tbuckley/cabot-search huggingface dataset:
Death after flumazenil: Authors' reply
Authors: W. Burr, P. Sandham, A. Judd
Journal: BMJ (1989)

to 1) blockers as the sole agent to treat hypertension associated with diabetes mellitus in black patients.It has been emphasised that the use of angio- tensin converting enzyme inhibitors should be tempered with caution."This is especially so with captopril as the sole agent for treating hypertension associated with diabetic nephropathv in different ethnic groups.
Long-Term Clinical Outcomes of Lyme Disease
Authors: Eric S. Asch
Journal: Annals of Internal Medicine (1995)

Letters15 June 1995Long-Term Clinical Outcomes of Lyme DiseaseEric S. Asch, Danuta I. Bujak, and Arthur WeinsteinEric S. AschSearch for more papers by this author, Danuta I. BujakSearch for more papers by this author, and Arthur WeinsteinSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-12-199506150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The report by Shadick and colleagues [1] confirms data from previous studies and strengthens the concerns of Lyme disease support groups that many patients who receive apparently adequate antibiotic treatment for Lyme disease do not recover completely [1, 2]. We recently described a large cohort of patients (n = 215) who had contracted Lyme disease in the mid-1980s in Westchester County, New York [3]. Although all patients in our larger sample were Lyme-antibody positive, the similarity between our findings and those of Shadick and colleagues are striking. Patients in our study had a relapse rate of 28% ...References1. Shadick NA, Phillips CB, Logigian EL, Steere AC, Kaplan RF, Berardi VP, et al. The long-term clinical outcomes of Lyme disease. A population-based retrospective cohort study. Ann Intern Med. 1994; 121:560-7. Google Scholar2. Dinerman H, Steere AC. Lyme disease associated with fibromyalgia. Ann Intern Med. 1992; 117:281-5. Google Scholar3. Asch ES, Bujak DI, Weiss M, Peterson MG, Weinstein A. Lyme disease: an infectious and postinfectious syndrome. J Rheumatol. 1994; 21:454-61. Google Scholar4. Bujak DI, Dornbush RL, Sabbeth BS, Weinstein A. Fibromyalgia and chronic fatigue syndrome induced by Lyme disease (Abstract). Arthritis Rheum. 1993; 36:S42. Google Scholar5. Bujak DI, Dornbush RL, Weinstein A. Cognitive and behavioral changes induced by Lyme disease (Abstract). Arthritis Rheum. 1994; 37:S160. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBorréliose de Lyme et neuroborrélioseBorreliosi di Lyme e neuroborreliosi 15 June 1995Volume 122, Issue 12Page: 960-962KeywordsAntibioticsChronic fatigue syndromeCohort studiesErythemaFatigueFibromyalgiaLyme diseaseMemoryPathogenesisPsychometrics ePublished: 15 August 2000 Issue Published: 15 June 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Credo for creeping paralysis
Authors: P. L. Rabin
Journal: JAMA (1983)

THREE years ago my husband developed the initial symptoms of amyotrophic lateral sclerosis (ALS). The diagnosis was determined clinically and unequivocally confirmed by electromyography. We were devastated by the diagnosis. Since we are both physicians, the full implications were immediately realized. The course that the illness followed was straight out of a textbook. Stiffness of the legs was followed by weakness. Footdrop developed first on the left, then on the right, and thereafter the disease process progressed inexorably to paralysis of the lower limbs. Weakness of the hands led quickly to global wasting of the small muscles and loss of function of the upper limbs. The paralysis extended more proximally, resulting in total quadraplegia. Bulbar symptoms followed with wasting of the tongue, dysarthria, dysphonia, and dysphagia. The most common response I have had from physicians who discussed the illness with me left me shocked and confused. A neurologist said, "It's
Post-operative Infection in a Casualty Department
Authors: J. McK. Buchanan, M. P. Curwen, R. A. Shooter, R. G. White
Journal: BMJ (1961)

A NEW STERNAL REFLEX MEDICALJOURNAL could abolish decerebrate rigidity by interrupting the connex.ons of thskin receptors.Responses evoked by sternal stimuli cannot be elicited from any other area of the skin, which suggests that sensory receptors in the midline of the sternal area play a special part in the elicitation of decerebrate responses. SummaryA new sternal reflex, elicitable in states of organic cerebral damage with somnolence or coma, is describ2d.The special susceptibility of the sternal region, due to ontogenetic and phylogenetic factors, is discussed.Pain stimuli applied to the manubrial area evoke defence reactions (motor and autonomic) which are impaired or absent on the sid, of tne paresis or paralysis.In lesions affecting the brain-stem decerebrate reactions are observed.Brief illustrative case histories are given.
Cardiac Tamponade with Anticoagulant Treatment of Myocardial Infarction
Authors: Jack Dickerson
Journal: JAMA (1960)

A case of hemopericardium producing cardiac tamponade is reported. The patient, a 50-year-old man, was hospitalized and treated with anticoagulants after a myocardial infarction. On the 19th day after the infarction the symptoms of acute cardiac tamponade were recognized. Medication with bishydroxycoumarin was discontinued and phytonadione administered. Symptoms of cardiac tamponade were relieved by pericardicentesis. The possibility of hemopericardium and cardiac tamponade is pertinent in cases of myocardial infarction.
Evidence and rhetoric about access to UK primary care
Authors: T. E. Cowling, M. J. Harris, A. Majeed
Journal: BMJ (2015)

As the general election in the UK approaches and NHS policies are set to take centre stage, <b>Thomas E Cowling</b>, <b>Matthew J Harris</b>, and <b>Azeem Majeed</b> discuss the evidence, uncertainty, and debate behind access to primary care
The Safety of Di(2-ethylhexyl) Phthalate in Patients Receiving Hemodialysis Treatment
Authors: A. P. Lundin
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Since 1940, di(2-ethylhexyl) phthalate (DEHP) has been used to make plastic materials pliable. Several years ago, DEHP was found to be carcinogenic in animals.<sup>1</sup>It is thought to be particularly hazardous for infants, who might absorb this chemical from pacifiers, teething rings, and plastic squeeze toys. Di(2-ethylhexyl) phthalate is also present in flexible containers used for parenteral solutions and blood transfusions and in dialysis blood tubing.<sup>2</sup>Its use in testing respirators for leaks is cause for additional concern. Besides causing liver cancer, DEHP has been shown to cause chronic liver damage in monkeys in doses lower than those received by patients being treated with hemodialysis, as well as causing testicular damage, birth defects, and embryonic death in rodents.<sup>3</sup>Drug metabolism by the liver is altered in rats given DEHP.<sup>4</sup>Up to 1 million pounds are being produced yearly, and it has entered the
Risk of lymphoma in patients with RA treated with anti-TNF agents
Authors: J P Franklin
Journal: Annals of the Rheumatic Diseases (2005)

Does anti-TNFα treatment increase lymphoma risk independently of disease severity?

Tumour necrosis factor (TNF)α, is a proinflammatory cytokine central to the pathogenesis of rheumatoid arthritis (RA). Drugs that block the action of this cytokine have been shown to be effective in reducing inflammation and slowing disease progression in patients with RA.1,2 TNFα also provides an essential immune function by promoting a cytotoxic response from T cells against B cell lymphomas.3,4 This raises a theoretical concern that agents blocking TNFα may contribute to an increased risk of such lymphomas, emphasising the need for long term safety surveillance of these drugs. These phenomena need to be considered against the background that the occurrence of lymphoma in patients with RA might be associated with disease activity or severity. If this were so, given the effectiveness of anti-TNFα agents, it is possible that their use may actually reduce lymphoma risk, or at least counteract any possible increase.

There is good evidence that the risk of lymphoma is related to RA severity. Baecklund and colleagues showed, using a nested case-control study of patients with RA with lymphoma, that inflammatory activity was strongly associated with the risk of developing lymphoma. This association persisted even after adjusting for differences in treatment exposure between groups.5 Overall, those patients classified as having “high inflammatory activity” were 25 times more likely to be diagnosed with lymphoma than those with “low inflammatory activity”. Wolfe published similar data showing a relationship between a high erythrocyte sedimentation rate and the risk of lymphoma.6 Thus, any interpretation of …
Critical roles for IL-4, IL-5, and eosinophils in chronic skin allograft rejection
Authors: Alain Le Moine, Véronique Flamand, François-Xavier Demoor, Jean-Christophe Noël, Murielle Surquin, Robert Kiss, Marie-Anne Nahori, Marina Pretolani, Michel Goldman, Daniel Abramowicz
Journal: Journal of Clinical Investigation (1999)

C57BL/6 mice injected with the 145-2C11 anti-CD3 mAb and grafted with MHC class II disparate bm12 skin develop a chronic rejection characterized by interstitial dermal fibrosis, a marked eosinophil infiltrate, and an obliterative intimal vasculopathy. Because these changes occur in the absence of alloreactive antibodies, we examined the contribution of cytokines in their pathogenesis. Chronically rejected grafts showed a marked accumulation of both IL-4 and IL-5 mRNA. Mixed lymphocyte reaction experiments established that mice undergoing chronic rejection were primed for IL-4, IL-5, and IL-10 secretion. In vivo administration of anti–IL-4 mAb completely prevented allograft vasculopathy as well as graft eosinophil infiltration and dermal fibrosis. Injection of anti–IL-5 mAb or the use of IL-5–deficient mice as recipients also resulted in the lack of eosinophil infiltration or dermal fibrosis, but these mice did develop allograft vasculopathy. Administration of anti–IL-10 mAb did not influence any histologic parameter of chronic rejection. Thus, in this model, IL-4– and IL-5–mediated tissue allograft eosinophil infiltration is associated with interstitial fibrosis. IL-4, but not eosinophils, is also required for the development of obliterative graft arteriolopathy.
Development and preselection of criteria for short term improvement after anti-TNF treatment in ankylosing spondylitis
Authors: J Brandt
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objective:</b> To develop and compare candidate improvement criteria for anti-TNFα treatment in ankylosing spondylitis with optimal discriminating capacity between treatment and placebo. <b>Methods:</b> Data from two randomised controlled trials which included 99 patients treated with infliximab or etanercept were used to evaluate 50 candidate improvement criteria. These were developed on the basis of pain, patient’s global assessment, function, morning stiffness, spinal mobility, and C reactive protein. Different levels of improvement in each domain (20–60%) were used to define Boolean type criteria. These criteria were compared with different percentages of improvement on the BASDAI and with modified ASAS improvement criteria. Bootstrap methods were applied to calculate 95% confidence intervals (CI) of the χ<sup>2</sup> test values to select the best candidate improvement criteria. <b>Results:</b> The best performing improvement criteria were “20% improvement in five of six domains” (χ<sup>2</sup> = 31.9 (95% CI, 18.0 to 46.9)) with a low placebo response of 2.9% and a high response to infliximab of 67.7%; and “ASAS 40% improvement” (χ<sup>2</sup> = 26.5 (13.3 to 41.1)), with response to placebo of 5.7% and response to infliximab of 64.7%. The good discriminating capacity of the two improvement criteria was confirmed by the combined dataset of the infliximab and etanercept trial. <b>Conclusions:</b> The “five of six” improvement criterion has the advantage of including the objective domains <i>spinal mobility</i> and <i>acute phase reactants</i>, but requires only 20% improvement. The ASAS 40% improvement criterion has the advantage of setting a high threshold, but only in patient reported outcomes. The choice between these improvement criteria needs to be based on further validation from upcoming trials.
T Cell Development in Mice Lacking All T Cell Receptor ζ Family Members (ζ, η, and FcεRIγ)
Authors: Elizabeth W. Shores, Masao Ono, Tsutomo Kawabe, Connie L. Sommers, Tom Tran, Kin Lui, Mark C. Udey, Jeffrey Ravetch, Paul E. Love
Journal: The Journal of Experimental Medicine (1998)

The ζ family includes ζ, η, and FcεRIγ (Fcγ). Dimers of the ζ family proteins function as signal transducing subunits of the T cell antigen receptor (TCR), the pre-TCR, and a subset of Fc receptors. In mice lacking ζ/η chains, T cell development is impaired, yet low numbers of CD4+ and CD8+ T cells develop. This finding suggests either that pre-TCR and TCR complexes lacking a ζ family dimer can promote T cell maturation, or that in the absence of ζ/η, Fcγ serves as a subunit in TCR complexes. To elucidate the role of ζ family dimers in T cell development, we generated mice lacking expression of all of these proteins and compared their phenotype to mice lacking only ζ/η or Fcγ. The data reveal that surface complexes that are expressed in the absence of ζ family dimers are capable of transducing signals required for α/β–T cell development. Strikingly, T cells generated in both ζ/η−/− and ζ/η−/−–Fcγ−/− mice exhibit a memory phenotype and elaborate interferon γ. Finally, examination of different T cell populations reveals that ζ/η and Fcγ have distinct expression patterns that correlate with their thymus dependency. A possible function for the differential expression of ζ family proteins may be to impart distinctive signaling properties to TCR complexes expressed on specific T cell populations.
Differential Neutrophil Counts in Pregnancy
Authors: Sanford F. Kuvin, George Brecher
Journal: New England Journal of Medicine (1962)

IT has long been recognized that a leukocytosis is commonly but not uniformly present during pregnancy. Virchow spoke of the "physiologic leukocytosis of pregnancy," which has been observed by most investigators to be an increase in the number of neutrophils.1 2 3 4 A "shift to the left" — that is, an increase in young granulocytic forms, especially in the later months of pregnancy — has been mentioned,5 but only De Lee6 noted that myelocytes may appear in the peripheral blood. We have been unable to find any figures to substantiate De Lee's statement or, indeed, the frequency and extent of other changes . . .
Reformulating the Federal Match as a Key to the Sustainability of Medicaid
Authors: Stephen W. Patrick, Matthew M. Davis
Journal: JAMA Pediatrics (2013)

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 Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast 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 Pediatrics journal
Cases Shewing the Necessity of Making Careful Vaginal Examinations and Inspection of Clots in Haemorrhage after Abortion
Authors: E. Copeman
Journal: BMJ (1863)

miscarried on September 10th, and lad such severe flooding afterwards, that I was sumn- imioned ten miles into the country to consult with her surgeon as to wlhat nieans should be adopted to secute ler from loss of life.A fNatws of about three months had beeti expelled in the nlo-ning, after which several clots passed, and lisemorrhage more or less had been going on all day, accompanied now anid then by severe abdominal pain1 and forcing.All was tlhouglht to be over, but no one, liad seen tlie placenta, and I suspected the bhemorrhage and pain were causeed by its retenition.On ex- anaiMtion, I fouind this the case; a small portion could be felt presenting at the os, and bv means of the expulsive pains excited by my marnipulations, a lae-ge firm pla- centa uvas soon stifficienitlI protruded to enable me to take it away.H.emorrhage ceased aflter this, and I left lier niext miiorning suffering only from faintness and vertigo from previouis loss of blood.She had a good recovery; and has never been pregnant sinice.CASE It.On July 12i, 1852, 1 vas summoned to a lady onD accounit of severe hitmorrhage in whlat slie stated to
Bronchial provocation studies in farmers with positive RAST to the storage mite <i>Lepidoglyphus destructor</i>
Authors: M. van Hage‐Hamsten, E. Ihre, O. Zetterström, S. G. O. Johansson
Journal: Allergy (1988)

Bronchial provocation studies with L. destructor (L. des.) extract were made on 12 farmers with asthma who were exposed daily to stored hay and grain and had positive radio‐allergo‐sorbent test (RAST) to L. des. All 12 farmers developed more than a 20 % fall in FEV 1 to the extract. None of the symptomatic farmers who were also RAST positive to the L. des. culture medium developed an asthmatic reaction to the medium extract. Neither four healthy farmers nor two patients with asthma caused by D. pteronyssinus (D. pt.) responded to L. des. or the L. des. culture medium. Challenges with D. pt. extract were negative in two symptomatic farmers who were RAST positive to L. des. and negative to D. pt. The present study further supports our previous hypothesis that there is an IgE‐mediated immunological mechanism behind L. des. ‐induced asthma in farmers and that atopic farmers are liable to develop occupational asthma caused by allergy to L. des. .
Treatment of the Systemic Capillary Leak Syndrome with Terbutaline and Theophylline: A Case Series
Authors: Naeem K. Tahirkheli
Journal: Annals of Internal Medicine (1999)

Background: The systemic capillary leak syndrome is a rare idiopathic disorder characterized by recurrent episodes of hypotension and hemoconcentration due to sudden transient extravasation of 10% to 70% of plasma. Mortality rates 5 years after diagnosis have been reported to be 76%. Objective: To assess the efficacy of a prophylactic regimen for the systemic capillary leak syndrome. Design: Case series. Setting: Tertiary referral center. Patients: Eight patients followed over the past 18 years. Intervention: Oral terbutaline plus aminophylline or theophylline. Measurements: Long-term clinical follow-up. Results: During a median follow-up of 9 years (range, 2 to 18 years), two patients (25%) died: one during an acute episode and one of complications related to long-term corticosteroid therapy. The other six patients are alive and healthy. The frequency and severity of the episodes decreased by a median of 30-fold. Recurrences were associated with decreased serum theophylline levels, possibly caused by enzyme induction or autoinduction. The extended-release form of medication was more successful. Sympathomimetic side effects were significant. Conclusions: A regimen of terbutaline and theophylline seems to be effective prophylaxis against the systemic capillary leak syndrome. Maintenance of therapeutic drug levels was associated with favorable results.
Lentiviral-mediated transfer of CNTF to schwann cells within reconstructed peripheral nerve grafts enhances adult retinal ganglion cell survival and axonal regeneration
Authors: Ying Hu, Simone G. Leaver, Giles W. Plant, William T.J. Hendriks, Simone P. Niclou, Joost Verhaagen, Alan R. Harvey, Qi Cui
Journal: Molecular Therapy (2005)

We recently described a method for reconstituting peripheral nerve (PN) sheaths using adult Schwann cells (SCs). Reconstructed PN tissue grafted onto the cut optic nerve supports the regeneration of injured adult rat retinal ganglion cell (RGC) axons. To determine whether genetic manipulation of such grafts can further enhance regeneration, adult SCs were transduced with lentiviral vectors encoding either ciliary neurotrophic factor (LV-CNTF) or green fluorescent protein (LV-GFP). SCs expressed transgenes for at least 4 weeks after transplantation. There were high levels of CNTF mRNA and CNTF protein in PN grafts containing LV-CNTF-transduced SCs. Mean RGC survival was significantly increased with these grafts (11,863/retina) compared with LV-GFP controls (7064/retina). LV-CNTF-transduced SCs enhanced axonal regeneration to an even greater extent (3097 vs 393 RGCs/retina in LV-GFP controls). Many regenerated axons were myelinated. The use of genetically modified, reconstituted PN grafts to bridge tissue defects may provide new therapeutic strategies for the treatment of both CNS and PNS injuries.
mTORC1 and mTORC2 differentially regulate homeostasis of neoplastic and non-neoplastic human mast cells
Authors: Daniel Smrž, Mi-Sun Kim, Shuling Zhang, Beverly A. Mock, Šárka Smržová, Wendy DuBois, Olga Simakova, Irina Maric, Todd M. Wilson, Dean D. Metcalfe, Alasdair M. Gilfillan
Journal: Blood (2011)
SOME REMARKS ON TEST MEALS.
Authors: HENRY SALZER
Journal: JAMA (1896)

Test meals are given for the purpose of testing the digestive and motor power of the stomach, and thus judging of the condition of the mucous membrane and its glandular elements, as well as of its muscular action and its size, for an enlarged, or rather dilated, stomach depends chiefly upon these conditions. The test meal now almost universally employed is Ewald's test breakfast, consisting of 30 to 50 grams of bread and 300 c.c. of warm water, or tea without sugar or milk. One hour after this meal a soft, elastic tube is introduced into the stomach, and the entire contents of the stomach brought up, either by attaching an aspirator apparatus to the tube, or by pressing with the hand at the epigastrium, and encouraging the patient to assist this pressure by contraction of the abdominal muscles as it is done for defecation. Other test meals have been
Asymptomatic Bacteriuria in Girl Entrants to Dundee Primary Schools
Authors: D. C. L. Savage, M. I. Wilson, E. M. Ross, W. M. Fee
Journal: BMJ (1969)

During the statutory medical examination on entrance to primary school 943 5-year-old girls were screened for asymptomatic bacteriuria. A prevalence of 2.1% was found. None of the 20 children with asymptomatic bacteriuria was recognized by the parents as having a urinary infection, though 14 of them had symptoms of lower urinary tract infection. In 16 of the children with bacteriuria either the intravenous pyelogram or the micturating cystogram was abnormal. In 12 the height and weight were below the 25th percentile, and in this group the most severe radiological changes were found.Though the significance of asymptomatic bacteriuria is unknown, these results confirm that in this age group it is often associated with a urinary tract abnormality.