tbuckley/cabot-search huggingface dataset:
A9.5 ARE arthroscopic guided synovial biopsies still relevant in rheumatology practice?
Authors: E Vieira-Sousa, L Narciso, F Saraiva, J A Pereira da Silva, J E Fonseca
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Synovial biopsies have been collected by rheumatologists for several decades using arthroscopic guidance with the additional advantages of joint visualization and lavage. We aim to analyse the outcomes of the first 20 knee arthroscopic guided synovial biopsies (AGB) recently performed at our centre for diagnosis and (non-orthopedic) therapeutic purposes. <h3>Methods</h3> AGB were performed according to standardised procedures. Nineteen were done for diagnostic purposes to patients with knee arthritis of unknown etiology, after application of a clinical algorithm. The remaining patient had a therapeutic indication. A macroscopic scoring for vascularization and proliferation was applied and synovial tissue processed for routine histology and microbiology assessment. <h3>Results</h3> 20 patients were submitted to AGB. Eight had a previous diagnosis of inflammatory arthritis: RA (2), JIA (2), PsA (3) and SLE (1). In all cases, patients were in joint remission with the exception of knee arthritis, raising the suspicion of undercurrent septic arthritis AGB allowed the exclusion of joint infection in 7 of 8 patients and septic arthritis was the established diagnosis in one case. This favoured rapid systemic therapeutic adjustment and/or intra-articular corticosteroids administration to induce remission, in non-infectious cases. In a PsA DMARD treated patient, direct visualization of crystal deposits on synovial membrane supported the diagnosis of concomitant crystal induced arthritis. The remaining patients had no previous rheumatic disease and presented with monoarthritis (7) or oligoarthritis (5) of unknown etiology. Considering the monoarthritis group, <i>Mycobacterium tuberculosis</i> was isolated in two patients. For the remaining five, infection was excluded and a definite diagnosis of osteoarthritis (1), crystal induced arthritis (3) and psoriatic arthritis (1) was established. In the oligoarthritis group, neither synovial membrane macroscopic, histology nor microbiology analysis helped to clarify the diagnosis. <h3>Conclusions</h3> In inflammatory arthritis, persistent synovitis of a single joint can be a red flag for joint infection, however, in this small series, the majority of patients exhibited uncontrolled disease activity rather than septic arthritis. The rate of joint tuberculosis was particularly high (10%) highlighting its endemic occurrence in Portugal and awareness for this etiology. The visualization of crystal deposits can be a complementary diagnostic tool in patients with crystal induced arthritis in which crystals are not identified in the synovial fluid. Despite application of commonly available synovial tissue study strategies (macroscopy, histology and microbiology) in 25% of patients it was not possible to establish a definite diagnosis indicating that further synovial tissue biomarkers for inflammatory arthritis diagnosis are required.
Impaired vasodilation of forearm resistance vessels in hypercholesterolemic humans.
Authors: M A Creager, J P Cooke, M E Mendelsohn, S J Gallagher, S M Coleman, J Loscalzo, V J Dzau
Journal: Journal of Clinical Investigation (1990)

The effect of hypercholesterolemia on vascular function was studied in humans. To eliminate the potential confounding effects of atherosclerosis, vascular reactivity was measured in the forearm resistance vessels of 11 normal subjects (serum LDL cholesterol = 111 +/- 7 mg/dl) and 13 patients with hypercholesterolemia (serum LDL cholesterol = 211 +/- 19 mg/dl, P less than 0.05). Each subject received intrabrachial artery infusions of methacholine, which releases endothelium-derived relaxant factor, and nitroprusside which directly stimulates guanylate cyclase in vascular smooth muscle. Maximal vasodilatory potential was determined during reactive hyperemia. Vasoconstrictive responsiveness was examined during intra-arterial phenylephrine infusion. Forearm blood flow was determined by venous occlusion plethysmography. Basal forearm blood flow in normal and hypercholesterolemic subjects was comparable. Similarly, reactive hyperemic blood flow did not differ between the two groups. In contrast, the maximal forearm blood flow response to methacholine in hypercholesterolemic subjects was less than that observed in normal subjects. In addition, the forearm blood flow response to nitroprusside was less in hypercholesterolemic subjects. There was no difference in the forearm vasoconstrictive response to phenylephrine in the two groups. Thus, the vasodilator responses to methacholine and nitroprusside were blunted in patients with hypercholesterolemia. We conclude that in humans with hypercholesterolemia, there is a decreased effect of nitrovasodilators, including endothelium-derived relaxing factor, on the vascular smooth muscle of resistance vessels.
Violence and Abuse Issues: Cross-Cultural Perspectives for Health and Social Services
Authors: Carl C. Bell
Journal: JAMA (2010)

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
Aberrant expression of T‐cell‐associated markers CD4 and CD7 on B‐cell chronic lymphocytic leukemia
Authors: Prashant Jani, Xiao Ying Qi, Hong Chang
Journal: American Journal of Hematology (2006)

Abstract By multiparameter flow cytometry, the T‐cell‐associated markers CD4 and CD7 were aberrantly coexpressed on a case of B‐cell chronic lymphocytic leukemia (CLL). The CLL had an immunophenotype: CD19+, CD20+, CD79b+, CD5+, CD23+, FMC7+, kappa+, CD4+, and CD7+. Molecular analysis confirmed clonal rearrangement of the immunoglobin heavy chain genes and a germline configuration of the T‐cell receptor genes. Fluorescence in situ hybridization showed trisomy 12 anomaly. There was no evidence of deletion 17p (p53), 11q23 (ATM), or 13q14 or translocation t(11:14). The patent was clinically stable without treatment. Although the pathogenesis of such aberrant immunophenotype remains to be determined, the current case illustrates the phenotypic heterogeneity of CLL, and emphasizes the importance of a comprehensive diagnostic approach including clinical, morphologic, immunophenotypic, and molecular cytogenetic studies. Am. J. Hematol. 2006. © Wiley‐Liss, Inc.
Contact allergy is unlikely to mimic basal cell carcinoma
Authors: F. M Chapman, B. Leatherbarrow, M. H Beck, N. R Telfer
Journal: BMJ (1999)

EDITOR—Hogg reported a textbook example of a basal cell carcinoma in which biopsy was non-diagnostic.1 The lesion apparently resolved after potent topical steroids were given based on a diagnosis of “sensitivity to PPD, a component of hair dye.”

We regularly deal with both periorbital tumours and allergic …
Effects of GDNF‐Loaded Injectable Gelatin‐Based Hydrogels on Endogenous Neural Progenitor Cell Migration
Authors: Deniece Fon, Aswan Al‐Abboodi, Peggy P. Y. Chan, Kun Zhou, Peter Crack, David I. Finkelstein, John S. Forsythe
Journal: Advanced Healthcare Materials (2014)

Brain repair following disease and injury is very limited due to difficulties in recruiting and mobilizing stem cells towards the lesion. More importantly, there is a lack of structural and trophic support to maintain viability of the limited stem/progenitor cells present. This study investigates the effectiveness of an injectable gelatin-based hydrogel in attracting neural progenitor cells (NPCs) from the subventricular zone (SVZ) towards the implant. Glial cell-line-derived neurotrophic factor (GDNF) encapsulated within the hydrogel and porosity within the hydrogel prevents glial scar formation. By directly targeting the hydrogel implant towards the SVZ, neuroblasts can actively migrate towards and along the implant tract. Significantly more doublecortin (DCX)-positive neuroblasts surround implants at 7 d post-implantation (dpi) compared with lesion alone controls, an effect that is enhanced when GDNF is incorporated into the hydrogels. Neuroblasts are not observed at the implant boundary at 21 dpi, indicating that neuroblast migration has halted, and neuroblasts have either matured or have not survived. The development of an injectable gelatin-based hydrogel has significant implications for the treatment of some neurodegenerative diseases and brain injuries. The ability of GDNF and porosity to effectively prevent glial scar formation will allow better integration and interaction between the implant and surrounding neural tissue.
Mortality and Neurologic Injury After Surgical Repair With Hypothermic Circulatory Arrest in Acute and Chronic Proximal Thoracic Aortic Pathology
Authors: Martin Czerny, Eva Krähenbühl, David Reineke, Gottfried Sodeck, Lars Englberger, Alberto Weber, Jürg Schmidli, Alexander Kadner, Gabor Erdoes, Florian Schoenhoff, Hansjörg Jenni, Mario Stalder, Thierry Carrel
Journal: Circulation (2011)

The goal of this study was to determine whether advanced age affects mortality and incidence of neurological injury in patients undergoing surgical repair with hypothermic circulatory arrest in acute and chronic thoracic aortic pathology.A university center audit was done of 523 consecutive patients (median age, 64 years; interquartile range, 56-71 years) between 2005 and 2010. Mortality in acute type A aortic dissection (207 patients) was 9.7%, and in chronic ascending aortic aneurysms (316 patients) was 2.2% (P<0.001). Neurological injury was observed in 16.9% of patients with acute type A aortic dissection (chronic ascending aortic aneurysms, 7.9%; P=0.002). Multivariable regression analysis revealed hypothermic circulatory arrest >40 minutes (odds ratio [OR], 4.21; 95% confidence interval [CI], 1.60-11.06; P=0.004) and redo surgery (OR, 3.44; 95% CI, 1.11-10.64; P=0.03) but not age (OR, 1.98; 95% CI, 0.73-5.38; P=0.18) as independent predictor of mortality. Emergency surgery (OR, 3.27; 95% CI, 1.31-8.15; P=0.01) and extracardiac arteriopathy (OR, 2.38; 95% CI, 1.26-4.50; P=0.008) but not age (OR, 1.80; 95% CI, 0.93-3.48; P=0.08) were independent predictors of neurological injury.Age is not associated with increased risk for mortality and neurological injury in patients undergoing surgical repair for acute and chronic thoracic aortic pathology with hypothermic circulatory arrest. Extended hypothermic circulatory arrest times, reflecting the extent of disease, and redo surgery predict mortality, whereas emergency surgery and extracardiac arteriopathy predict neurological injury.
Open letter: European Medicines Agency should remove barriers to access clinical trial data
Authors: B. Goldacre, F. Godlee, C. Heneghan, D. Tovey, R. Lehman, I. Chalmers, V. Barbour, T. Brown
Journal: BMJ (2014)

In an open letter to Guido Rasi, director of the European Medicines Agency, the AllTrials campaign urges the EMA to revise its trial data policy or risk losing the trust of patients and healthcare professionals
Misdiagnosing the persistent vegetative state
Authors: R. Cranford
Journal: BMJ (1996)

Diagnosing the persistent vegetative state is important and sometimes difficult. Patients who retain some degree of awareness must be recognised if their quality of life is to be maximised and inappropriate withdrawal of tube feeding prevented. On p 13 Keith Andrews and colleagues present a retrospective study of the clinical records of 40 patients admitted over three years to a single unit specialising in the rehabilitation of patients with profound brain damage.1 The authors conclude that 17 of these patients were misdiagnosed. Patients in the persistent vegetative state seem to be awake with their eyes open but show no evidence of awareness, but the 17 misdiagnosed patients were able to communicate consistently using eye pointing or a touch sensitive buzzer. Such an apparently high rate of misdiagnosis raises important concerns about the accuracy of the diagnosis of the vegetative state and related syndromes of severe brain damage.1 It also demands a critical review of the study's methods.

One important question is whether the sample of patients is representative. This …
Resting and Postexercise Apexcardiogram Correlated with Maximal Treadmill Stress Test in Normal Subjects
Authors: WILBERT S. ARONOW, JOHN CASSIDY, RONALD R. UYEYAMA
Journal: Circulation (1971)

Ninety-eight normal subjects, mean age 51 years, who had a maximal treadmill stress test had a satisfactory apexcardiogram at rest and after a double Master's test. The mean resting a-wave ratio was 11.6% in 13 normal subjects with an abnormal maximal treadmill test and 7.8% in 85 normal subjects with a normal treadmill test ( P &lt; 0.001). The mean postexercise a-wave ratio was 19.7% in 13 normal subjects with an abnormal treadmill test and 12.8% in 85 normal subjects with a normal treadmill test ( P &lt; 0.001). Four of 13 normal subjects (31%) with an abnormal treadmill test had a resting a-wave ratio of ≥15% compared with two of 85 normal subjects (2%) who had a normal treadmill test ( P &lt; 0.001). Seven of 13 normal subjects (54%) with an abnormal treadmill test had a postexercise a-wave ratio of ≥20% compared with eight of 85 normal subjects (9%) who had a normal treadmill test ( P &lt; 0.001).
Recurrent Common Bile Duct Stones After Endoscopic Retrograde Cholangioscopic Stone Removal: Is There a Role for Associated Periampullary Diverticulum?
Authors: S. J. Myung, M. H. Kim, D. W. Seo, S. K. Lee
Journal: Endoscopy (1998)

See also: Reply to Myung et al.Endoscopy 1998; 30(09): 872-872DOI: 10.1055/s-2007-1001428 See also: The Role of Surveillance Endoscopic Retrograde Cholangiopancreatography in Preventing Episodic Cholangitis in Patients with Recurrent Common Bile Duct StonesEndoscopy 1998; 30(01): 18-20DOI: 10.1055/s-2007-993722
Skeletal-Muscle Regeneration
Authors: Elizabeth D. Hay
Journal: New England Journal of Medicine (1971)

There has been for many years an almost complete lack of communication between the general pathologist and the experimental morphologist on the question of the ability of skeletal muscle to regenerate. I have consistently taught first-year medical students that the difference between muscle regeneration in the lowly salamander on which I work and the mammal was merely one of degree. This idea, I now realize, was routinely erased during the second year, when the same medical students were told by pathologists that neither skeletal nor cardiac muscle can regenerate in the human. The writing of an editorial on the subject . . .
Effects of amiodarone on refractory myocardial infarction: Experimental study
Authors: Maria I. Anastasiou-Nana, John N. Nanas, Serafim N. Nanas, Ageliki Rapti, Anastasios Poyadjis, Stamatina Stathaki, Spyridon D. Moulopoulos
Journal: Journal of the American College of Cardiology (1994)
Antagonistic Action of Aerosols of Prostaglandins F2 and E2 on Bronchial Muscle Tone in Man
Authors: A. P. Smith, M. F. Cuthbert
Journal: BMJ (1972)

Experiments were carried out in healthy male volunteers to investigate the effect of the inhalation of prostaglandin F<sub>2</sub>α (PGF<sub>2</sub>α) on airways resistance and the influence of the subsequent inhalation of prostaglandin E<sub>2</sub> (PGE<sub>2</sub>). Airways resistance, which reflects the tone of smooth muscle in the larger airways in man, was measured by total body plethysmography. The inhalation of PGF<sub>2</sub>α (40-60 μg) caused an increase in airways resistance in all subjects. Both PGE<sub>2</sub> (55 μg) and isoprenaline (550 μg) given by metered aerosol promptly reversed the bronchoconstriction induced by PGF<sub>2</sub>α, but isoprenaline was more effective in this respect. A role for these prostaglandins in the control of bronchial muscle tone is discussed.
Immunoarchitecture of the bone marrow in neutropenia: Increased HNK‐1 + cells define a subset of neutropenic patients
Authors: Louis J. Picker, Marshall E. Kadin, Annette Furst, Stephen H. Robinson
Journal: American Journal of Hematology (1987)

An immunoperoxidase technique was used to examine the distribution of lymphocyte subsets in bone marrow biopsies of 15 patients with neutropenia and seven non-neutropenic controls. The bone marrow of most patients and controls had similar distributions of immune effector cells characterized by a diffuse array of predominantly cytotoxic/suppressor T-cells and occasional nodular aggregates of helper T-cells. Cells displaying the natural killer cell marker HNK-1 were sparse in controls and most neutropenic patients. However, marked increases in marrow HNK-1 + cells were identified in four of the 15 patients. Three of these patients had diffuse HNK-1 + infiltrates associated with increased Leu 4+ (OKT-3+) T-cells while one had a nodular HNK-1+ infiltrate associated with small B-cell follicles. Each of these patients had clinical features similar to those described in the large granular lymphocyte (LGL) lymphocytosis (leukemia) syndrome, but only one of four demonstrated persistently increased numbers of LGLs in the peripheral blood. Thus, this study extends the association of neutropenia and increased numbers of cells with a T/NK phenotype to include patients whose bone marrow is the only demonstrable site of involvement. Since morphologic examination of the bone marrow could not identify the bone marrows with increased HNK-1+ cells, immunologic techniques are required to detect these cases.
Eye Movement Desensitization and Reprocessing for Posttraumatic Stress Disorder: A Pilot Blinded, Randomized Study of Stimulation Type
Authors: David Servan-Schreiber, Jonathan Schooler, Mary Amanda Dew, Cameron Carter, Patricia Bartone
Journal: Psychotherapy and Psychosomatics (2006)

&lt;i&gt;Background:&lt;/i&gt; Eye movement desensitization and reprocessing (EMDR) is becoming a recognized and accepted form of psychotherapy for posttraumatic stress disorder (PTSD). Yet, its mechanism of action remains unclear and much controversy exists about whether eye movements or other forms of bilateral kinesthetic stimulation contribute to its clinical effects beyond the exposure elements of the procedure. &lt;i&gt;Methods:&lt;/i&gt; Twenty-one patients with single-event PTSD (average Impact of Event Scale score: 49.5) received three consecutive sessions of EMDR with three different types of auditory and kinesthetic stimulation (tones and vibrations): intermittent alternating right-left (as commonly used with the standard EMDR protocol), intermittent simultaneous bilateral, and continuous bilateral. Therapists were blinded to the type of stimulation they delivered, and stimulation type assignment was randomized and counterbalanced. &lt;i&gt;Results:&lt;/i&gt; All three stimulation types resulted in clinically significant reductions of subjective units of distress (SUD). Yet, alternating stimulation resulted in faster reductions of SUD when only sessions starting with a new target memory were considered. &lt;i&gt;Conclusions:&lt;/i&gt; There are clinically significant effects of the EMDR procedure that appear to be independent of the nature of the kinesthetic stimulation used. However, alternating stimulation may confer an additional benefit to the EMDR procedure that deserves attention in future studies.
Antibiotic Therapy of Bacterial Endocarditis
Authors: JOSEPH E. GERACI, WILLIAM J. MARTIN
Journal: Circulation (1953)

Twenty-three patients with endocarditis caused by penicillin-sensitive streptococci have received short-term treatment with penicillin and dihydrostreptomycin, combined, for two weeks. Five of the patients died from complications of their infection; 18 were living and well, at the time of this study, after an average follow-up period of more than one year. No failures in treatment or relapses have occurred. It is concluded from the study of these patients that 1,000,000 units of aqueous procaine penicillin-G and 1 Gm. of dihydrostreptomycin sulfate given intramuscularly every 12 hours for two weeks is curative for this type of endocarditis.
Surgical Diseases of the Chest
Authors: Otto C. Brantigan
Journal: JAMA (1961)

An important, constantly progressing area of surgery has been unusually well covered by a group of authors whose experience allows them to write boldly and with authority. It is experience and boldness that allows the compilation of so much material in so brief a time as to permit the publication of the book before rapidly advancing knowledge in the field makes the work obsolete. There are so many diseases covered by this book that some are inadequately described, and yet a critical analysis indicates that clinical importance has dictated the amount of space allotted to each disease. No fault can be found with what has been written. Chapter 8, "The Mediastinum," and Chapter 13, "Thoracic Aorta and Great Vessels," are so clear, concise, and completely presented that they undoubtedly will remain as classics in their field. The text is easily readable and the illustrations are of a high quality. This
Cross-sectional echocardiographic visualization of the stenotic pulmonary valve.
Authors: A E Weyman, R A Hurwitz, D A Girod, J C Dillon, H Feigenbaum, D Green
Journal: Circulation (1977)

Real-time, cross-sectional echocardiograms of the pulmonary valve were recorded in 22 patients with valvular pulmonary stenosis (VPS) (14 mild, eight moderate or severe) and 25 normal subjects. Normally during systole the pulmonary leaflet echoes moved rapidly apart and in the fully opened position lay parallel and in close apposition to the margins of the pulmonary artery. In 20 of 22 patients with VPS in whom the pulmonary valve was recorded the systolic configuration of the leaflets, opening pattern of the leaflet echoes, and presence of presystolic doming served to differentiate the stenotic valve from normal. In contrast M-mode recordings of the pulmonary valve were possible in only 12 of these 22 cases (seven mild and five moderate or severe) and suggested VPS in only the five cases with moderate or severe stenosis. Cross-sectional echocardiography offers a direct, noninvasive method for visualizing the stenotic pulmonary valve and should be improvement over the indirect M-mode data.