tbuckley/cabot-search huggingface dataset:
Vitamin A inhibits pancreatic stellate cell activation: implications for treatment of pancreatic fibrosis
Authors: J A McCarroll
Journal: Gut (2005)

Activated pancreatic stellate cells (PSCs) are implicated in the production of alcohol induced pancreatic fibrosis. PSC activation is invariably associated with loss of cytoplasmic vitamin A (retinol) stores. Furthermore, retinol and ethanol are known to be metabolised by similar pathways. Our group and others have demonstrated that ethanol induced PSC activation is mediated by the mitogen activated protein kinase (MAPK) pathway but the specific role of retinol and its metabolites all-trans retinoic acid (ATRA) and 9-cis retinoic acid (9-RA) in PSC quiescence/activation, or its influence on ethanol induced PSC activation is not known. Therefore, the aims of this study were to (i) examine the effects of retinol, ATRA, and 9-RA on PSC activation; (ii) determine whether retinol, ATRA, and 9-RA influence MAPK signalling in PSCs; and (iii) assess the effect of retinol supplementation on PSCs activated by ethanol.Cultured rat PSCs were incubated with retinol, ATRA, or 9-RA for varying time periods and assessed for: (i) proliferation; (ii) expression of alpha smooth muscle actin (alpha-SMA), collagen I, fibronectin, and laminin; and (iii) activation of MAPKs (extracellular regulated kinases 1 and 2, p38 kinase, and c-Jun N terminal kinase). The effect of retinol on PSCs treated with ethanol was also examined by incubating cells with ethanol in the presence or absence of retinol for five days, followed by assessment of alpha-SMA, collagen I, fibronectin, and laminin expression.Retinol, ATRA, and 9-RA significantly inhibited: (i) cell proliferation, (ii) expression of alpha-SMA, collagen I, fibronectin, and laminin, and (iii) activation of all three classes of MAPKs. Furthermore, retinol prevented ethanol induced PSC activation, as indicated by inhibition of the ethanol induced increase in alpha-SMA, collagen I, fibronectin, and laminin expression.Retinol and its metabolites ATRA and 9-RA induce quiescence in culture activated PSCs associated with a significant decrease in the activation of all three classes of MAPKs in PSCs. Ethanol induced PSC activation is prevented by retinol supplementation.
Survival with angiotensin-converting-enzyme inhibition vs. direct vasodilation for the same hemodynamic goals in advanced heart failure: 106 randomized patients
Authors: Gregg Fonarow, Catherine Chelimsky-Fallick, Lynne W. Stevenson, Michael Luu, Michele Hamilton, Jaime Moriguchi, Julie Walden, Elaine Albanese, Jan Tillisch
Journal: Journal of the American College of Cardiology (1991)
Keeping the “Home” in Nursing Home
Authors: Lona Mody, Suzanne F. Bradley, Susan S. Huang
Journal: JAMA Internal Medicine (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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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 Internal Medicine journal
The Morning-after Pill
Authors: Laurence M. Demers
Journal: New England Journal of Medicine (1971)

The postcoital concept referred to as the morning-after pill is discussed. Animal studies indicate a parallelism between the estrogenicity of the postcoital contraceptive agent and its effectiveness as an antifertility drug. In human and subhuman primate postcoital contraception studies, diethylstilbestrol and estradiol were most effective in preventing pregnancy when given in high doses for 4 to 6 days after coitus. Side effects were not demonstrable. In man, an antiprogesterone effect with the high-dose estrogen treatment appears possible since it eliminates the usual thermal shift in basal body temperature and brings about changes noted in the progestational endometrium. Altering the estrogen-progesterone ratio slightly during the period before egg implantation with either estrogen or an antagonist to estrogen interferes with the sensitive hormonal requirements of the implantation process. Of the potential postcoital antifertility agents, the estrogenic compounds show no teratogenic properties, but the antimetabolites, alkaloids, and other cytotoxic drugs given in pregnancy do produce a number of teratogenic effects. There are advantages to the postcoital contraceptive agents. Effects appear to be localized in the uterus, and there appears to be no change in the length of the menstrual cycle following treatment. By eliminating the involvement of the higher centers of reproductive control in contraception, the majority of the unwanted side effects will be removed. Present research in postcoital contraception is centered on developing a nonsteroidal compound that exhibits the antifertility potency of estrogen, has the specificity of an antiimplantation agent, and yet is only weakly estrogenic. The use of prostaglandins is being studied at this time.
Comparison of Tc-99m MAG3 and Tc-99m DTPA in Renal Transplant Patients with Impaired Renal Function
Authors: ANDREW TAYLOR, JACK A. ZIFFER, DENNIS ESHIMA
Journal: Clinical Nuclear Medicine (1990)

Tc-99m mercaptoacetyltriglycine (MAG3) is a new Tc-99m renal agent that compares favorably to I-131 Hippuran in animal models, normal volunteers, and patients. Based on the fact that Tc-99m MAG3 has a much more rapid clearance than Tc-99m DTPA and a smaller volume of distribution, it was postulated that the image quality of Tc-99m MAG3 studies should be superior to scans obtained using Tc-99m DTPA, particularly in patients with impaired renal function. To test this hypothesis, Tc-99m DTPA and MAG3 images were obtained in three transplant patients during periods of stable but impaired renal function. In one study, the Tc-99m DTPA study was potentially misleading, whereas the Tc-99m MAG3 examination assessed the clinical situation correctly. In all three cases, the Tc-99m MAG3 images were superior.
Child of the 1960s Addresses Issues of the 1980s
Authors: Beverly Merz
Journal: JAMA (1987)

"MEDICINE GETS ITS FINGERS in every nook and cranny of human existence," says Gideon Bosker, MD, explaining why the field holds such fascination for the writer and reader alike. Bosker speaks from experience. He spends 30 hours a week intensely involved with the basic stuff of humanity as attending physician in the Department of Emergency Medicine at Good Samaritan Hospital and Medical Center in Portland, Ore. He spends another 30 hours as a writer—reflecting on the myriad aspects of human existence. Within the last decade the latter 30hour increments have involved writing or editing textbooks and journal articles in geriatric medicine and emergency medicine and designing continuing education seminars for specialists in those fields. They now also involve preparing the first issue of<i>Ambulatory Medicine Letter</i>—a newsletter for primary care physicians scheduled to debut in December. But his colleagues in medicine are only one sector of Bosker's audience. Since
Cause and Effect in Epidemiology
Authors: John C. Bailar
Journal: New England Journal of Medicine (1980)

Thomas Huxley once commented on "the great tragedy of Science — the slaying of a beautiful hypothesis by an ugly fact."1 In a Special Article by Hulley et al. in this issue, the theory that triglyceride is a cause of coronary heart disease has been wounded gravely, perhaps mortally. The culprit is the ugly fact that in most or all epidemiologic data now at hand, the observed association between triglyceride and coronary heart disease can be entirely explained by other recognized risk factors for the disease. The authors seem to have good epidemiologic reasons for recommending "that widespread screening and . . .
Utilization and Outcomes of Inpatient Surgical Care at Critical Access Hospitals in the United States
Authors: Adam J. Gadzinski, Justin B. Dimick, Zaojun Ye, David C. Miller
Journal: JAMA Surgery (2013)

<h3>Importance</h3> There is a growing interest in the quality and cost of care provided at Critical Access Hospitals (CAHs), a predominant source of care for many rural populations in the United States. <h3>Objective</h3> To evaluate utilization, outcomes, and costs of inpatient surgery performed at CAHs. <h3>Design, Setting, and Patients</h3> A retrospective cohort study of patients undergoing inpatient surgery from 2005 through 2009 at CAHs or non-CAHs was performed using data from the Nationwide Inpatient Sample and American Hospital Association. <h3>Exposure</h3> The CAH status of the admitting hospital. <h3>Main Outcomes and Measures</h3> In-hospital mortality, prolonged length of stay, and total hospital costs. <h3>Results</h3> Among the 1283 CAHs and 3612 non-CAHs reporting to the American Hospital Association, 34.8% and 36.4%, respectively, had at least 1 year of data in the Nationwide Inpatient Sample. General surgical, gynecologic, and orthopedic procedures composed 95.8% of inpatient cases at CAHs vs 77.3% at non-CAHs (<i>P</i> &lt; .001). For 8 common procedures examined (appendectomy, cholecystectomy, colorectal cancer resection, cesarean delivery, hysterectomy, knee replacement, hip replacement, and hip fracture repair), mortality was equivalent between CAHs and non-CAHs (<i>P</i> &gt; .05 for all), with the exception that Medicare beneficiaries undergoing hip fracture repair in CAHs had a higher risk of in-hospital death (adjusted odds ratio = 1.37; 95% CI, 1.01-1.87). However, despite shorter hospital stays (<i>P</i> ≤ .001 for 4 procedures), costs at CAHs were 9.9% to 30.1% higher (<i>P</i> &lt; .001 for all 8 procedures). <h3>Conclusions and Relevance</h3> In-hospital mortality for common low-risk procedures is indistinguishable between CAHs and non-CAHs. Although our findings suggest the potential for cost savings, changes in payment policy for CAHs could diminish access to essential surgical care for rural populations.
Novel Tests for Diagnosis of Invasive Aspergillosis in Patients with Underlying Respiratory Diseases
Authors: Juergen Prattes, Holger Flick, Florian Prüller, Christoph Koidl, Reinhard B. Raggam, Michael Palfner, Susanne Eigl, Walter Buzina, Ines Zollner-Schwetz, Christopher R. Thornton, Robert Krause, Martin Hoenigl
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Rationale: Invasive pulmonary aspergillosis has been increasingly reported in nonneutropenic patients, including those with underlying respiratory diseases.Objectives: We compared the diagnostic performances of galactomannan, 1,3-β-D-glucan, and Aspergillus-specific lateral-flow device tests with that of conventional culture by using bronchoalveolar lavage fluid samples from patients with underlying respiratory diseases.Methods: We analyzed 268 bronchoalveolar lavage samples from 221 patients with underlying respiratory diseases (and without hematologic malignancy or previous solid organ transplantation) that were collected for routine microbiological workup between February 2012 and May 2014 at the University Hospital of Graz, Austria. Invasive pulmonary aspergillosis was defined according to European Organization of Research and Treatment of Cancer/Mycoses Study Group criteria modified for patients with respiratory diseases.Measurements and Main Results: Thirty-one patients (14%) had probable or proven, 25 possible, and the remaining 165 patients no invasive pulmonary aspergillosis. Probable/proven aspergillosis was associated with a significantly higher (P = 0.034) 30-day mortality rate of 32%. Sensitivities, specificities, and diagnostic odd ratios differed markedly between galactomannan (cut-off 0.5: optical density index, 0.97, 0.81, 124.4; cut-off 1.0: 0.97, 0.93, 422.1; cut-off 3.0: 0.61, 0.99, 109.8), β-D-glucan (cut-off 80 pg/ml: 0.90, 0.42, 6.57; cut-off 200 pg/ml: 0.70, 0.61, 3.7), lateral-flow device tests (0.77, 0.92, 41.8), and mycological culture (0.29, 0.97, 14).Conclusions: Probable or proven invasive pulmonary aspergillosis was diagnosed in 14% of our study population and associated with significantly higher 30-day mortality rates. Although the performance of β-D-glucan was limited by low specificity and that of mycological culture by low sensitivity, the Aspergillus lateral-flow device seems to be a promising alternative to galactomannan testing, which remains the diagnostic gold standard for aspergillosis.Clinical trial registered with www.clinicaltrials.gov (NCT 02058316).
Addictive Drugs and Alcoholism
Authors: Donald B. Douglas
Journal: JAMA (1974)

To the Editor.—  Dr. Paul W. Cochran, in Drugs for Anxiety (229:521, 1974), asks whether he is alone in the woods in regard to his experience with diazepam. I am sure that large numbers of physicians and patients would agree with him, could they be heard from, particularly in regard to one of our gravest and commonest problems, the severe and growing misuse of addictive drugs as a treatment for alcoholism.  Mild warnings and unclear evaluations have concealed a really grave problem. The large number of suicide attempts by drug overdose, nearly always a culmination of protracted misuse, is one indication of the havoc caused by these drugs. Further evidence comes from extensive experience in the  Association of Alcoholics Anonymous of greater New York: 75% of alcoholics entering the Intergroup now are misusing one or more such drugs, namely barbiturates, amphetamines, and various substances that have been so tragically
Exercise Therapy in Hypertensive Men
Authors: John L. Boyer
Journal: JAMA (1970)

<h3>To the Editor:—</h3> Admittedly it might have made a better study had we randomly selected our hypertensive group from a hypertensive pool with the remainder of the group serving as hypertensive controls. This was considered at the time the study design was made. However, we felt our hypertensive patients had served as their own controls. They had been hypertensive minimally for a year and many for several years. They had been followed up regularly by their own physicians, had had numerous blood pressures taken in the office environment, and every effort had been made to keep all other variables constant. In addition, the blood pressure records by the laboratory personnel were remarkably similar to those obtained by the referring physicians throughout this study. Every hypertensive patient had a drop in diastolic pressure and the data show a bimodal distribution with one peak centered at 20 mm and the other at
Somatic Mutations of<i>IDH1</i>and<i>IDH2</i>in the Leukemic Transformation of Myeloproliferative Neoplasms
Authors: Anthony Green, Philip Beer
Journal: New England Journal of Medicine (2010)

To the Editor: Somatic mutations affecting the R132 residue of isocitrate dehydrogenase 1 (IDH1) and the homologous IDH2 R172 occur in central nervous system tumors.1,2 Recently (in the Sept. 10 issue of the Journal 3), alterations of IDH1 R132 (in exon 2) were reported in 16 of 188 patients with de novo acute myeloid leukemia, with a strong association with a normal karyotype; however, mutations of IDH2 R172 (in exon 4) were not detected. We sequenced exon 2 of the IDH1 gene and exon 4 of the IDH2 gene in patients with leukemia that had evolved from . . .
Central Congestive Fibrosis of the Liver in Myxedema Ascites
Authors: ALFRED BAKER
Journal: Annals of Internal Medicine (1972)

A 59-year-old woman with ascites had clinical and laboratory evidence of myxedema with no history of congestive heart failure or renal disease. A liver biopsy specimen showed typical central congestive fibrosis. The pericentral hepatocytes were replaced by connective tissue. Liver biopsy blocks from two previously reported cases of myxedema ascites were obtained, and routine and special stains again showed typical central congestive fibrosis. The pathogenesis of this previously unrecognized finding in patients with myxedema ascites is unknown.
Treatment of Post-Herpetic Neuralgia by Prolonged Electric Stimulation
Authors: P. W. Nathan, P. D. Wall
Journal: BMJ (1974)

The results of treating patients with severe post-herpetic neuralgia with prolonged self-administered electric stimulation from a portable apparatus were good in 11 out of 30 patients. None of these patients had had as good relief of pain with other forms of treatment. In 10 patients some effects from stimulation continued after stimulation stopped. In eight there was an improvement in the course of the neuralgia, and in two there was a cure.
Influences on the distribution of blood flow during cardiac tamponade in the conscious dog.
Authors: G A Bernath, T L Cogswell, R G Hoffman, H S Klopfenstein
Journal: Circulation Research (1987)

Cardiac tamponade is a spectrum ranging from pericardial effusions with minimal hemodynamic impairment to effusions causing circulatory collapse. In this study, we examined the roles played by the sympathetic nervous system and the renin-angiotensin system in controlling the distribution of blood flow in chronically instrumented conscious dogs during progressive cardiac tamponade. Fifty-one episodes of acute cardiac tamponade were induced to decompensation (decline in mean aortic blood pressure to 70% of the level present when the pericardium was free of fluid) in 6 dogs by intrapericardial infusion of warmed saline solution. Cardiac output (electromagnetic flow probe), intrapericardial pressure, aortic and right atrial blood pressures, and renal, coronary, and mesenteric artery blood flows (Doppler flow probes) were recorded during tamponade in the absence of blockade (control), during alpha-adrenergic blockade (phenoxybenzamine), beta-adrenergic blockade (propranolol), or angiotensin-converting enzyme blockade (captopril). Aortic and mesenteric artery blood flow decreased progressively during cardiac tamponade regardless of the presence or absence of blockade. Coronary artery blood flow did not significantly change during alpha-adrenergic blockade, suggesting that the continuous decline observed during cardiac tamponade in the absence of blockade was at least in part mediated by alpha-adrenergic mechanisms. Renal artery blood flow, in contrast, was well maintained in all situations, confirming the importance of autoregulation in this vascular bed during cardiac tamponade.
Variations in Phytoestrogen Content between Different Mill Dates of the Same Diet Produces Significant Differences in the Time of Vaginal Opening in CD-1 Mice and F344 Rats but Not in CD Sprague-Dawley Rats
Authors: Julius E. Thigpen, Kenneth D.R. Setchell, Elizabeth Padilla-Banks, Joseph K. Haseman, Hannah E. Saunders, Gordon F. Caviness, Grace E. Kissling, Mary G. Grant, Diane B. Forsythe
Journal: Environmental Health Perspectives (2007)

The optimum test diet and rodent species/strain for evaluating endocrine-disrupting compounds (EDCs) are critical.We conducted studies to evaluate rodent species sensitivity and the effects of diets varying in phytoestrogen content on the time of vaginal opening (VO) in CD-1 mice, Fischer 344 (F344) rats, and CD Sprague-Dawley (S-D) rats.Mice were weaned on postnatal day (PND) 15 and rats on PND19 and randomly assigned to control or test diets. Body weights, food consumption, and time of VO were recorded.The time of VO was significantly advanced in F344 rats fed diets containing daidzein and genistein, whereas these same diets did not advance VO in S-D rats. When animals were fed the AIN-76A diet spiked with genistein, time of VO was significantly advanced at all doses in CD-1 mice, at the two highest doses in F344 rats, and at the highest dose in S-D rats. The time of VO in F344 rats was more highly correlated with the phytoestrogen content than with the total metabolizable energy (ME) of 12 diets.The S-D rat is less sensitive to dietary phytoestrogens compared with the F344 rat or the CD-1 mouse, suggesting that the S-D rat is not the ideal model for evaluating estrogenic activity of EDCs. The profound effects of dietary phytoestrogens on the time of VO, an estrogen-sensitive marker, indicate that a standardized open-formula phytoestrogen-free diet containing a low ME level should be used to optimize the sensitivity of estrogenic bioassays.
Can T-type calcium channels make a change of heart after myocardial infarction? Fiction or fact, and for better or for worse?
Authors: L. Fabritz, S. Herzig
Journal: Cardiovascular Research (2011)

This editorial refers to ‘Role of T-type calcium channel subunits in post-myocardial infarction remodelling probed with genetically engineered mice’ by K. Le Quang et al. , pp. 420–428, this issue. 

The outcome of patients with myocardial infarction has improved dramatically over the last few decades. Evidence-based therapy comprises rapid recanalization with full restitution of flow by acute percutaneous coronary intervention, local and systemic antithrombotic treatment, the use of statins, β-adrenoceptor blockers, angiotensin-converting enzyme inhibitors, and aldosterone receptor antagonists to protect the heart from subsequent adverse remodelling.1 The term ‘cardiac remodelling’ refers to a process involving changes in morphology and mechanical and electrical function that occur after injury such as myocardial infarction and pressure or volume overload. Remodelling allows for the maintenance of haemodynamic function but also results in cardiac hypertrophy, reactivation of a foetal gene programme, and arrhythmias, all relevant for prevention and treatment of heart failure and sudden death.2

Voltage-gated calcium channels play a fundamental role in nano-environmental networks of calcium-dependent effector systems, affecting mechanical and electrical function as well as gene expression of the heart. They appear to be involved in the cardiac remodelling process. Although the classical L (‘long-lasting’, ‘large’)-type calcium channel is essential for cardiac contraction, its ‘little brother’, the T (‘transient’, ‘tiny’)-type calcium channel, was proposed to be involved in cardiac pathophysiology3 soon after its discovery.4 Although known to be regulated by hormones,5 hypoxia,6 and development,7 its pathophysiological role in the ventricular myocardium is far from being clear ( Table 1 ). Its subunits Cav3.1, 3.2, and 3.3 are also called α1G, α1H, and …