tbuckley/cabot-search huggingface dataset:
Over-diagnosis of Clostridium difficile
Authors: T. P. E. Chapman, T. Parks, E. L. Culver, M. Scarborough
Journal: BMJ (2011)

Settle and Kerr highlight the potential risks of late diagnosis of Clostridium difficile infection because of false negative toxin results.1 Clinicians need also to be aware of the implications of false positive results.

We recently reviewed all adult cases of presumed C difficile infection (defined as clinical …
Mechanisms of regulation of cell-mediated immunity. III. The characterization of azobenzenearsonate-specific suppressor T-cell-derived-suppressor factors.
Authors: M I Greene, B A Bach, B Benacerraf
Journal: The Journal of Experimental Medicine (1979)

Delayed type hypersensitivity to the hapten azobenzenearsonate (ABA) can be induced and suppressed by the administration of hapten-coupled syngeneic spleen cells by the appropriate route. Suppressor T cells stimulated by the intravenous administration of ABA-coupled spleen cells have been shown to produce a discrete subcellular factor(s) which is capable of suppressing delayed type hypersensitivity to azobenzenearsonate in the mouse. Such suppressor factors may be produced by the mechanical disruption of suppressor cells or by placing such suppressor cells in culture for 24 h. The suppressor factor(s) (SF) derived from ABA-specific suppressor cells exhibit biological specificity for the suppression of ABA delayed type hypersensitivity (DTH), but not trinitro-phenyl DTH, as well as the capacity to bind to ABA immunoadsorbents. Passage of suppressor factor(s) over reverse immunoadsorbents utilizing a rabbit anti-mouse F(ab')2 antiserum demonstrated that the antigen-specific T-cell derived SF does not bear conventional immunoglobulin markers. The suppressor factor(s) are not immunoglobulin molecules was further demonstrated by the inability of anti-ABA antibodies to suppress ABA DTH. Gel filtration of ABA suppressor factor(s) showed that the majority of the suppressive activity was present in a fraction with molecular weight ranging between 6.8 x 10(4) and 3.3 x 10(4) daltons. We also analyzed for the presence of determinants encoded by the H-2 major histocompatibility complex (MHC) and found that immunoadsorbents prepared utilizing antisera capable of interacting with gene products of the whole or selected gene regions of H-2 MHC, i.e., B10.D2 anti-B10.A and B10 anti-B10.A immunoadsorbents, retained the suppressive activity of ABA-SF. Elution of such columns with glycine HCl buffers (pH 2.8) permitted recovery of specific suppressive activity. Taken collectively such data supports the notion that suppressor T-cell-derived ABA suppressor factors have antigen-binding specificity as well as determinants controlled by the K end of the H-2 MHC. The distribution of strains capable of making SF has also been analyzed. The relationship of the antigen-binding specificity to VH gene products is discussed in this and the companion paper.
INCREASED VIRULENCE OF THE HOG-CHOLERA BACILLUS PRODUCED BY PASSAGE THROUGH RABBITS
Authors: Carl Tenbroeck
Journal: The Journal of Experimental Medicine (1917)

By passage through a series of eleven rabbits a culture of the hogcholera bacillus has increased its virulence a thousand times. A subcutaneous injection of twenty organisms, or 0.00000001 cc. of a 24 hour bouillon culture, or a drop of a bouillon culture rubbed lightly into the shaven skin, produces, in the rabbit, a characteristic disease resulting in death on or about the 6th day.
Continuous monitoring of the effect of pentagastrin on gastric emptying of solid food in man.
Authors: S G Hamilton, H J Sheiner, M F Quinlan
Journal: Gut (1976)

By continuous monitoring of a solid meal labelled with a radiopharmaceutical it has been possible to determine the effects of drugs on gastric emptying and motility during a single study. Predictably hyoscine delayed, and bethanechol increased, the rate of gastric emptying. Pentagastrin initially produced marked antral activity resulting in a physiological stricture and subsequent delay in the overall rate of gastric emptying. Fundal motility was unaffected though reflux from the antrum occurred.
Medical staff detained in Bahrain are released on bail after hunger strike
Authors: S. Arie
Journal: BMJ (2011)

Bahrain’s authorities have released 12 medical professionals facing charges of anti-state activity during pro-democracy protests in February and March after they went on hunger strike.

A military prosecutor, Yousuf Rashid Flaifal, said they were being released on bail pending a final verdict on their cases scheduled for 29 September.

The health of the 12—nine doctors, one paramedic, and two nurses—had deteriorated while they were in jail and many told their lawyers they had been tortured and forced into making confessions. Several had become unwell after they stopped eating—one had reportedly had a stroke and one was …
Effect of stem cell source on outcomes after unrelated donor transplantation in severe aplastic anemia
Authors: Mary Eapen, Jennifer Le Rademacher, Joseph H. Antin, Richard E. Champlin, Jeanette Carreras, Joseph Fay, Jakob R. Passweg, Jakub Tolar, Mary M. Horowitz, Judith C. W. Marsh, H. Joachim Deeg
Journal: Blood (2011)
Phase I Trial Using a Time-to-Event Continual Reassessment Strategy for Dose Escalation of Cisplatin Combined With Gemcitabine and Radiation Therapy in Pancreatic Cancer
Authors: Jeffrey H. Muler, Cornelius J. McGinn, Daniel Normolle, Theodore Lawrence, Diane Brown, Gwen Hejna, Mark M. Zalupski
Journal: Journal of Clinical Oncology (2003)

The primary objective of this study was to determine the maximum-tolerated dose of cisplatin that could be added to full-dose gemcitabine and radiation therapy (RT) in patients with pancreatic cancer.Nineteen patients were treated. Gemcitabine 1,000 mg/m(2) was administered over 30 minutes on days 1, 8, and 15 of a 28-day cycle. Cisplatin followed gemcitabine on days 1 and 15. The initial dose level of cisplatin was 30 mg/m(2), escalated to a targeted dose of 50 mg/m(2) using Time-to-Event Continual Reassessment Method. RT was initiated on cycle 1, day 1, in 2.4 Gy fractions to a total dose of 36 Gy. A second cycle of chemotherapy was planned following a 1-week rest.Four of eight patients experienced acute dose limiting toxicity at the 50 mg/m(2) cisplatin dose level. Patients treated at 30 and 40 mg/m(2) cisplatin dose level tolerated therapy without dose-limiting toxicity. Median survival was 10.7 months (95% CI, 5.4 to 18.2) for all patients, and 12.9 months (95% CI, 7.4 to 21.2) for those without metastasis.Cisplatin at doses up to 40 mg/m(2) may be safely added to full-dose gemcitabine and conformal RT. The Time-to-Event Continual Reassessment Method trial design allowed rapid completion of the study and confidence in the conclusion about the maximum tolerated dose, but accrued more patients to a dose level above the maximum tolerated dose than the typical phase I design. Local and systemic disease control and survival in this study cohort supports further investigation of gemcitabine-based RT and combination chemotherapy in this disease.
Gifts From Industry: Laundering Money or Supporting Education?
Authors: Douglas R. Waud
Journal: JAMA (1994)

<h3>To the Editor.</h3> —After reading the Resident Forum<sup>1</sup>on how to take bribes the official way, I could not help but burst with pride at being a member of the medical profession. Initially, reading the first rule, my reaction was negative. How can one be proud of a profession that has a written policy that permits accepting trinkets but nothing of value? It takes thousands of dollars to bribe a congressman or a judge, we are supposed to settle for "pens, diaries, books, or rulers." However, when I reached rule two I realized all was not lost. We do not accept money directly but have guidelines that dictate we launder it by funneling it through a specifically designated individual. When we couple this policy with the intent to "educate house staff" as to how we do things, one can rest assured that the future is secure. Organized crime must
Promoting HIV Testing in Older Children
Authors: M. J. Friedrich
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Suicidal Dilantin (Sodium Diphenylhydantoin) Poisoning
Authors: Jerome B. Tichner, Charles D. Enselberg
Journal: New England Journal of Medicine (1951)

THE reported incidence of toxic reactions to dilantin (sodium diphenylhydantoin) has varied from 15 to 93 per cent,1 , 2 since its introduction by Merritt and Putnam3 in 1938. These reactions have involved the central nervous system, the gastrointestinal tract, the skin, the gums, the hematopoietic system and, occasionally, the liver.4 5 6 7 8 9 To our knowledge, only 3 deaths attributable to dilantin have been reported.10 11 12 The purpose of this communication is to report a fourth case in which death was caused by the drug.Case ReportA 16-year-old girl was admitted to the Medical Service of Gouverneur Hospital on January 12, 1950, with a . . .
Pseudo-buried Barrett’s post radiofrequency ablation for Barrett’s esophagus, with or without prior endoscopic resection
Authors: Roos Pouw, Mike Visser, Robert Odze, Carine Sondermeijer, Fiebo Kate, Bas Weusten, Jacques Bergman
Journal: Endoscopy (2013)

<b>Background and study aim:</b> In our experience, biopsies from small residual islands of nonburied Barrett’s mucosa after radiofrequency ablation (RFA) are occasionally reported by pathologists to contain “buried Barrett’s” upon histological evaluation, despite the fact that these islands of columnar mucosa were visible endoscopically. The aim of this study was to evaluate the frequency of buried Barrett’s in biopsies obtained from small residual Barrett’s islands ( < 5 mm) sampled post-RFA, compared with biopsies from normal neosquamous epithelium. <b>Patients and methods:</b> Biopsies obtained from normal-appearing neosquamous epithelium and from small Barrett’s islands ( < 5 mm) in 69 consecutive Barrett’s patients treated with RFA were evaluated for the presence of buried columnar mucosa. <b>Results:</b> A total of 2515 biopsies were obtained from neosquamous epithelium during follow-up post-RFA. Buried glands were found in 0.1 % of biopsies from endoscopically normal neosquamous epithelium. However, when small islands of columnar mucosa were biopsied, buried glands were detected in 21 % of biopsies. <b>Conclusion:</b> To avoid accidental sampling of small islands resulting in a false-positive histological diagnosis of buried Barrett’s, thorough inspection should be performed before obtaining biopsies during post-RFA follow-up.
Suicide and the not-so-innocent bystander
Authors: R J ASPINALL
Journal: Gut (2000)

See article on page 343 

As the field of anticancer gene therapy edges closer to the mainstream, so we learn more of its current limitations as well as the potential for future success. With the technologies available today, it is simply not possible to achieve correction of every single genetic abnormality in every malignant cell. Hence most approaches investigated so far have involved a cytotoxic strategy, aiming to selectively destroy tumours while avoiding “collateral damage” to normal tissues.1 

The success or failure of such cytotoxic gene therapy is influenced by two important choices—what therapeutic gene should be introduced and what vector should carry it to the target? We already have a range of genetic prodrug activation therapy (GPAT) strategies available, based on introducing tumour specific “suicide” enzymes that can generate toxic metabolites from otherwise benign prodrugs. Common examples include the herpes simplex virus thymidine kinase (HSVtk), which confers sensitivity to the antiviral drug ganciclovir, or the Escherichia coli derived cytosine deaminase that converts 5-fluorocytosine into the antineoplastic …
Effects of testosterone on hypoxic ventilatory and carotid body neural responsiveness.
Authors: K Tatsumi, B Hannhart, C K Pickett, J V Weil, L G Moore
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Hypoxic (HVR) and hypercapnic ventilatory responses (HCVR) are known to be influenced by the administration of testosterone, but whether the hormone acts centrally or peripherally is unknown. To determine whether testosterone alters HVR, HCVR, and carotid sinus nerve (CSN) responsiveness to hypoxia, we compared the ventilatory and CSN responses of neutered male cats treated with testosterone with those of placebo-treated cats. Testosterone treatment increased resting ventilation and CO2 production but did not change end-tidal or arterial PCO2, implying that alveolar ventilation per unit CO2 production was unaltered. Testosterone treatment raised the HVR shape parameter A value 63% in the awake animals (from 16.9 +/- 4.2 to 28 +/- 4, p < 0.05) and 69% in the anesthetized cats (from 22.4 +/- 0.9 to 37.8 +/- 3.7, p < 0.05). Testosterone also augmented the HCVR slope S in awake cats (from 0.17 +/- 0.02 to 0.25 +/- 0.04, p < 0.05). Placebo treatment did not change HVR or HCVR. The CSN response to hypoxia was greater in the testosterone-treated than in the placebo-treated animals (A = 53.6 +/- 7.1 versus 27.1 +/- 5.5 respectively, p < 0.05). The crossplot of the simultaneously measured CSN activity and ventilation during progressive hypoxia showed that the central nervous system translation of CSN output into ventilation was similar in the hormone- and placebo-treated groups. Unilateral, proximal sectioning of the CSN decreased the ventilatory and the CSN responses to hypoxia in the testosterone-treated animals but not in the placebo group. These results indicated that testosterone increased hypoxic and hypercapnic ventilatory responsiveness and increased hypoxic sensitivity of the carotid body.(ABSTRACT TRUNCATED AT 250 WORDS)
New Method of Screening Young Children for Defects in Visual Acuity
Authors: A. Withnell, H. E. Wilson
Journal: BMJ (1968)

The methods used at present for screening young children's vision have disadvantages, such as that the child's intelligence can affect the result. In a new method three white cards are used; these are printed with one, two, or three black blocks arranged so that if a child can correctly state the number of blocks at 6 metres the visual acuity is at least 6/9. When tested on 186 children the new method gave better results than conventional tests; eight children with defective vision were picked up only by the new method and none were missed.
WHO not amused
Authors: J. E Asvall
Journal: BMJ (1987)

<h3>Objectives</h3> Elevated liver enzyme concentrations in blood are indicative of liver diseases and may provide an early signal for being at risk for other chronic diseases. Our study aimed to assess the relationships of alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate transaminase (AST) and the De Ritis ratio (AST/ALT) with incidence and mortality of cardiovascular diseases (CVD) and the four most common cancers, that is, breast, prostate, colorectal and lung. <h3>Setting, participants and outcome measures</h3> We analysed a case-cohort sample of the prospective European Prospective Investigation into Cancer and Nutrition-Heidelberg cohort, including cancer (n=1632), cancer mortality (n=761), CVD (n=1070), CVD mortality (n=381) and a random subcohort (n=2739) with an average follow-up duration of 15.6 years. Concentrations of liver enzymes were measured in prediagnostic blood samples and Prentice-weighted Cox regression models were used to estimate HRs with 95% CIs. <h3>Results</h3> High ALP levels were associated with increased risk for lung cancer and all-cause mortality (highest vs lowest quartile, multivariable adjusted HR=2.39 (95% CI 1.30 to 4.39), HR=1.31 (95% CI 1.02 to 1.67)), high AST levels with all-cause mortality (HR=1.45 (95% CI 1.15 to 1.82)), and a high De Ritis ratio with prostate cancer risk, all-cause and cancer mortality (HR=1.61 (95% CI 1.10 to 2.36), HR=1.60 (95% CI 1.25 to 2.04), HR=1.67 (95% CI 1.26 to 2.23)). Using cut-points for liver enzyme levels above normal, we observed positive associations for all-cause mortality with ALP, GGT and AST, and assigning a combined risk score resulted in positive associations with all-cause and cause-specific mortality. <h3>Conclusions</h3> Measurements of serum liver enzymes, as routinely performed in health check-ups, may support the identification of individuals at increased risk for all-cause mortality. Further prospective studies are needed to verify our first results on individual cancers and on a combined risk score.
Sugar and diabetes mellitus.
Authors: J Yudkin
Journal: BMJ (1979)

Aetiology of appendicitis SIR,-We read with interest the repeated assertion by Mr D P Burkitt and others that "the geographical distribution of appendicitis indicates that it is a disease associated with modern Western culture" (3 March, p 620).Reports, which often comprised moderately large series of cases of appendicitis, have recently been published from Africa,'-' South America,4 the Middle East,5-7 Malaysia,8 Indonesia,9 China,10 and even the Arctic."1The World Organisation of Gastroenterology re- search committee is conducting a large-scale multinational survey into the presentation of abdominal pain around the world.In every single centre, including Mexico City and Khon Kaen, Thailand, in large series of several hundred cases per centre, the commonest cause of admission to hospital with acute abdominal pain is acute appendicitis.It is not helpful therefore at the present time to equate appendicitis with modem Western culture.The relation between the two-if it exists at all-is undoubtedly far more complex than Mr Burkitt's simplistic assertion.
Mast cell activation syndromes: definition and classification
Authors: P. Valent
Journal: Allergy (2013)

Mast cell activation (MCA) occurs in a number of different clinical conditions, including IgE-dependent allergies, other inflammatory reactions, and mastocytosis. MCA-related symptoms may be mild, moderate, severe, or even life-threatening. The severity of MCA depends on a number of different factors, including genetic predisposition, the number and releasability of mast cells involved in the reaction, the type of allergen, presence of specific IgE, and presence of certain comorbidities. In severe reactions, MCA can be documented by a substantial increase in the serum tryptase level above baseline. When symptoms are recurrent, are accompanied by an increase in mast cell-derived mediators in biological fluids, and are responsive to treatment with mast cell-stabilizing or mediator-targeting drugs, the diagnosis of mast cell activation syndrome (MCAS) is appropriate. Based on the underlying condition, these patients can further be classified into i) primary MCAS where KIT-mutated, clonal mast cells are detected, ii) secondary MCAS where an underlying inflammatory disease, often in the form of an IgE-dependent allergy, but no KIT-mutated mast cells, is found, and iii) idiopathic MCAS, where neither an allergy or other underlying disease, nor KIT-mutated mast cells are detectable. It is important to note that in many patients with MCAS, several different factors act together to lead to severe or even life-threatening anaphylaxis. Detailed knowledge about the pathogenesis and complexity of MCAS, and thus establishing the exact final diagnosis, may greatly help in the management and therapy of these patients.
Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis
Authors: Ary Serpa Neto, Fabienne D. Simonis, Carmen S. V. Barbas, Michelle Biehl, Rogier M. Determann, Jonathan Elmer, Gilberto Friedman, Ognjen Gajic, Joshua N. Goldstein, Janneke Horn, Nicole P. Juffermans, Rita Linko, Roselaine Pinheiro de Oliveira, Sugantha Sundar, Daniel Talmor, Esther K. Wolthuis, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J. Schultz
Journal: Intensive Care Medicine (2014)
High Blood Pressure Upregulates Arterial L-Type Ca <sup>2+</sup> Channels
Authors: Aleksandra Pesic, Jane A. Madden, Miodrag Pesic, Nancy J. Rusch
Journal: Circulation Research (2004)

Long-lasting Ca2+ (Ca(L)) channels of the Ca(v)1.2 gene family contribute to the pathogenesis of abnormal arterial tone in hypertension. The physiological stimulus that enhances Ca(L) channel current in the vascular smooth muscle cells (VSMCs) remains unknown. The present study investigated if high blood pressure triggers an upregulation of vascular Ca(L) channel protein. Rat aortae were banded between the origins of the left renal (LR) and right renal (RR) arteries to selectively elevate blood pressure in the proximal RR arteries. After 2 days, the immunoreactivity on Western blots corresponding to the pore-forming alpha1C subunit of the Ca(L) channel was increased 3.25-fold in RR compared with LR arteries. This finding persisted at 28 days and was associated with abnormal Ca2+-dependent tone and higher Ca(L) currents in the VSMCs exposed to high pressure. Based on microelectrode studies indicating that RR arteries were depolarized compared with LR arteries, further studies examined if membrane depolarization, an inherent response of VSMCs to high blood pressure, increased alpha1C expression. Isolated rat renal arteries were cultured for 2 days in low K+ (4 mmol/L) or depolarizing high K+ (30 mmol/L) media. Arteries preconditioned in high K+ showed a 5.47-fold increase in alpha1C expression, enhanced Ca(L) channel current, and elevated Ca2+-dependent tone. These findings provide the first direct evidence that high blood pressure upregulates the Ca(L) channel alpha1C subunit in VSMCs in vivo and suggest that membrane depolarization is a potential signal involved in this interaction that may contribute to the development of abnormal vascular tone.
Endoscopic Laser Therapy for Small Villous Adenomas of the Duodenum
Authors: J. M. Ghilain, C. Dive
Journal: Endoscopy (1994)

Six patients with seven small, nonampullary duodenal villous or tubulovillous adenomas, two of which showed mild dysplasia, were treated by laser photocoagulation. The mean size of the tumors was 19 +/- 16 mm. Both argon and Nd-YAG lasers were used. All tumors were destroyed in one to five sessions. Recurrences of the lesion in two cases were successfully retreated, and both patients remained free of recurrence after 33 and 48 months, respectively. After a median follow-up of 59 months, all patients remained in remission, and five of them are still alive. One died after six months from a bronchogenic carcinoma. After a total of 18 laser sessions, no serious side-effects were observed, two patients exhibiting a transient melena possibly related to the procedure. We conclude that laser therapy is a good alternative to surgery for nonampullary duodenal villous tumors, especially in high-risk patients. Endoscopic follow-up is mandatory to detect and treat recurrence.