tbuckley/cabot-search huggingface dataset:
Optimizing ACE-Inhibitor Therapy for Chronic Kidney Disease
Authors: Lee A. Hebert
Journal: New England Journal of Medicine (2006)

In this issue of the Journal, Hou and colleagues1 present data indicating that the use of benazepril, an angiotensin-converting–enzyme (ACE) inhibitor, is feasible and beneficial in patients with advanced chronic kidney disease, a point that has been much debated. This clinical trial in China, which confirms pilot data from the same group,2 provides some clarity, demonstrating that ACE inhibitors can be administered in generous doses, even in patients with stage 4 chronic kidney disease, as defined by a glomerular filtration rate (GFR) of 15 to 29 ml per minute per 1.73 m2 and a serum creatinine level of approximately 3.0 . . .
Incidence of IDDM in the Province Of Rzeszów, Poland, 0- to 29-Year-Old Age-Group, 1980–1992
Authors: Marek A Grzywa, Anna K Sobel
Journal: Diabetes Care (1995)

To study the incidence of insulin-dependent diabetes mellitus (IDDM) in the province of Rzeszów, Poland, and to test for differences in incidence by age at diagnosis, time cluster, sex, urban-rural population, and season.A registry was established in 1990 to collect new IDDM cases among people 0-29 years of age, from 1980 to 1992. Data were collected according to the Diabetes Epidemiology Research International Group recommendations.The average age-standardized incidence of IDDM was 5.31/100,000 population (95% confidence interval [CI] 4.67-6.04) for those 0-29 years of age. Among males, it was 5.68/100,000 (CI 4.77-6.77), and among females it was 4.93/100,000 (CI 4.07-5.97). The incidence for children 0-14 years old was 5.11/100,000 (CI 4.27-6.11) and for those 15-29 years old, 5.55/100,000 (CI 4.60-6.68). The incidence of IDDM in autumn (September through November) was the highest (87 of 243 cases) and differed statistically from each of the other seasons. The incidence of IDDM among the urban and rural populations did not differ. There were also no differences between the sexes and the groups divided by 5-year age intervals.This study documents the low incidence rate and seasonal dependence of IDDM among people 0-29 years of age in the province of Rzeszów, Poland.
Increased Carotid Artery Intimal-Medial Thickness in Asymptomatic Older Subjects With Exercise-Induced Myocardial Ischemia
Authors: Yoji Nagai, E. Jeffrey Metter, Christopher J. Earley, Mary K. Kemper, Lewis C. Becker, Edward G. Lakatta, Jerome L. Fleg
Journal: Circulation (1998)

Previous studies have shown an association between symptomatic coronary artery disease (CAD) and increased intimal-medial thickness of the common carotid artery (CCA IMT), a purported index of atherosclerosis. This study determines whether CCA IMT is increased in asymptomatic older subjects with an ischemic ST-segment response to treadmill exercise.CCA IMT was measured by B-mode ultrasound in community-dwelling volunteers from the Baltimore Longitudinal Study of Aging, including 397 healthy subjects (age, 58.5+/-15.8 years) with normal ECG responses to maximum treadmill exercise, 72 asymptomatic subjects (age, 66.1+/-13.4 years) with exercise-induced horizontal or downsloping ST-segment depression >/=1 mm, and 38 subjects (age, 77. 4+/-7.8 years) with clinically manifest CAD as diagnosed by medical history and resting ECG. Forty-three subjects with abnormal exercise ECGs also underwent exercise thallium scintigraphy. Exercise-induced ST-segment depression was associated with increased IMT (P<0.0001) independent of age and manifest CAD. After adjustment for age, IMT values progressively increased from healthy subjects to asymptomatic subjects with positive exercise ECG alone to those with concordant positive ECG and thallium scintigraphic findings who had virtually identical IMT to subjects with manifest CAD. Each 0.1-mm increase in IMT was associated with a 1.91-fold (95% CI, 1.46 to 2.50; P<0.0001) increased risk for concordant positive exercise tests or manifest CAD, independent of other significant predictors of CAD.CCA IMT is increased in older subjects with asymptomatic myocardial ischemia as evidenced by exercise ECG alone or in combination with thallium scan. Carotid ultrasound may help to identify asymptomatic individuals with CAD.
Bradykinin-Induced Increase in Total and Effective Blood Flow in Skeletal Muscle
Authors: Rita L. Paldino, Chester Hyman, Jim Lenthall
Journal: Circulation Research (1962)

The effect of the synthetic peptide, bradykinin, on total and nutritional blood flow through mammalian skeletal muscle in anesthetized rats, cats, and rabbits was studied. The intra-arterial administration of the drug consistently and significantly increases total blood flow through the gastrocuemius muscle of chloralose-anesthetized cats and rabbits. A similar increase in clearance of the dye "Water Blue" from microinjection sites in the spino-trapezius muscle of the rat and clearance of iodide ions from skeletal muscle in the larger species was established. Bradykinin causes active dilatation of the nutritional circulation as well as increased total blood flow through muscle.
Hypoxia enhances isoproterenol-induced increase in heart interstitial adenosine, depressing beta-adrenergic contractile responses.
Authors: R A Fenton, J G Dobson
Journal: Circulation Research (1993)

Endogenous interstitial adenosine may protect the hypoxic heart by attenuating beta-adrenergic-induced contractile and metabolic responses, thereby reducing energy utilization. Constant-flow perfused rat hearts were used to study: 1) the effect of hypoxia on isoproterenol (ISO)-induced increase in interstitial adenosine, as estimated with epicardial surface transudates, and 2) the role of endogenous adenosine in hypoxic depression of ISO-induced contractile responses. ISO (1 nM for 10 minutes) in the normoxic heart increased transudate adenosine 114% from a pre-ISO normoxic value of 343 pmol/ml. ISO administered to the hypoxic heart increased transudate adenosine 357% from a pre-ISO hypoxic value of 797 pmol/ml. The absolute magnitude of the ISO-induced increase in transudate adenosine was 625% greater during hypoxia than during normoxia. This was associated with a reduction in the ISO-induced contractile response during hypoxia. In other experiments, with normoxia ISO (10 nM for 10 seconds) increased developed left ventricular pressure by 140 mm Hg, and the maximum rates of left ventricular pressure development and relaxation by 5,860 and 2,771 mm Hg/sec, respectively, above control values of 90 mm Hg, 2,250 mm Hg/sec, and 1,875 mm Hg/sec. Hypoxia reduced the three ISO-induced contractile responses by 50%, 56%, and 36%. However, 1,3-dipropyl-8-cyclopentylxanthine (5 x 10(-7) M), an adenosine A1-receptor antagonist, added to the hypoxic hearts resulted in only a 31%, 39%, and 9% reduction in the ISO-induced responses in developed left ventricular pressure and the maximum rates of left ventricular pressure development and relaxation, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
The cognitive impenetrability of visual perception: Old wine in a new bottle
Authors: Howard Egeth
Journal: Behavioral and Brain Sciences (1999)

Pylyshyn's argument is very similar to one made in the 1960s to the effect that vision may be influenced by spatial selective attention being directed to distinctive stimulus features, but not by mental set for meaning or membership in an ill-defined category. More recent work points to a special role for spatial attention in determining the contents of perception.
Clinical and pathological significance of interleukin 6 overexpression in systemic sclerosis
Authors: Korsa Khan, Shiwen Xu, Svetlana Nihtyanova, Emma Derrett-Smith, David Abraham, Christopher P Denton, Voon H Ong
Journal: Annals of the Rheumatic Diseases (2012)

Objective To determine the potential clinical and pathological significance of altered expression of interleukin 6 (IL-6) in systemic sclerosis (SSc). Methods Serum IL-6 and soluble IL-6 receptor levels were measured in patients with SSc (n=68) and healthy controls (n=15). Associations between serum IL-6 level and C reactive protein, platelet count and key clinical outcomes in SSc were explored. Expression of IL-6 in skin biopsies was also examined and western blot and reverse transcription PCRanalysis were performed using cultured dermal fibroblasts. The effect of IL-6 trans-signalling on production of extracellular matrix proteins was assessed and downstream signalling pathways were examined using pharmacological inhibitors. Results Serum IL-6 level was frequently elevated in patients with SSc, particularly in those with diffuse cutaneous SSc (dcSSc) with thrombocytosis and elevated acute phase markers. Prominent expression in the skin was observed in dermal fibroblasts, mononuclear cells and endothelial cells in patients with early dcSSc. In vitro experiments supported a potent profibrotic effect of IL-6 trans-signalling via the JAK2/STAT3 and ERK pathways. High IL-6 expression early in dcSSc appears to be associated with more severe skin involvement at 3 years and worse long-term survival than in those without elevated IL-6 levels. Conclusion Our results confirm the overexpression of IL-6 in dcSSc and support the potential of IL-6 as a surrogate marker for clinical outcome in this disease. The data also provide rationale for clinical studies targeting IL-6 trans-signalling as a potential antifibrotic therapy for SSc.
Nosocomial Outbreak of Klebsiella Infection Resistant to Late-Generation Cephalosporins
Authors: Kenneth S. Meyer
Journal: Annals of Internal Medicine (1993)

Objective: To describe the epidemiology, antimicrobial susceptibility, and control of widespread ceftazidime-resistant Klebsiella pneumoniae infections in a North American hospital and circumstances that led to delayed detection. Design: A 2-year epidemiologic, microbiologic, and clinical cohort study. Setting: A 487-bed general hospital in New York City. Patients and Clinical Isolates: Patient records were reviewed retrospectively and prospectively. Isolates were obtained from the Clinical Microbiology Laboratory. Results: Four hundred thirty-two isolates of ceftazidime-resistant Klebsiella pneumoniae were recovered during a 19-month study period. The peak incidence reached 17.3% of all Klebsiella isolates. One hundred fifty-five patients were colonized or infected, representing more than 70 per 1000 average daily census. Infections occurred in 39% of patients from whom ceftazidime-resistant Klebsiella was isolated. These included 14 bacteremias and 17 pulmonary infections among 52 infected patients. The outbreak coincided with increasing use of ceftazidime therapy for multiresistant Acinetobacter infections. Reduction in ceftazidime use and barrier precautions markedly reduced the incidence of colonization and infection. Ceftriaxone, ceftizoxime, cefotaxime, and cephamycins were inhibitory, but not bactericidal, against ceftazidime-resistant Klebsiella and appeared effective by routine disc diffusion tests. In contrast, imipenem provided consistent bactericidal activity. Preliminary studies indicated that the outbreak was caused by one or more plasmid-mediated lactamases. Conclusions: Nosocomial ceftazidime-resistant Klebsiella pneumoniae may be resistant to the bactericidal activity of all cephalosporins and cephamycins. Such isolates appear susceptible to cephalosporins other than ceftazidime by routine disc diffusion testing. Ineffective therapy, delayed detection of resistance, and epidemic spread are potential consequences. Imipenem provides consistent bactericidal activity. Ceftazidime restriction and barrier precautions for colonized and infected patients are effective control measures.
REPORT OF TWO CASES OF EXOPHTHALMIC GOITER IN MEN.
Authors: D. A. VANDERHOOF
Journal: JAMA (1906)

<h3>Case 1.</h3> —C. M., a man, aged 47; was born in northern Illinois. <h3>History.</h3> —His family history contains nothing of special interest. The man is a carpenter and has been a hard worker all his life. He is the father of 14 children, 13 of whom are living. They are all healthy and in good physical condition. The patient has always been of a rather nervous temperament, and says that this condition has been growing worse during the last five years, although he managed to keep up his work until the fall of 1904. During the last few years he has also been troubled with muscular rheumatism in his limbs, badly at times, although this seemed to depend to a great extent on atmospheric conditions. Otherwise he has always been normal both physically and mentally as far as is known. <h3>Examination.</h3> —He came under my observation during January, 1905. He
RENAL TORSION WITH ISCHEMIA CAUSING HYPERTENSION
Authors: Lester A. Riskind
Journal: JAMA (1942)

This report is presented because of its unusual bearing on renal hypertension. The major implications seem consistent with scientific validity.  Since Goldblatt's work, impetus has been given to research on hypertension, and a great many articles have been written on the association of disorders of the kidney to high blood  McCann 1 postulated the following events in cases of nephroptosis exhibiting orthostatic hypertension:  1. Erect posture causes some slight interference with the afferent blood supply in consequence of which renin is produced.  2. The action of renin results in constriction of the vasa efferentia in both kidneys with the result that the total renal blood flow is still further decreased, while at the same time the glomerular filtration remains relatively constant, owing to the compensatory effect of increased intraglomerular pressure.  In his series of 5 cases in which nephropexy was performed or kidney belts were applied the hypertension still
Prophylactic Anticoagulant Therapy for Coronary Artery Disease
Authors: Arthur J. Seaman, Herbert E. Griswold, Ralph B. Reaume, Leonard W. Ritzman
Journal: JAMA (1964)

Experience in the first seven years of a double-blindfold controlled study of continuous prophylactic anticoagulant therapy following myocardial infarction has demonstrated no difference in survival of patients receiving phenindione as compared with those receiving placebo treatment or no treatment. All patients received anticoagulant therapy for six weeks during initial or recurrent acute myocardial infarctions. All were selected for study before being assigned randomly to treatment groups. Longer hospitalization was required for anticoagulant-treated patients. There was no appreciable reduction of arterial thrombo-embolic complications.
Eye sign in an 18 year old man with psychosis
Authors: A. Aggarwal, M. Bhatt
Journal: BMJ (2009)

An 18 year old man presented after developing progressive dysarthria and abnormal limb postures. From the age of 15 he had been increasingly irritable, belligerent, and difficult to discipline. He played truant from school, wandered aimlessly around the city claiming to be a dynamic entrepreneur, and heard voices plotting against him. Examination revealed psychosis, severe dysarthria, and generalised dystonia with prominent oromandibular involvement. A diagnostic eye sign was noted (fig 1⇓). Treatment for 18 months led to considerable clinical improvement and regression of the abnormality in the eye. Fig 1 Diagnostic eye sign ### Short answers Fig 2 Kayser-Fleischer rings, visible as a greenish ring at the outer corneal surface (arrow)
Inhibition of multidrug resistance transporter-1 facilitates neuroprotective therapies after focal cerebral ischemia
Authors: Annett Spudich, Ertugrul Kilic, Hongyi Xing, Ülkan Kilic, Katharina M Rentsch, Heidi Wunderli-Allenspach, Claudio L Bassetti, Dirk M Hermann
Journal: Nature Neuroscience (2006)
Widespread and early myocardial gene expression by adeno-associated virus vector type 6 with a β-actin hybrid promoter
Authors: Shunsuke Kawamoto, Qun Shi, Yoshio Nitta, Jun-ichi Miyazaki, Margaret D. Allen
Journal: Molecular Therapy (2005)

Gene therapy for acute cardiac events such as myocardial infarction requires early gene expression over an entire region of myocardium, which has not been possible using adeno-associated virus (AAV) vectors to date. Here we demonstrate marked improvement in the distribution and rapidity of gene expression in myocardium using the AAV pseudotype 6 (AAV6) vector, compared to the standard serotype 2 (AAV2) vector. An alkaline phosphatase (AP) reporter construct driven by the chicken β-actin promoter was packaged in either AAV6 or AAV2 capsids and delivered to rat hearts in vivo by direct injection. AP expression was evident in both AAV6 and AAV2 vector-treated hearts as early as 1 day after injection, but increased rapidly in AAV6 vector-treated hearts during the first 7 days. The amplitude of AP activity produced by the AAV6 vector was 5-fold greater than that produced by the equivalent AAV2 vector at both 3 and 7 days postinjection. Additionally, the AAV6 vector transduced a myocardial volume that was 10-fold larger than the AAV2 vector. These results indicate the significant potential of AAV6 serotype vectors for early gene expression and widespread regional transduction of myocardium, both auspicious results for in vivo applications in acute cardiac disease.
Everyone's a Little Bit Biased (Even Physicians)
Authors: Daylian M. Cain
Journal: JAMA (2008)

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
Prophylaxis of postpneumonectomy empyema.
Authors: P Goldstraw
Journal: Thorax (1980)

OBJECTIVE: Anti-tumor necrosis factor-a (TNF-alpha) therapy has been successfully used in patients with active ankylosing spondylitis (AS) and other subtypes of spondyloarthritis (SpA). Treatment options for patients with severe forms of undifferentiated spondyloarthritis (uSpA), a rather frequent SpA subset, are limited. In this open study we examined the efficacy of the TNF-alpha receptor fusion protein etanercept in patients with uSpA. METHODS: Ten patients classified to have uSpA according to modified European Spondylarthropathy Study Group criteria in a severe and active stage of disease were included in the study and received etanercept in a dosage of 25 mg two times a week for 12 weeks, followed by an observation period of 12 weeks. The following outcome variables were used: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Functional Index (BASFI), pain on a numerical rating scale, disability by the Funktionsfragebogen Hannover (FFbH), a validated questionnaire to assess functional disability, and quality of life (Medical Outcome Study Short Form-36, SF-36). The primary outcome variable was defined as &gt;or= 50% improvement of the BASDAI. RESULTS: Treatment with etanercept resulted in a &gt;or= 50% regression of disease activity in 60% (95% CI 31-83%) of the patients. The mean BASDAI at baseline of 6.1 (range 3.7-9.2) dropped significantly to 3.5 at Week 12 (0.8-8.7; p = 0.01). Function, spinal pain, peripheral arthritis, enthesitis, quality of life, and acute phase reactants improved similarly. The FFbH improved from 62.8% to 69.7%. After cessation of anti-TNF therapy, 4 out of 8 patients relapsed after an average of 4.5 weeks (range 3-6). Two patients went into longstanding remission. No severe adverse events or major infections were observed. CONCLUSION: This study strongly suggests that treatment with etanercept has short term efficacy in patients with active and severe uSpA. Since it is known that 30-50% of uSpA patients develop AS over time, it will be important to study whether this can be prevented by anti-TNF-alpha therapy.
Statins could be useful in organ transplantation
Authors: A. Berger
Journal: BMJ (2000)

Statins have an effect on the immune system that is completely independent of their conventional use in reducing cholesterol levels.

Scientists in Switzerland have elucidated the mechanism by which statins seem able to confer benefit on patients receiving heart transplants. Their observations may lead to a reduction in the heavy use of potent drugs such as cyclosporin for all transplant patients ( Nature Medicine 2000;6:1399-402). 

Whereas the beneficial …
Central Nervous System and Limb Anomalies in Case Reports of First-Trimester Statin Exposure
Authors: Robin J. Edison, Maximilian Muenke
Journal: New England Journal of Medicine (2004)

To the Editor: The cholesterol-lowering statin drugs are contraindicated in pregnancy1; therefore, few data exist regarding their safety in human gestation. We reviewed 178 cases of first-trimester statin exposure reported to the Food and Drug Administration (FDA) from 1987 through 2001 for patterns suggesting possible drug-related effects on embryogenesis. After the exclusion of cases involving first-trimester elective or spontaneous abortions (46 and 42 cases, respectively), pregnancy loss due to maternal illness (15), fetal genetic disorders (3), transient neonatal disorders (5), or loss to follow-up (15), 52 cases were considered evaluable (Table 1). Among these cases, there were 20 reports . . .
The application of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) scaffolds for tendon repair in the rat model
Authors: William R. Webb, Tina P. Dale, Alex J. Lomas, Guodong Zeng, Ian Wimpenny, Alicia J. El Haj, Nicholas R. Forsyth, Guo-Qiang Chen
Journal: Biomaterials (2013)
Points from Letters: New Problems of Rheumatism
Authors: T. Robertson
Journal: BMJ (1949)

Urea for Migraine SIR, -Dr.Nevil Leyton (Aug. 6,p. 335) pleads for a serious attempt to treat sufferers from "migrainous" headaches, and mentions urea as a remedy to be tried in obstinate cases.May I go further and suggest the use of this drug as a first line of preventive treatment in every case, whether of recent origin or of long standing ?It is surprising how many patients will derive considerable benefit, if not complete relief, from attacks.The dosage advised is as follows: 20 gr. (1.3 g.) of urea in water three times a day for a week, followed by the same dose twice a day for two weeks and further treatment with a daily dose of 20 gr. for an indefinite period.-Iam, etc., Birmingham.
Influenza as a life changing event
Authors: P. Mortimer
Journal: BMJ (2010)

Pandemic flu is nothing new, and in the three years from 1889 the world was, as now, in its grip. 

The year 1891 found a little known Dr Conan Doyle struggling to build an ophthalmic practice in two rented rooms, one to be a consulting room and the other a waiting room, close to Harley Street. He later wrote that both proved to be waiting rooms, so that it was from there that he was able …
Lifestyle changes or metformin reduce type 2 diabetes risk in women with gestational diabetes, US study shows
Authors: S. Mayor
Journal: BMJ (2015)

Women with gestational diabetes have an increased risk of type 2 diabetes for years after giving birth, but intensive lifestyle changes or metformin therapy reduce this risk by more than a third, a US study has found.

The Diabetes Prevention Program Outcomes Study, reported in the Journal of Clinical Endocrinology and Metabolism ,1 followed up 288 women with gestational diabetes and compared them during pregnancy with 1226 women without this condition. All of the women had …