tbuckley/cabot-search huggingface dataset:
The domiciliary consultation service: time to take stock.
Authors: L J Donaldson, P M Hill
Journal: BMJ (1991)

OBJECTIVE--To review the use of the domiciliary consultation service in modern clinical practice in the Northern region. DESIGN--Retrospective study of data on domiciliary consultations from claim forms for payment submitted to the regional health authority by consultants during 1984-5 and prospective study during 1985-9. Peer review of patterns of practice by consultants. SETTING--15 Of the 16 health districts in the Northern region, comprising a mixed urban and rural population of about 2.8 million. PARTICIPANTS--760 Consultants in 28 specialties and 1666 general practitioners who were eligible to perform or request domiciliary consultations. MAIN OUTCOME MEASURES--Numbers of domiciliary consultations, general practitioners9 requests for consultations, and consultants performing consultations and expenditure on the service by the region. RESULTS--Use of the domiciliary consultation service in the Northern region declined by 53% between 1984-5 and 1988-9, considerably in excess of the national rate of decline of 27%, and expenditure on the service was reduced, after allowing for inflation, by 604,000 pounds, or 38%, in real terms. Most consultants and general practitioners used the service sparingly whereas a small proportion used it heavily; a few specific consultants and general practitioners were responsible for a relatively high rate of domiciliary consultations. Contrary to the original definition of domiciliary consultation, the general practitioner accompanied the consultant on only one occasion in 17 and, in one specialty examined (paediatrics) patients who received domiciliary consultations seemed to have minor medical problems. CONCLUSIONS--Peer review examination of the pattern of practice in the domiciliary consultation service proved effective in rationalising use of the service, although a substantial minority of consultants and general practitioners continued to use the service heavily. The place of the service in modern clinical practice would benefit from a national review.
Anorexia nervosa in a 70 year old man
Authors: N Nagaratnam, D F Ghougassian
Journal: BMJ (1988)

This was confirmed when he was no longer exposed to the chemical and his symptoms improved.People susceptible to malignant hyperthermia can lead a normal life provided that they take certain precautions, which include avoiding inappropriate anaesthetic agents and neuroleptic drugs and not taking severe exercise in hot conditions.Avoiding occupational exposure to halogenated hydrocarbons such as bromochlorodifluoromethane should be added to the list as these may cause rhabdomyolysis.
Relationship between serial measurements of N-terminal pro-brain natriuretic peptide and ambulatory cardiac filling pressures in outpatients with heart failure
Authors: Frieder Braunschweig, Astrid Fahrleitner, Stefano Ghio, Maurizio Mangiavacchi, Parwis Fotuhi, Uta C. Hoppe, Cecila Linde
Journal: Journal of the American College of Cardiology (2003)
Effects of Doxorubicin on Excitation-Contraction Coupling in Guinea Pig Ventricular Myocardium
Authors: Yong-Xiao Wang, Michael Korth
Journal: Circulation Research (1995)

Abstract Doxorubicin, an anticancer drug, was recently shown to release Ca 2+ from cardiac sarcoplasmic reticulum (SR) by increasing the open probability of Ca 2+ release channels. In the present study, we investigated the effects of doxorubicin on excitation-contraction coupling of guinea pig heart preparations. In papillary muscles contracting at 0.5 Hz, 100 μmol/L doxorubicin produced within 3 hours the following effects: it increased the force of contraction by 269.3±19.8% (n=6) and prolonged the time to peak force by 75.1±8.7% (n=6), relaxation time by 54.7±8.7% (n=6), and action potential duration (APD) at 90% repolarization (APD 90 ) by 38.6±2.9% (n=3). Despite its positive inotropic effect, doxorubicin depressed the early contraction component by increasing the latency between stimulus and the onset of force development. In single myocytes, 100 μmol/L doxorubicin prolonged APD 90 by 62.1% (n=18) and blocked time-dependent delayed rectifier K + current (I K ) by 44% (n=9). Ca 2+ inward current and inward rectifier K + current were not affected by doxorubicin. Ca 2+ transients elicited in myocytes loaded with the fluorescent Ca 2+ indicator fura 2 were strongly suppressed by doxorubicin in their initial rising phase. Thereafter, doxorubicin produced a delayed rise in intracellular Ca 2+ , which reached a late peak exceeding that of the control peak by 52±8% (n=5). The results suggest that doxorubicin decreases Ca 2+ -induced Ca 2+ release from cardiac SR, probably by increasing the SR Ca 2+ leak. On the other hand, prolongation of APD due to inhibition of I K allows more Ca 2+ to enter the cell. After being only temporarily buffered by the SR, Ca 2+ may accumulate in the cytosol as long as depolarization is maintained and lead to a more complete activation of contractile proteins.
A1.53 A novel pro-inflammatory B cell population in the rheumatoid synovium can be identified by expression of FCRL4
Authors: L Yeo, H Lom, M Juarez, C Buckley, A Filer, K Raza, D Scheel-Toellner
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background and Objectives</h3> The importance of B cells in the pathogenesis of rheumatoid arthritis (RA) is highlighted by the clinical effectiveness of rituximab. Potential mechanisms for B cells in driving disease processes include autoantibody production, antigen presentation and cytokine secretion. Our recent findings suggest a pro-inflammatory and destructive role for B cells via production of RANKL, TNF-α and IL-6. A memory B cell subset in tonsils which expresses Fc receptor-like 4 (FcRL4) has previously been found to produce RANKL. We sought to determine whether the RANKL-expressing B cells present in the RA synovium belong to this subset. Methods: Synovial fluid and peripheral blood cells from RA patients were analysed for B cell differentiation markers by flow cytometry. Synovial tissue samples from RA patients were assessed using immunofluorescence and immunohistochemistry. FcRL4 mRNA expression was determined in synovial samples from RA patients and uninflamed control subjects by real-time PCR. FcRL4+ and FcRL4- CD19<sup>+</sup> B cells were sorted from synovial fluid using a MoFlo cell sorter. mRNA expression of 48 cytokines was determined using Taqman microfluidic cards. <h3>Results</h3> FcRL4 expressing B cells were detected in the synovial fluid (median 14% of B cells) at a significantly higher frequency compared to peripheral blood (median 0.04%; p = 0.004). RANKL was significantly enriched in the FcRL4+ B cell population compared to the FcRL4- population. FcRL4+ B cells were predominantly switched memory B cells, expressing significantly higher levels of CD80, CD86, CD95, CD20 and CD11c than FcRL4- cells. Sorted FcRL4+ B cells expressed significantly higher mRNA levels of RANKL and TNF-α than FcRL4- B cells. FcRL4+ B cells expressing RANKL were present in synovial tissue, and were distributed under the synovial lining layer and in perivascular cuffs. FcRL4 mRNA was detected in synovium from RA patients but not uninflamed controls, and FcRL4 expression in RA synovium correlated positively with the degree of leukocyte infiltration. <h3>Conclusions</h3> We have identified a novel pro-inflammatory subset of B cells in the RA synovium which expresses RANKL and TNF-α and shows considerable expression of co-stimulatory molecules indicating a potential pathogenic role in RA. As these cells express high levels of CD20 it is conceivable that their removal contributes to the anti-inflammatory clinical effect of rituximab.
The Poor Quality of Early Evaluations of MRI-Reply
Authors: Samuel B. Sheps
Journal: JAMA (1988)

In Reply.—  Dr Baum suggests that the criticism of early studies of MRI recently published by Cooper et al 1 was biased as a result of reviewing early investigations that were, in his view, primarily concerned with technical aspects of this diagnostic modality. While I shall let Cooper et al address the issues of sample selection specifically, I note that my editorial comment that the proliferation of MRI in the early 1980s was based on descriptive rather than evaluative research seems to be confirmed by Dr Baum. My concern regarding this state of affairs, given the cost of MRI, remains. Moreover, I recognize that the stages identified by Dr Baum exist and I reiterate his point that only after a consensus has been reached on stages 1 through 4 (what I would term the technological and clinical calibration stages ) can one address the issue of clinical effectiveness. Similarly, however, the
A Two-Dimensional Ballistocardiographic Study of the Relation of Body Size to Ballistic Amplitude in Children
Authors: GWENDOLYN L. MORRIS, MELVILLE I. SINGER
Journal: Circulation (1956)

Simultaneous longitudinal and transverse ballistocardiograms were obtained from 20 normal boys and 20 normal girls ranging in age from 4 to 15 years. A highly significant correlation was found to exist between body surface area and the basal mean IJ amplitude.
Critical Role for Stromal Interaction Molecule 1 in Cardiac Hypertrophy
Authors: Jean-Sébastien Hulot, Jérémy Fauconnier, Deepak Ramanujam, Antoine Chaanine, Fleur Aubart, Yassine Sassi, Sabine Merkle, Olivier Cazorla, Aude Ouillé, Morgan Dupuis, Lahouaria Hadri, Dongtak Jeong, Silke Mühlstedt, Joachim Schmitt, Attila Braun, Ludovic Bénard, Youakim Saliba, Bernhard Laggerbauer, Bernhard Nieswandt, Alain Lacampagne, Roger J. Hajjar, Anne-Marie Lompré, Stefan Engelhardt
Journal: Circulation (2011)

Cardiomyocytes use Ca2+ not only in excitation-contraction coupling but also as a signaling molecule promoting, for example, cardiac hypertrophy. It is largely unclear how Ca2+ triggers signaling in cardiomyocytes in the presence of the rapid and large Ca2+ fluctuations that occur during excitation-contraction coupling. A potential route is store-operated Ca2+ entry, a drug-inducible mechanism for Ca2+ signaling that requires stromal interaction molecule 1 (STIM1). Store-operated Ca2+ entry can also be induced in cardiomyocytes, which prompted us to study STIM1-dependent Ca2+ entry with respect to cardiac hypertrophy in vitro and in vivo.Consistent with earlier reports, we found drug-inducible store-operated Ca2+ entry in neonatal rat cardiomyocytes, which was dependent on STIM1. Although this STIM1-dependent, drug-inducible store-operated Ca2+ entry was only marginal in adult cardiomyocytes isolated from control hearts, it increased significantly in cardiomyocytes isolated from adult rats that had developed compensated cardiac hypertrophy after abdominal aortic banding. Moreover, we detected an inwardly rectifying current in hypertrophic cardiomyocytes that occurs under native conditions (i.e., in the absence of drug-induced store depletion) and is dependent on STIM1. By manipulating its expression, we found STIM1 to be both sufficient and necessary for cardiomyocyte hypertrophy in vitro and in the adult heart in vivo. Stim1 silencing by adeno-associated viruses of serotype 9-mediated gene transfer protected rats from pressure overload-induced cardiac hypertrophy.By controlling a previously unrecognized sarcolemmal current, STIM1 promotes cardiac hypertrophy.
Nonleg Venous Thrombosis in Critically Ill Adults
Authors: Lana A. Castellucci, Philip S. Wells, Lisa Duffett
Journal: JAMA (2015)

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
The Epistolary Itch
Authors: F. J. Ingelfinger
Journal: New England Journal of Medicine (1977)

Ideally, words gracing the Journal's pages, whether crystal clear or obfuscatory, are inspired by lofty motives and resolute commitment. The facts, however, are that annoyance has been to a large degree responsible for what is probably the Journal's most widely read department. I refer to Correspondence.Letters to the editor, like the animal kingdom, can be divided along taxonomic lines. About a third belong to the family of auto-inspired communication; their subject matter is unrelated to any specific item previously printed in the Journal. The remaining two thirds consist of responses elicited by the language or ideas appearing in . . .
Abstract 4745: TLR8 agonist and Doxil chemotherapy potently activate human antitumor immune response in a human immune system mouse model
Authors: Andrea Facciabene, Alexander Malykhin, Maura Mathews, Chungyun Fang, Greg Dietsch, Rob Hershberg, George Coukos
Journal: Cancer Research (2011)

Abstract Because of differences between mouse and human immune systems, many of the effects of immunomodulatory drugs cannot be fully studied in syngeneic mouse models. We thus generated a novel tumor-bearing mouse model with human immune system (HIS) to study interactions between chemotherapy and immune modulatory therapy. We tested the individual effects and the interactions between doxorubicin, a drug which induces immunogenic tumor cell death and activates antigen-presenting cells, and VTX-2337, a novel small-molecule TLR8 agonist, which induces potent activation and type 1 polarization of human myeloid DCs but is inactive on murine leukocytes. Nod/SCID/ILRγc knock out (NSG) mice were inoculated with human CD34+ cord blood cells from HLA-A2+ human donors; transplanted s.c. with human HLA-A2+ OVCAR5 ovarian cancer tumors; and treated with pegylated liposomal doxorubicin (Doxil); VTX-2337; or a combination. NSG-HIS mice exhibited a full human hematopoietic system, including human monocytes, macrophages and plasmacytoid and myeloid DCs as well as T and B cell subsets. In NSG-HIS mice, VTX-2337 induced dose-dependent activation of human Monocytes CD14+ and CD11c+ cells with upregulation of CD80, CD86, CD83, CD40 and MHCII within 6 hrs. Transient, dose-dependent upregulation of human Th1 cytokines but also IL-10 was observed in the plasma of treated mice, reaching peaks within 6 hrs and subsiding within 24 hrs. Doxil induced mild activation of CD11c+ DCs and mild upregulation of Th1 cytokines. The combination of two drugs induced potent activation of CD11c+ DCs and marked increase in Th1 cytokines with significant decrease of IL-10. HLA-A2+ OVCAR5 tumors were successfully engrafted, exhibiting infiltration by human leukocytes. VTX-2337 and Doxil treatment independently induced tumor-infiltrating lymphocytes and restricted growth of human ovarian tumor xenografts in a dose-dependent manner, while the combination of the two drugs induced the highest frequency of Leukocytes (hCD45) and potently restricted growth of ovarian tumors. Combined activation of innate and adaptive immunity by VTX-2337 and Doxil, as well sensitization of tumor cells by Doxil to adaptive and innate immune effector mechanisms was at the basis of the observed interactions suppressing tumor growth. We conclude that the NSG-HIS provided a suitable tool to establish potent interactions between TLR8 agonist and Doxil chemotherapy, which warrant clinical testing. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4745. doi:10.1158/1538-7445.AM2011-4745
Correction: Migrating Ovaries: Early Life Influences on Later Gonadal Function
Authors: Peter D Gluckman, Alan S Beedle
Journal: PLoS Medicine (2007)

In PLoS Medicine, volume 4, issue 5, doi:10.1371/journal.pmed.0040190:

Reference 22 was truncated. The full reference should be:

22. Barker DJ, Osmond C, Forsen TJ, Kajantie E, Eriksson JG (2005) Trajectories of growth among children who have coronary events as adults. N Engl J Med 353: 1802–1809.
On the Art of Making References
Authors: J. B. Bailey
Journal: BMJ (1895)

THB advice given by the venerable President of to Mr. Burgon, " always verify your references;" good necessary though it is, does not in the present day to the root of the matter.Before the references can fied they must be quoted, and here is the pitfall into so many authors stumble.The greatly increased number journals makes exact references more necessary than By pointing out some of the more common errors a little gress may perhaps be made towards getting .uniformity
Serum Proteolytic Enzyme Activity in Pancreatic Disease
Authors: Martin H. Floch, Victor W. Groisser
Journal: New England Journal of Medicine (1960)

RECENT reports have stressed the diagnostic value of measuring serum proteolytic activity in patients with pancreatitis and pancreatic carcinoma.1 2 3 4 Nardi,1 utilizing a synthetic substrate, benzoyl-l-arginine amide hydrochloride, observed an increase in serum proteolytic activity. This was initially considered due to an elevation of serum trypsin.1 , 2 Brown4 confirmed the finding of increased proteolytic enzyme activity in pancreatic disease by measuring the hydrolysis of a similar synthetic substrate, benzoy l-l-arginine ethyl-ester hydrochloride. He chose to describe this as arginine exopeptidase, noting that it represented nonspecific arginine-ester hydrolysis and not merely trypsin activity.This report concerns our observations of serum proteolytic activity in . . .
Immunosuppressive drugs in ulcerative colitis: twisting facts to suit theories?
Authors: B E Sands
Journal: Gut (2006)

Immunosuppressive drugs have become a mainstay of therapy for the inflammatory bowel diseases. Although robust evidence exists in support of the use of these drugs in Crohn's disease, a close evaluation of the available data in ulcerative colitis reveals a much weaker evidence base. In particular, randomised controlled trials of azathioprine, the most commonly used immunosuppressive agent, do not provide rich evidence of efficacy whereas observational cohorts suggest this agent is effective, particularly in patients with relapsing disease who require corticosteroids. Ciclosporin is also effective in the most refractory cases but its efficacy needs to be carefully weighed against the possibility of rare but life threatening complications. Although the evidence base in support of immunosuppressive drugs in ulcerative colitis is not as strong as in Crohn's disease, these agents clearly have a role in the treatment of this disease.
Immunoblotting detection of so-called 'antikeratin antibodies': a new assay for the diagnosis of rheumatoid arthritis.
Authors: V Gomes-Daudrix, M Sebbag, E Girbal, C Vincent, M Simon, J Rakotoarivony, M Abbal, B Fournie, G Serre
Journal: Annals of the Rheumatic Diseases (1994)

OBJECTIVES--To assess the diagnostic value for rheumatoid arthritis (RA), of an immunoblotting assay based on the rat oesophagus epithelium antigens recognised by the so-called 9antikeratin antibodies9 (9AKA9), antigens that have been identified as three non-cytokeratin proteins (referred to as A, B and C proteins). METHODS--After polyacrylamide gel electrophoresis in non-denaturing conditions and electrotransfer of an epithelial extract, the immunoreactivities to the A, B and C proteins of a series of serum samples from 88 patients with RA and 100 patients with non-rheumatoid rheumatic diseases, were semiquantitatively evaluated. RESULTS--A total of 81.8% of RA serum samples recognised the three proteins, while 91% of non-RA serum samples only weakly recognised the A and B proteins but not the C protein. Only in the group of RA patients, were the titres of the antibodies to the A, B and C proteins found to be significantly correlated with each other and with the titres of 9AKA9 detected by the standard indirect immunofluorescence (IIF) method. For a diagnostic specificity of 99%, the diagnostic sensitivities of the detection of the A and B proteins were 50% and 43.2%, respectively, when those of the detection of 9AKA9 by IIF and of IgM-rheumatoid factor by enzyme-linked immunosorbent assay were 42% and 54%, respectively. In contrast, at a same specificity of 99%, the diagnostic sensitivity of the detection of the C protein was significantly higher with a value of 70.5%. CONCLUSION--This immunoblotting assay which is the first immunochemical method proposed for the detection of 9AKA, should be validated on larger series of patients but can already be considered as a very powerful test for the serological diagnosis of RA.
Tuberculosis contact tracing: are the British Thoracic Society guidelines still appropriate?
Authors: S F Hussain, R Watura, B Cashman, I A Campbell, M R Evans
Journal: Thorax (1992)

The value of contact tracing in South Glamorgan for the period May 1987 to December 1989 was assessed. Tuberculosis was diagnosed in six (3.5%) of 170 close contacts. All were young and were detected in the initial screening. Tuberculosis was not found among 441 casual contacts. The value of follow up of contacts after the initial screening and of screening casual contacts in districts with a low prevalence of tuberculosis is questioned.
Gonadal Peptides as Mediators of Development and Functional Control of the Testis: An Integrated System with Hormones and Local Environment*
Authors: Lucio Gnessi, Andrea Fabbri, Giovanni Spera
Journal: Endocrine Reviews (1997)

Introduction II.Neurohormones/Neuropeptides A. GH-releasing hormone (GHRH) B. Pituitary adenylate cyclase-activating peptide (PACAP) C. GnRH D. CRH E. Oxytocin (OT) F. Arginine vasopressin (AVP)
Obamacare to save US hospitals $5.7bn in 2014
Authors: M. McCarthy
Journal: BMJ (2014)

US hospitals are projected to save $5.7bn (£3.5bn; €4.5bn) in uncompensated care costs in 2014 because of the increased number of patients who have obtained health insurance through the Affordable Care Act, shows an analysis by the Department of Health and Human Services.1

Three quarters (74%) of the …
<i>Staphylococcus aureus</i>Bacteremia — Consider the Source
Authors: Gordon L. Archer, Michael W. Climo
Journal: New England Journal of Medicine (2001)

When it enters the blood, Staphylococcus aureus is one of the most lethal human pathogens. In 1941, Skinner and Keefer reported that 82 percent of 122 patients treated at Boston City Hospital for S. aureus bacteremia died of their infection.1 From 1990 to 1995, according to the National Nosocomial Infection Surveillance system of the Centers for Disease Control and Prevention (CDC), 16 percent of hospital-acquired cases of bacteremia in the United States were due to S. aureus, a proportion second only to that involving coagulase-negative staphylococci.2 Because of the availability of effective antibacterial therapy, mortality from S. aureus bacteremia is . . .