever found out the truth, that great relationship she built with her patient will be forever ruined. There will be no trust in a person who lies. I have always found that if patients could not deal with the truth of any situation, they and you are better off separating. As Agrawal said in her article, one lie leads to another. And then where does it end?David R. Fulp, MDChesapeake, VA 23322Reference1. Agrawal A. Lies to a patient. Ann Intern Med. 2008;148:707. [PMID: 18458285] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Chesapeake, VA 23322.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLies to a Patient Abha Agrawal Truthfulness and Personal Disclosure in the Physician–Patient Relationship Abha Agrawal Truthfulness and Personal Disclosure in the Physician–Patient Relationship David Lewis Truthfulness and Personal Disclosure in the Physician–Patient Relationship Dean Blakeley Metrics 21 October 2008Volume 149, Issue 8Page: 593KeywordsConflicts of interestDisclosure ePublished: 21 October 2008 Issue Published: 21 October 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Coagulation Tests and Platelet Economy in Atherosclerotic and Control Subjects
Authors: E. A. MURPHY, J. F. MUSTARD
Journal: Circulation (1962)

Blood coagulation was studied in 31 atherosclerotic male subjects and in 44 control male subjects. The mean platelet adhesive index was significantly greater in the atherosclerotic group and the plasma thromboplastin time was significantly shorter. These two tests are measures of the activity of the early stages of coagulation. The other in vitro tests of coagulation showed no significant differences. At present, platelet consumption is probably the only available measure of the activity of the early stages of coagulation in vivo. Platelet survival and daily turnover was accordingly determined with DFP 32 . Mean platelet survival was shorter and mean platelet turnover was greater in the atherosclerotic group. Division of the groups according to family history of atherosclerosis proved important. The most clearly separated groups were the atherosclerotic group with a positive history and the controls with a negative history. The remaining two subgroups are much more alike. This was true of both in vitro and in vivo tests. Despite the high experimental error, the in vivo tests correlate well with the in vitro tests of the early stages of clotting though poorly with tests of the later stages. It is concluded that differences exist between atherosclerotic and control subjects in the early stages of coagulation, and that in vitro tests are satisfactory indices of this difference. In their present form, none of these tests is suitable for diagnostic or prognostic purposes in the individual.
Mortality in patients with haematemesis and melaena: a prospective study.
Authors: P S Hunt, J Hansky, M G Korman
Journal: BMJ (1979)

In a prospective study of death in 817 patients with haematemesis and melaena admitted on 894 occasions, the protocol included admission of all patients to a defined unit, early endoscopy and resuscitation, and planned management. Over the three consecutive two-year periods of the study mortality significantly decreased from 9% to 2.4%. Although the operative rate remained the same, the operative mortality fell from 16% to 1.6%. The fall in mortality was greatest in patients with bleeding gastric ulcers. These results suggest that prospective studies with a defined policy can influence the mortality in patients with upper gastrointestinal bleeding.
Prognostic Value of Preoperative Cardiac Troponin I in Patients Undergoing Emergency Coronary Artery Bypass Surgery With Non–ST-Elevation or ST-Elevation Acute Coronary Syndromes
Authors: Matthias Thielmann, Parwis Massoudy, Markus Neuhäuser, Konstantinos Tsagakis, Günter Marggraf, Markus Kamler, Klaus Mann, Raimund Erbel, Heinz Jakob
Journal: Circulation (2006)

Cardiac troponin I (cTnI) is a highly sensitive and specific biomarker which has been shown to predict patient outcome pre- and postoperatively following elective coronary artery bypass surgery (CABG). Whether preoperatively elevated cTnI levels similarly predict the outcome in patients undergoing emergency CABG with acute myocardial infarction (AMI) is currently unknown.A possible correlation between preoperative cTnI and in-hospital mortality and major adverse cardiac events (MACE) was investigated in 57 patients with ST-elevation AMI (STEMI) in group 1 and 197 with Non-ST-elevation AMI (NSTEMI) in group 2, who were operated within 24 hours after onset of symptoms. Primary study end point was all-cause in-hospital mortality. Secondary end points were low cardiac output syndrome (LCOS) and hospital course. CTnI levels on admission were higher in group 1 compared with group 2 (7.1+/-1.8 versus 1.4+/-1.8 ng/mL; P<0.001). Overall in-hospital mortality was higher in group 1 compared with group 2 (14.3 versus 4.1%; odds ratio [OR], 3.9, 95% confidence interval [CI], 1.3 to 12.3; P<0.01). LCOS occurred in 16/57 (28.1%), and 18/197 (9.1%) patients, respectively (OR, 3.9, 95% CI, 1.7 to 8.8; P<0.001). Postoperative ventilation time, intensive care, and hospital stay were significantly longer in group 1 versus group 2. Multivariate logistic regression analyses revealed preoperative cTnI as the strongest independent predictor for in-hospital mortality (P<0.001) and MACE (P<0.001) in all AMI patients, regardless whether ST-elevation was included as an additional risk factor or not.Preoperative cTnI measurement before emergency CABG appears as a powerful and independent determinant of in-hospital mortality and MACE in acute STEMI and NSTEMI.
Erythraemic Myelosis Terminating in Erythroleukaemia
Authors: J. R. Hindmarsh, T. A. J. Wickham
Journal: BMJ (1955)

TREATMENT OF LEUKAEMIA remissions in five out of thirteen patients, of various ages, with acute leukaemia, and partial remissions in two others.The remissions were only temporary, and resis- tance to further therapy with 6-MP eventually resulted.Six patients with chronic myeloid leukaemia showed a varying response.One patient in the acute terminal phase had a remission lasting four and a half months.Two patients with chronic lymphatic leukaemia, two with multiple myeloma, and one with reticulosis of the skin did not respond, while one patient with mycosis fungoides obtained some improvement.6-MP is of low toxicity and no serious complications have followed its use.
Storage Age of Red Blood Cells for Transfusion of Premature Infants
Authors: Ravi Mangal Patel, Cassandra D. Josephson
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
The Solitary Thyroid Nodule
Authors: Katsutaro Shimaoka
Journal: JAMA (1980)

To the Editor.—  We share the concern and opinion expressed by Blum and Rothschild (1980;243:242) in their article on suppressive therapy for the thyroid nodule. We have previously reported that clinical differentiation of thyroid cancer from benign goiter is satisfactory (1962;181:179). In a double-blind study in which placebo and triiodothyronine (T 3 ) were compared, we have shown that the regression of goiter could be achieved by T 3 at a significantly higher rate than the spontaneous regression by placebo (46% vs 9%, P   In another randomized doubleblind study, we have also demonstrated that both T 3 and thyroxine (T 4 ) were effective in shrinking goiters. 1 However, we found that T 3 achieves significantly better results than T 4 (73% vs 49%, P  3 and 0.2 mg per day for T 4 ) is
Concerning Rates to the Denver Meeting.
Authors: A. H. Tufts
Journal: JAMA (1897)

Sioux Falls, S. D., Dec. 16, 1897. <h3>To the Editor:</h3> —Dr. J. F. Jenkins in theJournalof December 11, thinks that if the Committee on Transportation could obtain the same rates to the meeting of theAmerican Medical Associationthat other less important bodies get, we could have at least five thousand physicians present at the Denver meeting next year. Now, we have been informed that the doctors formerly had all they could ask for in the way of rates, until they abused their privileges. The railroad companies finally kept tab, and discovered that in one year, free transportation to the amount of about $60,000 had been called for and used to go to places other than theAssociation, over and above that actually used in good faith. The railroads thereupon cut off free transportation over each other's lines to their surgeons, thereby punishing the innocent with the guilty.
Covalent association of C3b with C4b within C5 convertase of the classical complement pathway.
Authors: Y Takata, T Kinoshita, H Kozono, J Takeda, E Tanaka, K Hong, K Inoue
Journal: The Journal of Experimental Medicine (1987)

The C5 convertase of the classical complement pathway is a complex enzyme consisting of three complement fragments, C4b, C2a, and C3b. Previous studies have elucidated functional roles of each subunit (4, 6, 7), but little is known about how the subunits associate with each other. In this investigation, we studied the nature of the classical C5 convertase that was assembled on sheep erythrocytes. We found that one of the nascent C3b molecules that had been generated by the C3 convertase directly bound covalently to C4b. C3b bound to the alpha' chain of C4b through an ester bond, which could be cleaved by treatment with hydroxylamine. The ester bond was rather unstable, with a half-life of 7.9 h at pH 7.4 and 37 degrees C. Formation of the C4b-C3b dimer is quite efficient; e.g., 54% of the cell-bound C3b was associated with C4b when 25,000 molecules of C4b and 12,000 molecules of C3b were present per cell. Kinetic analysis also showed the efficient formation of the C4b-C3b dimer; the rate of dimer formation was similar to or even faster than that of cell-bound monomeric C3b molecules. These results indicate that C4b is a highly reactive acceptor molecule for nascent C3b. High-affinity C5-binding sites with an association constant of 2.1 X 10(8) L/M were demonstrated on C4b-C3b dimer-bearing sheep erythrocytes, EAC43 cells. The number of high-affinity C5-binding sites coincided with the number of C4b-C3b dimers, but not with the total number of cell-bound C3b molecules. Anti-C4 antibodies caused 80% inhibition of the binding of C5 to EAC43 cells. These results suggest that only C4b-associated C3b serves as a high-affinity C5 binding site. EAC14 cells had a small amount of high-affinity C5 binding sites with an association constant of 8.1 X 10(7) L/M, 100 molecules of bound C4b being necessary for 1 binding site. In accordance with the hypothesis that C4b-associated C4b might also serve as a high-affinity C5-binding site, a small amount of C4b-C4b dimer was detected on EAC14 cells by SDS-PAGE analysis. Taken together, these observations indicate that the high-affinity binding of C5 is probably divalent, in that C5 recognizes both protomers in the dimers. The high-affinity binding may allow selective binding of C5 to the convertase in spite of surrounding monomeric C3b molecules.
Necrosis of a Pheochromocytoma with Shock
Authors: John P. Delaney, A. Zorel Paritzky
Journal: New England Journal of Medicine (1969)

HEMORRHAGE into a pheochromocytoma with subsequent shock has been described but five times,1 2 3 4 with only one recorded survival. In no case was the diagnosis made before either surgical exploration or post-mortem examination.Case ReportA 32-year-old housewife had a 4-year history of intermittent episodes of throbbing headache, palpitation, anxiety, tremulousness, flushing or pallor and blurred vision. Six months before admission, the frequency of these spells increased from 1 or 2 per week to 3 or 4 each day.In the month before admission laboratory evaluation revealed 24-hour urinary vanillyl-mandelic acid excretions of 13 and 14 mg (normal, 0.7 to 6.8 . . .
Pulmonary interstitial disease mimicking idiopathic pneumonia syndrome as the initial site of relapse of neuroblastoma following autologous bone-marrow transplantation: A case report
Authors: Raymond G. Watts, Elizabeth Mroczek-Musulman
Journal: American Journal of Hematology (1996)

Pulmonary interstitial infiltrates are a common diagnostic dilemma following bone-marrow transplantation. We present a case report of a child presenting with recurrent, metastatic neuroblastoma after bone-marrow transplantation, manifested initially as pulmonary interstitial disease mimicking idiopathic pneumonia syndrome. © 1996 Wiley-Liss, Inc.
Short-term survival after acute myocardial infarction predicted by hemodynamic parameters.
Authors: P D Verdouw, F Hagemeijer, W G Dorp, A V Vrom, P G Hugenholtz
Journal: Circulation (1975)

In the acute phase of myocardial infarction, short-term prediction of the likelihood of survival helps the physician choose the appropriate therapy for individual patients. Of 122 patients admitted to the coronary care unit of the Thoraxcenter, University Hospital, Rotterdam, with an acute myocardial infarction, 16 died from pump failure. In these and the 106 survivors, the predictive value of peripheral systolic (SP) and diastolic (DP) blood pressure, pulmonary capillary wedge pressure (PCW), mixed venous oxygen saturation (MVO2sat) in the pulmonary artery and heart rate (HR), both alone and in combination, was evaluated at the time of admission and 24 hours later. When, at admission, (DP X MVO2sat)/PCW exceeded 250%, 97/99 patients survived, whereas values below 250% were associated with death in 14/23. All other papameters, taken alone or in other combinations, showed less discriminatory power. Thb mean value of this index in survivors (549%) was statistically different (P less than 0.001) from the mean value in nonsurvivors (183%). Twenty-four hours later all survivors with admission values lower than 250% had an improved index. Of the 14 nonsurvivors with admission values lower than 250%, seven had already died, and in seven others the index had decreased still further; Linear discriminant analysis showed that (0.024 SP -- 0.217 PCW + 0.234 MVO2sat) was the most powerful prognostic index at the time of admission; its time course did not provide a more effective prediction of ultimate fatality than (DP XMVO2sat)/PCW. Determination of (DP X MVO2sat)/PCW in patients hospitalized for acute myocardial infarction provides a reliable prognosis for short-term patient survival. Its practical value in guiding patient management, more particularly for initiating mechanical circulatory assistance or for emergency surgery, must be further assessed.
Compensatory regeneration as a mechanism for renal tubule carcinogenesis of fumonisin B1 in the F344/N/Nctr BR rat.
Authors: P C Howard, A Warbritton, K A Voss, R J Lorentzen, J D Thurman, R M Kovach, T J Bucci
Journal: Environmental Health Perspectives (2001)

Fumonisin B1(FB1) is a fungal metabolite of Fusarium verticillioides (= F. moniliforme), a fungus that grows on many crops worldwide. Previous studies demonstrated that male BD IX rats consuming diets containing 50 ppm fumonisin B1 developed hepatocellular carcinomas. In our recent studies, diets containing FB1 at 50 ppm or higher concentrations induced renal tubule carcinomas in male F344/N/Nctr BR rats and hepatocellular carcinomas in female B6C3F1/Nctr BR mice. The carcinogenicity of FB1 in rats and mice is not due to DNA damage, as several laboratories have demonstrated that FB1 is not a genotoxin. FB1 induces apoptosis in cells in vitro. Including FB1 in the diets of rats results in increased hepatocellular and renal tubule epithelial cell apoptosis. In studies with F344/N/Nctr BR rats consuming diets containing up to 484 ppm FB1 for 28 days, female rats demonstrated more sensitivity than male rats in the induction of hepatocellular apoptosis and mitosis. Conversely, induction of renal tubule apoptosis and regeneration were more pronounced in male than in female rats. Induction of renal tubule apoptosis and hyperplasia correlated with the incidence of renal tubule carcinomas that developed in the 2-year feeding study with FB1 in the F344/N/Nctr BR rats. The data are consistent with the hypothesis that the induction of renal tubule carcinomas in male rats could be partly due to the continuous compensatory regeneration of renal tubule epithelial cells in response to the induction of apoptosis by fumonisin B1.
Expression of SphK1 impairs degranulation and motility of RBL-2H3 mast cells by desensitizing S1P receptors
Authors: Puneet S. Jolly, Meryem Bektas, Kenneth R. Watterson, Heidi Sankala, Shawn G. Payne, Sheldon Milstien, Sarah Spiegel
Journal: Blood (2005)
Proteins Required for Centrosome Clustering in Cancer Cells
Authors: Blanka Leber, Bettina Maier, Florian Fuchs, Jing Chi, Phillip Riffel, Simon Anderhub, Ludmila Wagner, Anthony D. Ho, Jeffrey L. Salisbury, Michael Boutros, Alwin Krämer
Journal: Science Translational Medicine (2010)

Identified in an RNA interference screen, proteins that prevent spindle multipolarity in human cancer cells may prove to be promising drug targets.
Concentration of iron in synovial membrane, synovial fluid, and serum in rheumatoid arthritis and other joint diseases.
Authors: G B Senator, K D Muirden
Journal: Annals of the Rheumatic Diseases (1968)

In a recent communication (Muirden and Senator, 1968) we have described the occurrence and distribu- tion of iron in the synovial membrane in patients with rheumatoid arthritis.Histological examinations of material from 27 joints in 23 patients showed positive Prussian blue staining in all but one biopsy.In fourteen biopsies of both normal synovium and synovium from other joint disorders, iron was absent from the synovial membrane except in a case with haemochromatosis and one with pig- mented villo-nodular synovitis.Samples of synovium removed at the time of these surgical procedures were retained for chemical estimation of the iron concentration and these results have been compared with iron levels in the serum and synovial fluid.Material* Synovial tissue was obtained from twenty patients with rheumatoid arthritis presenting for joint surgery at the Royal Melbourne Hospital.All patients satisfied diag- nostic criteria for "classical" or "definite" rheumatoid arthritis (Ropes, 1959).In ten of them it was possible to obtain synovial fluid from the joint at the time it was opened.Blood for serum iron estimation was obtained before surgery in fifteen of these patients.Synovial tissue was also obtained from seven patients undergoing surgical procedures for joint pathology other than rheumatoid arthritis (Cases 24-29, 32), and post mortem from the knee joints of five patients with no previous history of joint disease (Cases 33-37).Synovial fluid could not be obtained in sufficient amounts to measure the iron concentration in this group. MethodsThe tissue obtained from operation was immediately washed free of blood clot with chilled, iron-free, isotonic