tbuckley/cabot-search huggingface dataset:
Caring for the Poor
Authors: Jeffrey R. Botkin
Journal: JAMA (1988)

To the Editor.  —My father was of a medical generation that trained and practiced before Medicare, Medicaid, and the medical-industrial complex. Care for the poor was an integral part of his training and uncompensated care for the poor became an integral part of his subsequent medical practice. As my father would tell it, the indigent patients in those days made few demands and were content to allow the physician to do what the physician felt was best. Perhaps they understood it was charity they were receiving.  Care for the poor was an important part of my training as well, but the social roles have changed. We now speak of the principle of autonomy and respect for patient rights, which hold irrespective of the patient's financial status. This ethical sensitivity was both a cause and a result of Medicare and Medicaid. These programs, warts and all, have resulted in a significant
Interferon-β Sensitivity of Tumor Cells Correlates With Poor Response to VA7 Virotherapy in Mouse Glioma Models
Authors: Janne Ruotsalainen, Miika Martikainen, Minna Niittykoski, Tuulia Huhtala, Tytti Aaltonen, Jari Heikkilä, John Bell, Markus Vähä-Koskela, Ari Hinkkanen
Journal: Molecular Therapy (2012)

In our recent study, replicative alphaviral vector VA7 was found to be effective against orthotopic human U87-glioma xenografts in an athymic mouse model eradicating the tumors with single intravenous (i.v.) injection. Here, we tested the efficacy of VA7 in immunocompetent orthotopic GL261 and CT-2A glioma models of C57BL/6 mouse in vivo. The cell lines were susceptible to VA7 infection in vitro, but GL261 infection was highly restricted in confluent cell cultures, and mouse interferon-β (IFNβ) pretreatment prevented the replication of VA7 in both cell lines. When mice bearing orthotopic GL261 or CT-2A tumors were administered neurotropic VA7, either i.v. or intracranially (i.c.), the vector was unable to infect the tumor and no survival benefit was achieved. Pretreatments with immunosuppressive cyclophosphamide (CPA) and rapamycin markedly lowered serum-neutralizing antibodies (NAbs) but had no effect on tumor infection or survival. Intracranial GL261 tumors were refractory also in athymic C57BL/6 mice, which have serious defects in their adaptive immunity. Implanted VA7-infected GL261 cells formed tumors with only slightly delayed kinetics and without improving survival thus excluding the participation of physical barriers and indicating robust host IFN action. Mouse and human IFNβ do not seem be species cross-reactive, which might limit the translational relevance of xenograft models in oncolytic virotherapy.
BAG3 Regulates Motility and Adhesion of Epithelial Cancer Cells
Authors: Masahiro Iwasaki, Sachiko Homma, Akinori Hishiya, Samuel J. Dolezal, John C. Reed, Shinichi Takayama
Journal: Cancer Research (2007)

Abstract BAG3 protein binds to and regulates Hsp70 chaperone activity. The BAG3 protein contains a WW domain and a proline-rich region with SH3-binding motifs, suggesting that it may interact with proteins relevant to signal transduction, recruiting Hsp70 to signaling complexes and altering cell responses. BAG3 overexpression has been observed in human cancers. We show here that homozygous BAG3-deficient mouse embryonic fibroblasts (MEF) exhibit delayed formation of filopodia and focal adhesion complexes when freshly plated. BAG3-deficient MEFs show reduced cell motility in culture. We observed that endogenous BAG3 protein is highly expressed in many human epithelial cancer cell lines, especially adenocarcinomas. Gene transfer–mediated overexpression of BAG3 increased motility of Cos7 cell and several human cancer cell lines, including breast cancer MCF7 and prostate cancer DU145 and ALVA31 cell lines. Conversely, reduction of BAG3 protein by RNA interference (RNAi) decreased cell motility in four of four epithelial tumor lines tested. We observed an influence of BAG3 on cell adhesion in culture. In Cos7 kidney epithelial cells, BAG3 protein partially colocalizes with actin at the leading edge of migrating cells, wherein active actin polymerization and nucleation occur. RNAi-mediated reductions in BAG3 expression were associated with decreased Rac1 activity, suggesting a role for BAG3 in regulating this small GTPase involved in actin-cytoskeleton dynamics. In mice, RNAi-mediated reductions in BAG3 in a human tumor xenograft suppressed invasion and metastasis in vivo. Thus, the high levels of BAG3 protein seen in some epithelial cancer cell lines may be relevant to mechanisms of tumor invasion and metastasis. [Cancer Res 2007;67(21):10252–8]
Reye's Syndrome in Nonpediatric Age Groups
Authors: Rajiv R. Varma
Journal: JAMA (1979)

Reye's syndrome (encephalopathy and fatty liver) is generally considered a disease of children. Four patients, aged 16, 18, 19, and 23 years, with Reye's syndrome were initially seen by internists. A viral prodrome followed by vomiting and encephalopathy without focal neurological signs or jaundice clinically suggested Reye's syndrome. Normal findings of CSF examination (except for increased opening pressure), abnormal findings of liver function tests, and increased blood ammonia further supported the diagnosis. None was hypoglycemic. Reye's syndrome was related to influenza B virus in three patients and to Varicella in another. Three patients survived. Reye's syndrome may be seen intially by general practitioners, emergency room physicians, internists, or psychiatrists. The importance of considering this syndrome in the differential diagnosis of unexplained encephalopathy in adults is stressed.
Ethics Consultation in the Intensive Care Unit
Authors: Rosemary Quigley
Journal: JAMA (2003)

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
Heroic Treatment for Nonmalignant Disease
Authors: George E. Ehrlich
Journal: JAMA (1982)

Severe progressive rheumatoid arthritis remains a therapeutic challenge. The usual approach has been described by Wilbur Blechman as resembling choices from a Cantonese restaurant menu—take one or more from column A and also from column B. Thus, the control of inflammation, or at least of the symptoms produced by inflammation, is made a responsibility of nonsteroidal antiinflammatory drugs and, in some cases, of corticosteroids. At the same time, inhibition of the progression of the disease generally requires addition of disease-modifying antirheumatic drugs, also known as remission-inducing drugs, such as gold salts, penicillamine, antimalarials, azathioprine, and a variety of experimental drugs and procedures borrowed from the treatment of other diseases. Gold compounds were first introduced because of a confusion between tuberculosis and rheumatoid arthritis; penicillamine began as an agent to remove copper from patients who had Wilson's disease; chloroquine and hydroxychloroquine sulfate were used to prevent or treat malaria, while azathioprine
P747Association of oxidized low-density lipoproteins and vascular damage in patients with autoimmune pathology
Authors: NA Bashlakova, TD Tyabut, AE Buglova, EV Kundzer, LN Maslinskaya, GA Babak
Journal: Cardiovascular Research (2014)

Background: Clinical evidence suggests that oxidatively modified form of low-density lipoprotein cholesterol (LDL) is more important than native LDL in atherogenesis and vascular damage. The accelerated development of atherosclerosis has been recognized in patients with autoimmune diseases. An autoimmune component of atherogenesis is actually discussed.
Lincomycin Therapy and Urinary Glucose Tests
Authors: James D. Panzer
Journal: JAMA (1969)

To the Editor:—  To answer the question, Does antibiotic therapy, specifically lincomycin hydrochloride monohydrate, and the metabolic products resultant from this therapy present in the urine have any effect on the validity of urine glucose evaluation, the following experiment was done.  An aliquot of urine was obtained from normal subjects (six per group) who had received either placebo, 300, 600, 900, 1,200, or 1,500 mg of lincomycin hydrochloride monohydrate given intravenously within a one-hour period. (Urine was collected over a 24-hour period from the start of the infusion.) Glucose was added to this urine in the following concentrations: 0.25, 0.50, 0.75, 1.0, and 2.0 grams per 100 ml, which corresponds to the values (Clini-Test), respectively, of: trace, 1+, 2+, 3+, and 4+. The urine was tested prespiking and postspiking (Clini-Test, Tes-Tape, and Lab Sticks). (The latter two tests give only a positive or negative result.)  All prespiking tests were negative.
Coronary Spasm Producing Coronary Thrombosis and Myocardial Infarction
Authors: G. Michael Vincent, Jeffrey L. Anderson, Hiram W. Marshall
Journal: New England Journal of Medicine (1983)

THE pathophysiology of acute myocardial infarction has been a subject of considerable discussion, as indicated in two recent reviews.1 , 2 The respective roles of coronary thrombosis and coronary spasm are unclear. It has been suggested that coronary spasm may lead to infarction,3 4 5 6 7 8 and a recent report demonstrated the presence of coronary thrombosis at catheterization six hours after the onset of infarction in a patient with variant angina.9 However, conclusive proof that coronary spasm can lead to infarction, with or without thrombosis, has not been reported. This article describes the occurrence of coronary spasm leading to thrombosis, with development of myocardial infarction. . . .
Medicolegal Application of Human Blood Grouping
Authors: Reuben Ottenberg
Journal: JAMA (1983)

Although the inheritance, according to definite mendelian principles, of group-specific substances in human blood has been known for ten years, the application of this information to medicolegal questions has not yet been made. It is my object in the present paper to present the possibilities of this practical application and to define the instances in which it can be used. The term iso-agglutination describes the agglutination of red blood cells by contact with blood serum derived from another individual of the same species. Landsteiner, in 1901, showed that this is a normal phenomenon in all human blood, and reduced its occurrence to a definite law. With regard to the behavior of their serum and red blood cells, all human beings, without regard to race, sex or state of health, fall into one of three groups. In the first group the red cells are not agglutinable by any other human serum,
Comparison by Controlled Clinical Trial of Streptokinase and Heparin in Treatment of Life-threatening Pulmonary Embolism
Authors: D. A. Tibbutt, J. A. Davies, J. A. Anderson, E. W. L. Fletcher, J. Hamill, J. M. Holt, M. L. Thomas, G. D. J. Lee, G. A. H. Miller, A. A. Sharp, G. C. Sutton
Journal: BMJ (1974)

Treatment with heparin or streptokinase was allocated randomly to 30 patients with life-threatening pulmonary embolism verified by angiography. Treatment was given for 72 hours and pulmonary angiography was repeated. There was significantly greater (P &lt; 0·001) evidence of thrombolysis in those patients treated with streptokinase compared with those treated with heparin. The reduction of systolic and mean pulmonary arterial pressures was also significantly greater (P &lt; 0·05 and P &lt; 0·02 respectively) in the streptokinase group. Seven patients failed to complete 72 hours of the trial treatment: five successfully underwent pulmonary embolectomy. Six of these “failures” had initial pulmonary angiographic scores of 24 or more and systemic systolic blood pressure recordings of 100 mm Hg or less. Patients with these features should probably be considered for pulmonary embolectomy as the initial treatment. A febrile reaction commonly occurred in the streptokinase group; otherwise side effects were no more common than in the heparin group.
Ocular Sarcoidosis
Authors: Rayamajhi Sampanna Jung, Bhagwant Rai Mittal, Nagarjuna V. Maturu, Rajender Kumar, Anish Bhattacharya, Dheeraj Gupta
Journal: Clinical Nuclear Medicine (2014)

Sarcoidosis is a multisystemic disease, which may affect almost any organ including the eyes. Recently, F-FDG PET/CT has proved to be a very useful molecular imaging method allowing to obtain a complete morphofunctional cartography of active inflammatory sites and to assess treatment response in patients with sarcoidosis. We report 2 cases of sarcoidosis where F-FDG PET/CT showed intense FDG uptake in the eye globes along with multiple enlarged mediastinal lymph nodes suggestive of active sarcoidosis with ocular involvement.
Regulation of the fasting enterohepatic circulation of bile acids by the migrating myoelectric complex in dogs.
Authors: R B Scott, S M Strasberg, T Y El-Sharkawy, N E Diamant
Journal: Journal of Clinical Investigation (1983)

The purpose of this study was to correlate the fasting enterohepatic circulation (EHC) of bile acids with the migrating myoelectric complex. Four dogs were surgically provided with a functional cholecystectomy, a duodenal cannula for direct vision cannulation of the common bile duct, and 12 bipolar electrodes implanted from stomach to terminal ileum. Bile was collected in equal-volume, timed aliquots over 6 to 10 h. Aliquots were sampled and either returned to the duodenum for study of the intact EHC, or collected and retained in order to study the time course of the bile acid pool washout. In the washout experiments boluses of radiolabeled taurocholic acid were instilled into the duodenum before and after duodenal phase III of the migrating motor or myoelectric complex (MMC). In another group of experiments the bile acid pool was washed out and during a continuous duodenal infusion of taurocholic acid bile was collected to study the pattern of hepatic secretion. Results: (a) In all experiments, a single broad peak of bile flow and bile acid secretion occurred at 35-55% of the MMC migration time. At this time the MMC had migrated to a point 70-85% of the distance along the small intestine. (b) During bile acid pool washout the peak of bile flow and bile acid secretion occurred with the distal migration of the first MMC and then bile flow and bile acid secretion rates decreased to a minimum and stabilized. (c) In bile acid pool washout experiments the radiolabeled bile acids instilled into the duodenum prior to duodenal phase III were secreted and peaked with peak endogenous bile acid secretion. The secretion of radiolabeled bile acids instilled into the duodenum after duodenal phase III was delayed until the subsequent cycle of the MMC. 88% of the bile acid pool collected over 6 h was secreted during the distal migration of the first MMC (2.4 +/- 0.4 h). (d) After bile acid pool washout and during continuous duodenal infusion of taurocholic acid, hepatic bile flow and bile acid secretion continued to fluctuate with the same pattern observed with the EHC intact. Conclusions: (a) In the fasting state, the transport of intestinal bile acids to the liver is pulsatile rather than continuous and is determined by the MMC. Maximum hepatic secretion occurs when phase III of the MMC propels the intraluminal bile acid pool to its site of absorption in the distal small bowel. (b) The "housekeeping" action of the MMC is very efficient and clears 88% of the 6-h washout bile acid pool in one pass.
Origin and development of exocrine pancreatic insufficiency in experimental renal failure.
Authors: M M Lerch, P Hoppe-Seyler, W Gerok
Journal: Gut (1994)

Chronic renal failure affects the physiological function of many organ systems. One of them is the exocrine pancreas. Although varying degrees of pancreatic insufficiency are the dominating clinical characteristic of uraemic pancreatic disease, it remains unclear whether this disease should be regarded as a manifestation of chronic pancreatitis, arising from recurring attacks of acute pancreatitis, or represents a distinct entity. The exocrine pancreas was studied in a model of experimental renal failure. The pancreas was removed from each rat at selected time points over eight weeks after subtotal nephrectomy and from a standard rat model of pancreatitis for comparison. The data show that the in vitro secretory response is considerably changed in renal failure (increased during early acute and decreased during chronic renal failure). While the pancreatic content of digestive enzymes progressively declines, DNA and protein synthesis increase over time. Acinar cell deletion is increased and accompanied by an increased rate of mitosis. This increased cellular turnover is not associated with tissue oedema, pancreatic fibrosis, inflammatory changes, autophagocytosis or subcellular redistribution of lysosomal hydrolases, all of which are characteristic for pancreatitis. The ultrastructural changes of uraemic pancreatic disease bear no resemblance to the changes seen in pancreatitis. It is concluded that the morphological and biochemical changes in early uraemic pancreatic disease are quite distinct, correspond with toxic damage of the pancreas, and are dominated by functional impairment and an increased cellular turnover.
Fertility Rates in Female Patients with Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
Authors: Rose M. Mulaikal, Claude J. Migeon, John A. Rock
Journal: New England Journal of Medicine (1987)

Among 80 women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (40 with the simple virilizing form and 40 with the salt-losing form), 40 reported having an adequate introitus and being heterosexually active. In 15 of 25 patients with the simple virilizing form, 25 pregnancies resulted in 20 normal children, whereas only 1 of 15 women with the salt-losing form became pregnant; this pregnancy was electively terminated. Several factors seem to be responsible for the low fertility rates: noncompliance with therapy was probably high, as suggested by hirsutism and poor endocrine follow-up in 25 percent of patients; whereas 49 patients had regular menstrual periods, 14 had irregular periods, 10 had amenorrhea, 5 had undergone hysterectomy, and 2 had entered menopause; 87 percent of patients with salt loss and 50 percent of those with simple virilization (P less than 0.001) had remained single; the vaginal introitus was reported to be inadequate for intercourse by 35 percent of patients (53 percent of those with salt loss and 18 percent of those with simple virilization; P less than 0.002); and heterosexual activity was reported less frequently among patients with an inadequate introitus. The status of the introitus seemed to have a more important role in the sexual activity reported than did the degree of prenatal exposure to androgen (which was higher among patients with salt loss than among those with simple virilization). However, our data did not rule out an effect of androgen exposure on female fetuses. Our experience indicates that improved surgical correction of the external genitalia and better compliance with therapy will be necessary to improve fertility rates among women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
Abstract 17090: Multifocal Ectopic Purkinje Tachycardia: A New Familial Syndrome.
Authors: gabriel laurent, Samuel Saal, Mohamed Yassine Amarouch, Laurence Faivre, Christel Thauvin-Robinet, Philippe Charron, Pascale Richard, Vincent Probst, Estelle Baron, Isabelle Baro, Julien Barc, Jean Jacques Schott, Jean Merot, Rodolphe Turpault, Yves Coudiere, Gildas Loussouam, Florence Kyndt, Jean Eric Wolf
Journal: Circulation (2010)

Introduction: We report a new cardiac familial syndrome characterized by frequent polymorphic premature ventricular contractions (PVCs) originating from multiple ectopic foci from the left fascicul...
Protective Heterologous Antiviral Immunity and Enhanced Immunopathogenesis Mediated by Memory T Cell Populations
Authors: Liisa K. Selin, Steven M. Varga, Iris C. Wong, Raymond M. Welsh
Journal: The Journal of Experimental Medicine (1998)

A basic principle of immunology is that prior immunity results in complete protection against a homologous agent. In this study, we show that memory T cells specific to unrelated viruses may alter the host's primary immune response to a second virus. Studies with a panel of heterologous viruses, including lymphocytic choriomeningitis (LCMV), Pichinde (PV), vaccinia (VV), and murine cytomegalo (MCMV) viruses showed that prior immunity with one of these viruses in many cases enhanced clearance of a second unrelated virus early in infection. Such protective immunity was common, but it depended on the virus sequence and was not necessarily reciprocal. Cell transfer studies showed that both CD4 and CD8 T cell populations from LCMV-immune mice were required to transfer protective immunity to naive hosts challenged with PV or VV. In the case of LCMV-immune versus naive mice challenged with VV, there was an enhanced early recruitment of memory phenotype interferon (IFN) γ–secreting CD4+ and CD8+ cells into the peritoneal cavity and increased IFN-γ levels in this initial site of virus replication. Studies with IFN-γ receptor knockout mice confirmed a role for IFN-γ in mediating the protective effect by LCMV-immune T cell populations when mice were challenged with VV but not PV. In some virus sequences memory cell populations, although clearing the challenge virus more rapidly, elicited enhanced IFN-γ–dependent immunopathogenesis in the form of acute fatty necrosis. These results indicate that how a host responds to an infectious agent is a function of its history of previous infections and their influence on the memory T cell pool.
Les Rhumatismes en Medecine et dans la Societe
Authors: M.H.L. Desmarais
Journal: Annals of the Rheumatic Diseases (1953)

REVIEWSa case for such treatment in every variety of the disease, save perhaps in early cases which may go into remission spontaneously.Severe progressive rheumatoid arthritis provides many difficulties, but good results may be achieved, and in the long-standing crippled cases a com- bination of hormone therapy and orthopaedic treatment should be considered.They have also been impressed with the action of these drugs in scleroderma.They conclude by stating that cortico-suprarenal hormone therapy has become a part of current practice for rheumatic conditions, both acute and chronic.They believe this to be warranted by the good results obtained, as compared to the ineffectiveness of other treatments, but feel disquieted because of the risks which are run when these drugs are used, and the uncertainty, as yet, of the long-term results.They stress the need for further research, particularly on mixed courses of cortisone and ACTH, the combination of chryso-and hormone therapy, and the local use of hydrocortisone.OSWALD SAVAGE.