tbuckley/cabot-search huggingface dataset:
Reversal of atrial natriuretic peptide resistance by increasing distal tubular sodium delivery in patients with decompensated cirrhosis
Authors: William T. Abraham, Marije E. Lauwaars, Jin K. Kim, Ricardo L. Peñna, Robert W. Schrier
Journal: Hepatology (1995)

To test the hypothesis that diminished sodium delivery to the distal tubular site of atrial natriuretic peptide (ANP) action accounts for renal ANP resistance in cirrhosis, 12 cirrhotic patients with ascites were studied at baseline and during the infusion of ANP alone (0.15 μg/kg/min), mannitol alone (4 g/hr), and ANP plus mannitol for 3 hours each. Distal tubular sodium delivery, as assessed by lithium clearance, was increased during the infusion of mannitol (13.8 ± 3.4 to 23.7 ± 5.7 mL/min; P &lt; .05) and during the ANP plus mannitol infusion (13.8 ± 3.4 to 28.5 ± 6.3 mL/min; P &lt; .001) in 6 patients, subsequently termed “responders.” Both responders and non-responders were resistant to the natriuretic effect of ANP infused alone, and mannitol alone did not produce an increase in urinary sodium excretion. However, in responders, the mannitol-induced increase in distal tubular sodium delivery resulted in a fivefold increase in urinary sodium excretion during ANP infusion (29 ± 6 to 154 ± 40 μmol/min, P &lt; .01). Urinary cyclic guanosine monophosphate (cGMP) excretion increased significantly and to a similar extent during ANP and ANP plus mannitol in all 12 patients, supporting the active biological responsiveness of renal ANP receptors. Unlike responders, nonresponders showed a significant decrease in arterial blood pressure and an increase in plasma renin activity during ANP plus mannitol, consistent with worsened arterial underfilling caused by ANP-induced vasodilation. Thus, the present results support the hypothesis that diminished distal tubular sodium delivery is a major factor contributing to ANP resistance in cirrhosis. (Hepatology 1995; 22:737-743.)
The Psychotherapy of Hope: The Legacy of Persuasion and Healing
Authors: Walter A. Brown
Journal: JAMA (2012)

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
MDM2–p53 Pathway in Hepatocellular Carcinoma
Authors: Xuan Meng, Derek A. Franklin, Jiahong Dong, Yanping Zhang
Journal: Cancer Research (2014)

Abstract Abnormalities in the TP53 gene and overexpression of MDM2, a transcriptional target and negative regulator of p53, are commonly observed in cancers. The MDM2–p53 feedback loop plays an important role in tumor progression and thus, increased understanding of the pathway has the potential to improve clinical outcomes for cancer patients. Hepatocellular carcinoma (HCC) has emerged as one of the most commonly diagnosed forms of human cancer; yet, the current treatment for HCC is less effective than those used against other cancers. We review the current studies of the MDM2–p53 pathway in cancer with a focus on HCC and specifically discuss the impact of p53 mutations along with other alterations of the MDM2–p53 feedback loop in HCC. We also discuss the potential diagnostic and prognostic applications of p53 and MDM2 in malignant tumors as well as therapeutic avenues that are being developed to target the MDM2–p53 pathway. Cancer Res; 74(24); 7161–7. ©2014 AACR.
Noninvasive Diagnosis of Hepatocellular Carcinoma in Cirrhotic Liver: Current Guidelines and Future Prospects for Radiological Imaging
Authors: Jens Ricke, Max Seidensticker, Konrad Mohnike
Journal: Liver Cancer (2012)

Noninvasive imaging has become the standard for hepatocellular carcinoma (HCC) diagnosis in cirrhotic patients. Typical imaging features of HCC such as arterial wash-in and venous wash-out deliver very high specificity and acceptable sensitivity even in nodules from 1 to 2 cm in diameter. However, limitations apply specifically in hypovascular HCC, for which the addition of new techniques such as diffusion-weighted magnetic resonance imaging (DW-MRI) or hepatobiliary MRI is helpful. Whereas DW-MRI adds to both the sensitivity and specificity, hepatobiliary MRI additionally contributes valuable information in cirrhotic patients on the histopathology of small lesions, including early HCC and high-grade dysplastic nodules. Biopsy of small, atypical lesions is associated with a high rate of false-negative findings and should be used only after careful consideration in selected patients. Here, we review the current international guidelines on HCC diagnosis as well as the latest developments in imaging that may contribute to safe detection and accurate characterization of suspicious nodules in patients with liver cirrhosis.
Locus specificity of polymorphic alleles and evolution by a birth-and- death process in mammalian MHC genes
Authors: X. Gu, M. Nei
Journal: Molecular Biology and Evolution (1999)

We have conducted an extensive phylogenetic analysis of polymorphic alleles from human and mouse major histocompatibility complex (MHC) class I and class II genes. The phylogenetic tree obtained for 212 complete human class I allele sequences (HLA-A, -B, and -C) has shown that all alleles from the same locus form a single cluster, which is highly supported by bootstrap values, except for one HLA-B allele (HLA-B*7301). Mouse MHC class I loci did not show locus-specific clusters of polymorphic alleles. This was considered to be because of either interlocus genetic exchange or the confusing designation of loci in different haplotypes at the present time. The locus specificity of polymorphic alleles was also observed in human and mouse MHC class II loci. It was therefore concluded that interlocus recombination or gene conversion is not very important for generating MHC diversity, with a possible exception of mouse class I loci. According to the phylogenetic trees of complete coding sequences, we classified human MHC class I (HLA-A, -B, and -C) and class II (DRB1) alleles into three to five major allelic lineages (groups), which were monophyletic with high bootstrap values. Most of these allelic groups remained unchanged even in phylogenetic trees based on individual exons, though this does not exclude the possibility of intralocus recombination involving short DNA segments. These results, together with the previous observation that MHC loci are subject to frequent duplication and deletion, as well as to balancing selection, indicate that MHC evolution in mammals is in agreement with the birth-and-death model of evolution, rather than with the model of concerted evolution.
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS IN TWINS
Authors: Herbert H. Davis
Journal: JAMA (1924)

H. Leslie Moore<sup>1</sup>recently reported the occurrence of hypertrophic pyloric stenosis in twins. At 4 weeks of age each had a Rammstedt operation. Each did well at first, but this lasted only a few days, and they both died of respiratory paralysis, six and eight days after the operation. Moore states that he has been unable to find any other case of this malady in twins in the literature. He also says that it would be interesting to know whether it ever occurred in one twin and not in the other. In 1919, I observed a similar condition in twin boys, born Oct. 14, 1919, and referred by Dr. Clyde Moore. <h3>REPORT OF CASES</h3> J., the first infant, did well until 13 days old, when he began to vomit. At that time he vomited practically everything he ate. At birth, he weighed 5 pounds, 12 ounces (2.60 kg.) and
647 LIVER TRANSPLANTATION FOR INTRAHEPATIC CHOLANGIOCARCINOMA (ICC) AND COMBINED HEPATOCELLULAR-CHOLANGIOCARCINOMA(CHCC-CC)
Authors: C. Rodríguez de Lope, J. Colmenero, R. Miquel, A. Forner, J. Rimola, M. Reig, M. Navasa, J. Bruix
Journal: Journal of Hepatology (2011)
SOURCES OF THE ANTIBODIES DEVELOPING AFTER REPEATED TRANSFUSION
Authors: Oswald H. Robertson, Peyton Rous
Journal: The Journal of Experimental Medicine (1922)

The massive agglutination observable in the shed blood of transfused rabbits, and associated not infrequently with sudden marked blood destruction, has a practical significance in connection with the untoward results of repeated transfusion from donors originally compatible; and it has special theoretical interest because the clumping of the cells is apparently an autoagglutination. To determine the actual source of the antibodies has been the object of the present work. The agglutination in its most marked form has been traced to isoantibodies elicited by the presence in the body of corpuscles originally found compatible; and the frequently associated, rapid blood destruction is doubtless of similar origin. Occasionally antibodies develop in the donor bloods during the period of transfusion, but they are so weak as to be negligible. There remain instances of what would seem to be true autoagglutination due to serum bodies induced by the transfusions as a by-product, so to speak, in the manufacture of isoagglutinins. The antigenic relationship between the red cells of different rabbits is so close that normal isoagglutinins became fixed in the cold upon their elaborator's own corpuscles. Agglutinins exist within the red cells of rabbits-as has been claimed by Klein. They are readily demonstrable in watery extracts of the dried corpuscles. Whether similar agglutinins ever exist within human cells remains to be determined. We have not found them in the normal corpuscles.
Catheter Survival During Long-Term Insulin Therapy With an Implanted Programmable Pump
Authors: Marina Scavini, Laura Galli, Sanford Reich, R Philip Eaton, M Arthur Charles, Fredrick L Dunn
Journal: Diabetes Care (1997)

OBJECTIVE To survey catheter complications and to analyze catheter survival during long-term intraperitoneal and intravenous insulin therapy with an implanted programmable pump with a sideport. RESEARCH DESIGN AND METHODS Catheter occlusions were documented by measuring dynamic catheter resistance. Catheter migrations or breaks were demonstrated by × ray. When flushing the catheter with buffer solution through the sideport failed to clear the occlusion, catheters were replaced or laparoscopy was performed for the excision of fibrous tissue growth. Broken or migrated catheters were replaced. RESULTS Occlusions were the most common catheter complications, and the majority of them (79% intraperitoneal and 84% intravenous) were cleared by flushing the catheter. Survival at 3 years was significantly higher for intraperitoneal catheters compared with intravenous catheters (60% intraperitoneal and 22% intravenous). CONCLUSIONS Nonsurgical management of catheter occlusions contributed to extend catheter lifetime. Intraperitoneal catheters have a lower morbidity and a higher survival than intravenous catheters.
Small bowel obstruction in a young woman
Authors: H Pak
Journal: Gut (2005)

Recent innovations in interventional cardiology have dramatically expanded the therapeutic options for patients with cardiac conditions. Interventional cardiology is no longer limited to the treatment of coronary artery disease but allows also treatment of valvular disease, stroke prevention, hypertension, etc. One of the most important new treatment options is the percutaneous treatment for aortic valve stenosis (transcatheter aortic valve implantation), since aortic valve disease is a rather common problem in elderly patients, with many of them at high risk for surgery. Similarly, mitral regurgitation is often associated with comorbidities which make surgery high risk. The MitraClip is a promising percutaneous alternative to surgical valve repair or replacement. Other procedures discussed in this review are the percutaneous left atrial appendage closure as a non-pharmacologic therapy to prevent strokes, and renal denervation for resistant hypertension. This review explains the basic principles of these procedures, the most important clinical evidence, and also provides additional recent clinical data on each of these them.
Urinary eosinophil protein X in children: the relationship toasthma and atopy and normal values
Authors: E. Tauber, G. Halmerbauer, T. Frischer, C. Gartner, F. Horak, A. Veiter, D. Y. Koller, M. Studnicka
Journal: Allergy (2000)

Background: In epidemiologic studies, it may be difficult to identify children with bronchial asthma. Since this is the most common chronic respiratory disease in childhood, and its prevalence is still increasing, reliable methods for identification of asthmatic children are required. This study evaluates the use of urinary eosinophil protein X (U‐EPX) in epidemiologic studies in identifying atopic and asthmatic children. Methods: U‐EPX was measured in 877 Austrian schoolchildren. The skin prick test (SPT) was performed with eight common aeroallergens, and established questionnaires were used to assess respiratory symptoms. Results: Of our cohort, 2.8% reported physician‐diagnosed asthma, 5.1% reported wheezing within the last 12 months, and 24.1% were found to be atopic. In children with physician‐diagnosed asthma, as well as in atopic children (positive SPT), median U‐EPX levels were significantly higher than in healthy subjects (142.8 and 89.6 vs 63.9 µg/mmol creatinine, P &lt;0.0001 and P &lt;0.0001, respectively). In addition, perennial sensitization to inhalant allergens resulted in higher U‐EPX levels than did seasonal sensitization. The odds ratio for U‐EPX levels over the 90th percentile was significantly elevated for asthma, for wheezing, for nocturnal cough, and for breathlessness at exercise, as well as for seasonal and perennial sensitization. Pulmonary function was negatively relatedto U‐EPX levels. Conclusions: Measurement of U‐EPX, which can be obtained easily, may be helpful in diagnosing both asthma and atopy in children. However, there is a great overlap between controls and symptomatics, a fact which reduces the sensitivity of U‐EPX in determination of the prevalence of asthma in epidemiologic studies.
ORAL ANTICOAGULANT (OAC) UTILIZATION IN ATRIAL FIBRILLATION AFTER THE INTRODUCTION OF NOVEL ORAL ANTICOAGULANTS
Authors: Joseph Biskupiak, Sameer Ghate, Melissa Hamilton, Xianchen Liu, Xianying Pan, Sumesh Kachroo, Diana Brixner, Nassir Marrouche
Journal: Journal of the American College of Cardiology (2014)
Managing urinary tract infection.
Authors: J Spencer, D Lindsell
Journal: BMJ (1993)

EDITOR,-Going public necessitates taking the rough with the smooth, but the BMJs account of my reinstatement is unjust.'Clare Dyer was not present at the two day public hearing last August.Had she been she would have known that the 20 complaints she alludes to as fact were wholly unsubstantiated and, indeed, had not even materialised.They were the claims of one colleague who was also making allegations concerning my mental health.The number of reports of health care professionals being silenced, threatened, or dismissed is growing, and common characteristics of these cases are emerging.They include abuse of power, character assassination, and, sadly, colluding colleagues acting out of personal antagonism, jealousy, or a derisive self interest.
Mucosal IgA recognition of Helicobacter pylori 120 kDa protein, peptic ulceration, and gastric pathology
Authors: J.E. Crabtree, J.D. Taylor, R.V. Heatley, T.M. Shallcross, B.J. Rathbone, J.I. Wyatt, D.S. Tompkins
Journal: The Lancet (1991)
Corticothalamic necessity, qualia, and consciousness
Authors: Sam M. Doesburg, Lawrence M. Ward
Journal: Behavioral and Brain Sciences (2007)

The centrencephalic theory of consciousness cannot yet account for some evidence from both brain damaged and normally functioning humans that strongly implicates thalamocortical activity as essential for consciousness. Moreover, the behavioral indexes used by Merker to implicate consciousness need more development, as, besides being somewhat vague, they lead to some apparent contradictions in the attribution of consciousness.
Reduced Glomerular Filtration Rate and Its Association with Clinical Outcome in Older Patients at Risk of Vascular Events: Secondary Analysis
Authors: Ian Ford, Vladimir Bezlyak, David J Stott, Naveed Sattar, Chris J Packard, Ivan Perry, Brendan M Buckley, J. Wouter Jukema, Anton J. M de Craen, Rudi G. J Westendorp, James Shepherd
Journal: PLoS Medicine (2009)

Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).Glomerular filtration rate was estimated (eGFR) using the Modification of Diet in Renal Disease equation and was categorized in the ranges ([20-40], [40-50], [50-60]) >or= 60 ml/min/1.73 m(2). Baseline risk factors were analysed by category of eGFR, with and without adjustment for other risk factors. The associations between baseline eGFR and morbidity and mortality outcomes, accrued after an average of 3.2 y, were investigated using Cox proportional hazard models adjusting for traditional risk factors. We tested for evidence of an interaction between the benefit of statin treatment and baseline eGFR status. Age, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, C-reactive protein (CRP), body mass index, fasting glucose, female sex, histories of hypertension and vascular disease were associated with eGFR (p = 0.001 or less) after adjustment for other risk factors. Low eGFR was independently associated with risk of all cause mortality, vascular mortality, and other noncancer mortality and with fatal and nonfatal coronary and heart failure events (hazard ratios adjusted for CRP and other risk factors (95% confidence intervals [CIs]) for eGFR < 40 ml/min/1.73m(2) relative to eGFR >or= 60 ml/min/1.73m(2) respectively 2.04 (1.48-2.80), 2.37 (1.53-3.67), 3.52 (1.78-6.96), 1.64 (1.18-2.27), 3.31 (2.03-5.41). There were no nominally statistically significant interactions (p < 0.05) between randomized treatment allocation and eGFR for clinical outcomes, with the exception of the outcome of coronary heart disease death or nonfatal myocardial infarction (p = 0.021), with the interaction suggesting increased benefit of statin treatment in subjects with impaired GFRs.We have established that, in an elderly population over the age of 70 y, impaired GFR is associated with female sex, with presence of vascular disease, and with levels of other risk factors that would be associated with increased risk of vascular disease. Further, impaired GFR is independently associated with significant levels of increased risk of all cause mortality and fatal vascular events and with composite fatal and nonfatal coronary and heart failure outcomes. Our analyses of the benefits of statin treatment in relation to baseline GFR suggest that there is no reason to exclude elderly patients with impaired renal function from treatment with a statin.
Innovative low cost technologies for biomedical research and diagnosis in developing countries
Authors: Josefina Coloma, Eva Harris
Journal: BMJ (2004)

The relation between science, technology, and economic development is unquestionable. However, in the poorest countries of the world, this relation is tenuous at best, mainly due to the fact that science and technology typically require a large amount of investment in terms of both capital and higher education. In this article, we document the ingenuity and innovative approaches of our colleagues in developing countries who conduct biomedical research and laboratory diagnosis with limited resources. Not only is what they have achieved laudable, but there is much that the rest of the world can and should learn from these examples.

The lack of resources in academic and state laboratories in the developing world produces a creative pressure that forces scientists to invent and reuse as much as possible. The innovations range from substitute equipment, recycling of otherwise disposable materials, and adaptation of cell lines to new temperatures or growth media to simplification of protocols and production of home made kits and reagents.1–6 For example, plastic pipette tips, consumed in large quantities and usually disposed of after one use, can be reused for certain procedures after disinfection and extensive washing. To make the process more efficient and less expensive, an ingenious Bolivian researcher, Nataniel Mamani, created a tip washer from a plastic jar and inner tubing. The tips fit perfectly into the tubing, allowing water to pass through and effectively wash out the bleach and soap used to clean them (fig 1).7 This simple contraption can save a laboratory hundreds of dollars a month.



Fig 1 
Mamani's pipette tip washer: economic and effective



#### Summary points

Researchers in the developed world can learn much from the ingenuity and passion of colleagues in developing countries

Working in resource poor settings fosters creativity and a mindset for conservation and better management of resources

Understanding …
Maternal Alcohol Use during Breast-Feeding and Infant Mental and Motor Development at One Year
Authors: Ruth E. Little, Kevin W. Anderson, Cynthia H. Ervin, Bonnie Worthington-Roberts, Sterling K. Clarren
Journal: New England Journal of Medicine (1989)

The detrimental effects of maternal drinking during pregnancy on fetal health have been documented. The consequences for infants of maternal drinking during breast-feeding are unknown, but research in animals suggests that the infant could be affected by exposure to alcohol through the mother's milk. In a study of 400 infants born to members of a health maintenance organization, we investigated the relation of the mother's use of alcohol during breast-feeding to the infant's development at one year of age. Mental development, as measured by the Bayley Mental Development Index (MDI), was unrelated to maternal drinking during breast-feeding. However, motor development, as measured by the Psychomotor Development Index (PDI), was significantly lower in infants exposed regularly to alcohol in breast milk (after alcohol exposure during gestation was controlled for), with a dose–response relation (P for linear trend, 0.006). The infants of breast-feeding mothers who had at least one drink daily had a mean PDI score of 98, whereas the infants exposed to less alcohol in breast milk had a mean PDI score of 103 (95 percent confidence interval for the difference of the two means, 1.2 to 9.8). The effect was more pronounced when mothers who supplemented breast-feeding with formula were excluded from the analysis. The association persisted even after we controlled for more than 100 potentially confounding variables, including smoking and other drug use during pregnancy and in the postpartum period. We conclude that ethanol ingested through breast milk has a slight but significant detrimental effect on motor development, but not mental development, in breast-fed infants. (N Engl J Med 1989; 321:425–30.)