tbuckley/cabot-search huggingface dataset:
High expression of the bile salt-homeostatic hormone fibroblast growth factor 19 in the liver of patients with extrahepatic cholestasis
Authors: Frank G. Schaap, Niels A. van der Gaag, Dirk J. Gouma, Peter L. M. Jansen
Journal: Hepatology (2008)

Fibroblast growth factor 19 (FGF19) is an endocrine factor produced by the small intestine in response to uptake of luminal bile salts. In the liver, FGF19 binds to FGF receptor-4, resulting in down-regulation of cytochrome P (CYP) 7A1 and reduced bile salt synthesis. Down-regulation of CYP7A1 under cholestatic conditions has been attributed to bile salt-mediated induction of the transcriptional repressor short heterodimer partner (SHP), because the interrupted enterohepatic cycle of bile salts is thought to abrogate intestinal FGF19 production and thus result in lowering of plasma FGF19 levels. Unexpectedly, we observed marked elevation of plasma FGF19 in patients with extrahepatic cholestasis caused by a pancreatic tumor (2.3 +/- 2.3 in cholestatic versus 0.40 +/- 0.25 ng/mL and 0.29 +/- 0.12 ng/mL in postcholestatic patients who received preoperative drainage by biliary stenting, P = 0.004, and noncholestatic control patients, P = 0.04, respectively). Although FGF19 messenger RNA (mRNA) is virtually absent in normal liver, FGF19 mRNA was strongly increased (31-fold to 374-fold, P < 0.001) in the liver of cholestatic patients in comparison with drained and control patients. In the absence of changes in SHP mRNA, CYP7A1 mRNA was strongly reduced (7.2-fold to 24-fold, P < 0.005) in the liver of cholestatic patients in comparison with drained and control patients, indicating an alternative regulatory pathway. Alterations in transcripts encoding hepatobiliary transporters [adenosine triphosphate-binding cassette, subfamily C, member 3 (ABCC3)/multidrug resistance protein 3 (MRP3), organic solute transporter alpha/beta (OSTalpha/beta), organic anion-transporting polypeptide (OATP1B1)] further suggest that bile salts are secreted via a nonbiliary route in patients with extrahepatic cholestasis.The liver expresses FGF19 under conditions of extrahepatic cholestasis. This is accompanied by a number of adaptations aimed at protecting the liver against bile salt toxicity. FGF19 signaling may be involved in some of these adaptations.
Dutch doctors warn of dangers of overuse of antibiotics in farming
Authors: T. Sheldon
Journal: BMJ (2010)

Public health experts in the Netherlands are calling for an urgent reduction in the use of antibiotics in farming as evidence mounts of transmission of antimicrobial resistance to humans through the food chain.

Dutch agriculture tops a European league table of the use of antibacterial agents per weight of slaughtered animal ( Journal of Antimicrobial Chemotherapy 2010;65:2037-40, doi:10.1093/jac/dkq247). Amid concerns that this has caused a rise in numbers of bacteria producing extended spectrum β lactamase (ESBL)—an enzyme that confers resistance to modern antibiotics, including cephalosporins—the government this year ordered a 50% cut in antibiotic use by farmers within four years.

This followed a call by Roel Coutinho, director of the Centre …
Diastolic dysfunction as a cause of heart failure
Authors: Sheldon E. Litwin, William Grossman
Journal: Journal of the American College of Cardiology (1993)

Diastolic dysfunction is an important cause of symptoms in patiente with various types of cardiac disease. Increased left ventricular diastolic pressure may lead to pulmonary congestion, even in the setting of normal left ventricular systolic function. Although the physiology of diastolic function is complex, left ventricular diastolic pressure may become elevated through one of three broad mechanisms. Abnormalities intrinsic to the left ventricle may include 1) impaired left ventricular relaxation, a finding that is common in most cardiac diseases and may be particularly important during ischemia; 2) increased left ventricular wall thickness relative to cavity volume, which will shift the diastolic pressure-volume relation such that the same volume is associated with a higher pressure; and 3) increased myocardial stiffness, which is thought to be associated with interstitial fibrosis or scar tissue formation. In addition, diastolic pressures may become elevated because of factors extrinsic to the left ventricle. These may include 1) increased central blood volume, which will increase left ventricular pressure without altering the left ventricular pressure-volume relation; and 2) ventricular interaction mediated by pericardial restraint, which may cause a parallel upward shift of the diastolic pressure-volume relation. Treatment of the factors extrinsic to the left ventricle tends to be much more successful man treating abnormalities that are intrinsic to the ventricle. Improved understanding of myocardial relaxation at the cellular level and delineation of the molecular regulation of myocyte hypertrophy and fibroblast proliferation may lead to new and innovative approaches to the treatment of heart failure.
Use of the rabbit ear artery to serially assess foreign protein secretion after site-specific arterial gene transfer in vivo. Evidence that anatomic identification of successful gene transfer may underestimate the potential magnitude of transgene expression.
Authors: D W Losordo, J G Pickering, S Takeshita, G Leclerc, D Gal, L Weir, M Kearney, J Jekanowski, J M Isner
Journal: Circulation (1994)

BACKGROUND The development of molecular strategies for the treatment of restenosis has been hindered by low efficiencies of in vivo arterial transfection. Expression of intracellular marker proteins is generally evident in &lt; 1% of vascular smooth muscle cells after in vivo arterial transfection. Efforts to improve the efficiency of in vivo gene transfer have been further impeded by the use of transgenes encoding for intracellular marker proteins, necessitating tissue removal and limiting survey for expression to one point in time. METHODS AND RESULTS To study gene expression on a serial basis in vivo and determine the relation between a secreted gene product and transfection efficiency after in vivo arterial gene transfer, a method for performing and serially monitoring gene expression in vivo was developed using the central artery of the rabbit ear. Liposome-mediated transfection of plasmid DNA containing the gene for human growth hormone (hGH) was successfully performed in 18 of 23 arteries. Serum hGH levels measured 5 days after transfection ranged from 0.1 to 3.8 ng/mL (mean, 0.97 ng/mL); in contrast, serum drawn from the control arteries demonstrated no evidence of hGH production. Serial measurement of hGH from transfected arteries demonstrated maximum hGH secretion 5 days after transfection and no detectable hormone after 20 days. Despite these levels of secreted gene product documented in vivo, immunohistochemical staining of sections taken from the rabbit ear artery at necropsy disclosed only rare cells in which there was evidence of successful transfection. CONCLUSIONS These experiments demonstrate a useful method of performing serial in vivo analyses of gene expression after vascular transfection and that anatomic analyses of transfection efficiency may underestimate the potential magnitude of expression in the case of a secreted gene product. These findings have implications for the clinical application of somatic gene therapy because low-efficiency transfection with a gene encoding for a secreted protein may achieve therapeutic effects not realized by transfection with genes encoding for proteins that remain intracellular.
CD40L+ CD4+ memory T cells migrate in a CD62P-dependent fashion into reactive lymph nodes and license dendritic cells for T cell priming
Authors: Alfonso Martín-Fontecha, Dirk Baumjohann, Greta Guarda, Andrea Reboldi, Miroslav Hons, Antonio Lanzavecchia, Federica Sallusto
Journal: The Journal of Experimental Medicine (2008)

There is growing evidence that the maturation state of dendritic cells (DCs) is a critical parameter determining the balance between tolerance and immunity. We report that mouse CD4+ effector memory T (TEM) cells, but not naive or central memory T cells, constitutively expressed CD40L at levels sufficient to induce DC maturation in vitro and in vivo in the absence of antigenic stimulation. CD4+ TEM cells were excluded from resting lymph nodes but migrated in a CD62P-dependent fashion into reactive lymph nodes that were induced to express CD62P, in a transient or sustained fashion, on high endothelial venules. Trafficking of CD4+ TEM cells into chronic reactive lymph nodes maintained resident DCs in a mature state and promoted naive T cell responses and experimental autoimmune encephalomyelitis (EAE) to antigens administered in the absence of adjuvants. Antibodies to CD62P, which blocked CD4+ TEM cell migration into reactive lymph nodes, inhibited DC maturation, T cell priming, and induction of EAE. These results show that TEM cells can behave as endogenous adjuvants and suggest a mechanistic link between lymphocyte traffic in lymph nodes and induction of autoimmunity.
Psychiatric Care of the Medical Patient
Authors: Philip G. Lindsay
Journal: JAMA (1994)

The medicalization of psychiatry is well illustrated in this virtually encyclopedic work by the editorial team of Alan Stoudemire and Barry S. Fogel. Together with their other two recent works—<i>Medical-Psychiatric Practice</i>, volumes one and two—the essential library of current information about medical psychiatry is formed. While this book is a revised and expanded version of their original 1987 volume,<i>Principles of Medical Psychiatry</i>, it is made even more useful by including numerous new chapters and topics and by updating the original work. The number of authors has expanded from 49 in the original volume to 78 in the current one. The number of chapters has expanded as well, from 33 to 45. More important, the work is substantially better written and organized, aided significantly by the extensive use of tables, giving the book the feel of a database. Several noteworthy directions have been pursued that round out this volume:
Severe anaphylactic reaction to bovine serum albumin at the first attempt of artificial insemination
Authors: B. Wüthrich, A. Stern, S. G. O. Johansson
Journal: Allergy (1995)

A 33‐year‐old woman without history of previous atopic diseases or drug allergies developed a severe anaphylactic reaction with asthma, vomiting, itching, generalized urticaria, and angioedema during artificial insemination with her husband's sperm. The sperm‐processing medium contained bovine serum albumin (BSA). Skin prick test and RAST demonstrated an IgE‐mediated hypersensitivity to BSA as well as a polyvalent atopic sensitization to pollens, animal danders, cow's milk, beef, pork, and mutton. SDS—PAGE studies indicated serum albumin to be the appropriate allergen with a high degree of cross‐reactivity between serum albumin from different animal species. Artificial insemination with fluid containing potential allergens can, therefore, represent an unnecessary risk for atopic females, even in the absence of prior clinical symptoms of allergic diseases. Preoperative testing with the medium is recommended.
Observing Countertransference in Brief Dynamic Psychotherapy
Authors: Cl&aacute;udio Laks Eizirik, Fl&aacute;via Costa, Fl&aacute;vio Kapczinski, Renato Piltcher, Rosane Gauer, Zelig Libermann
Journal: Psychotherapy and Psychosomatics (1991)

Six cases treated with Brief Dynamic Psychotherapy were studied. Initial countertransferential reactions were identified, and expectations were determined concerning the evolution of the patient-therapist relationship. The existence of a basic pattern of emotional response to the patient in the therapist throughout the treatment was observed, and the authors propose to denominate it countertransferential focus. Three clinical vignettes are reported.
Nationwide study of decisions concerning the end of life in general practice in the Netherlands
Authors: L Pijnenborg, J J M van Delden, J W P F Kardaun, J J Glerum, P J van der Maas
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To gain insight into decisions made in general practice about the end of life. <b>Design</b>: Study I: interviews with 405 physicians. Study II: analysis of death certificates with data obtained on 5197 cases in which decisions about the end of life may have been made. Study III: prospective study with doctors from study I: questionnaires used to collect information about 2257 deaths. The information was representative for all deaths in the Netherlands. <b>Results</b>: Over two fifths of all patients in the Netherlands die at home. General practitioners took fewer decisions about the end of life than hospital doctors and doctors in nursing homes (34%, 40%, and 56% of all dying patients, respectively). Specifically, decisions to withhold or withdraw treatment to prolong life were taken less often. Euthanasia or assisted suicide, however, was performed in 3.2% of all deaths in general practice compared with 1.4% in hospital practice. In over half of the cases concerning pain relief or non-treatment general practitioners did not discuss the decision with the patient, mostly because of incapacity of the patient, but in 20% of cases for “paternalistic” reasons. Older general practitioners discussed such decisions less often with their patients. Colleagues were consulted more often if the general practitioner worked in group practice. <b>Conclusion</b>: Differences in work situation between general practitioners and hospital doctors and differences between the group of general practitioners contribute to differences in the number and type of decisions about the end of life as well as in the decision making process.
Provocative Red Blood Cell Scintiscan in Occult Chronic Gastrointestinal Hemorrhage
Authors: RICHARD S. BAKALAR, PAUL R. TOURIGNY, EUGENE D. SILVERMAN, RUSSELL O. SCHUB
Journal: Clinical Nuclear Medicine (1994)

A patient with a chronic occult gastrointestinal bleeding site is described. Because an extensive examination failed to locate the site of bleeding, a heparin infusion was used in conjunction with a conventional Tc-99m labeled red cell bleeding study. A mid-jejunal ulcer was safely localized before elective surgery. A protocol for a heparin provocative bleeding study is proposed.
Descending necrotizing mediastinitis after upper gastrointestinal endoscopy
Authors: K. Kaira, H. Yasuoka, T. Ichikawa, S. Oh-i, T. Hisada, T. Ishizuka, M. Mori
Journal: Endoscopy (2007)

An 83-year-old man presented with a 2-week history of intermittent left-sided chest pain. His chest radiograph and electrocardiogram were unremarkable, and so upper gastrointestinal endoscopy was performed for screening purposes. The intubation and procedure were carried out without difficulty, although the patient gagged occasionally. There was no obvious evidence of a site of perforation. Shortly after endoscopy, the patient became distressed, complaining of diffuse cervical swelling and a severe sore throat. Examination at that time revealed subcutaneous emphysema of the neck. He had a fever, dyspnea, and hypoxemia. His laboratory results revealed a white blood cell count of 18 000/mm3 and a C-reactive protein level of 22.5 mg/dl. A chest radiograph showed pneumomediastinum and subcutaneous emphysema. Cervical and thoracic computed tomographic scans revealed cervical necrotizing fasciitis and descending necrotizing mediastinitis (Figure [1]).
Mechanism of allopurinol-mediated increase in enzyme activity in man
Authors: Thomas D. Beardmore, Jay S. Cashman, William N. Kelley
Journal: Journal of Clinical Investigation (1972)

Allopurinol therapy in man interferes with pyrimidine biosynthesis de novo by inhibition of one or both of the two enzymes, orotate phosphoribosyltransferase (OPRT) and orotidylic decarboxylase (ODC), responsible for the conversion of orotic acid to uridine-5'-monophosphate. Inhibition of this pathway in vivo is followed in 1-3 wk by an increase in the activity of both of these enzymes in erythrocytes and of ODC in circulating leukocytes. This drug-mediated increase in enzyme activity in erythrocytes could not be attributed to enzyme stabilization or induction in vivo but appeared to be due to enzyme "activation." "Activation" of the OPRT enzyme was directly demonstrated in erythrocytes studied in vitro after incubation with oxipurinol, and to a lesser extent, with allopurinol. No evidence for "activation" of the ODC enzyme was demonstrated in vitro. This response to allopurinol therapy provides an excellent model for examining the mechanism of increased enzyme activity in response to drug administration.
The Occipito-posterior Position
Authors: S. J. Hadfield
Journal: BMJ (1940)

MEDICALJOISNAL 81 subsequent albuminuria, and such swelling of the hands as occuirred was general and not confined to the joints.Also none were given drugs of the suilphonamide group.I am inclined to think (and to this extent I agree with Dr. IFrench) that we have been dealing with a mixed infection, probably -streptococcal but non-haemolytic.Since writing my first letter I have heard that in the Cambridge Pathological Laboratory a streptococcuLs has been grown in large ntumbers from every case of rubella examined.l-am,etc.,
Two large meals may be better for diabetic patients than six smaller meals, study shows
Authors: J. Wise
Journal: BMJ (2014)

Eating two larger meals a day may be better than six smaller meals for controlling weight and blood sugar in patients with type 2 diabetes, a small study has shown.1

The randomised crossover study, published in Diabetologia , included 54 patients who were being treated with oral hypoglycaemic drugs and had a body mass index of 27-50 kg/m2 and HbA1c …
Studies on the Control of Hypertension by Hyphex
Authors: HENRY A. SCHROEDER, JOHN D. MORROW, H. MITCHELL PERRY
Journal: Circulation (1953)

This report is the first of a series on a method for treatment of hypertension by oral hexamethonium chloride and hydrazinophthalazine. When strictly followed blood pressure was maintained at reasonable or normal levels in 80 per cent of 258 cases of severe hypertension. The malignant stage, when present, was reversed. Renal insufficiency and severe cerebral atherosclerosis limit the effectiveness of the method for prolongation of life.
Targeted Inhibition of Intrinsic Coagulation Limits Cerebral Injury in Stroke without Increasing Intracerebral Hemorrhage
Authors: Tanvir F. Choudhri, Brian L. Hoh, Charles J. Prestigiacomo, Judy Huang, Louis J. Kim, Ann Marie Schmidt, Walter Kisiel, E. Sander Connolly, David J. Pinsky
Journal: The Journal of Experimental Medicine (1999)

Agents that restore vascular patency in stroke also increase the risk of intracerebral hemorrhage (ICH). As Factor IXa is a key intermediary in the intrinsic pathway of coagulation, targeted inhibition of Factor IXa–dependent coagulation might inhibit microvascular thrombosis in stroke without impairing extrinsic hemostatic mechanisms that limit ICH. A competitive inhibitor of native Factor IXa for assembly into the intrinsic Factor X activation complex, Factor IXai, was prepared by covalent modification of the Factor IXa active site. In a modified cephalin clotting time assay, in vivo administration of Factor IXai caused a dose-dependent increase in time to clot formation (3.6-fold increase at the 300 μg/kg dose compared with vehicle-treated control animals, P &amp;lt; 0.05). Mice given Factor IXai and subjected to middle cerebral artery occlusion and reperfusion demonstrated reduced microvascular fibrin accumulation by immunoblotting and immunostaining, reduced 111In-labeled platelet deposition (42% decrease, P &amp;lt; 0.05), increased cerebral perfusion (2.6-fold increase in ipsilateral blood flow by laser doppler, P &amp;lt; 0.05), and smaller cerebral infarcts than vehicle-treated controls (70% reduction, P &amp;lt; 0.05) based on triphenyl tetrazolium chloride staining of serial cerebral sections. At therapeutically effective doses, Factor IXai was not associated with increased ICH, as opposed to tissue plasminogen activator (tPA) or heparin, both of which significantly increased ICH. Factor IXai was cerebroprotective even when given after the onset of stroke, indicating that microvascular thrombosis continues to evolve (and may be inhibited) even after primary occlusion of a major cerebrovascular tributary.
Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study
Authors: M Hedenus, G Birgegård, P Näsman, L Ahlberg, T Karlsson, B Lauri, J Lundin, G Lärfars, A Österborg
Journal: Leukemia (2007)
The Cause of Follicular Spicules in Multiple Myeloma
Authors: Gregory A. Hosler, Lisa Weibel, Richard C. Wang
Journal: JAMA Dermatology (2014)

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 Dermatology 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 Dermatology journal
Left atrial volume is more strongly associated with prevalent congestive heart failure and predictive of incident congestive heart failure in the elderly than doppler mitral inflow velocities or deceleration time
Authors: John S. Gottdiener, Dalane W. Kitzman, Gerard P. Aurigemma, Alice M. Arnold, Cheryl S. Egher, Karen M. Fowle, Jeffrey C. Hill
Journal: Journal of the American College of Cardiology (2003)