tbuckley/cabot-search huggingface dataset:
Cognitive Impairment and Decline Are Associated with Carotid Artery Disease in Patients without Clinically Evident Cerebrovascular Disease
Authors: S. Claiborne Johnston, Ellen S. O'Meara, Teri A. Manolio, David Lefkowitz, Daniel H. O'Leary, Steven Goldstein, Michelle C. Carlson, Linda P. Fried, W. T. Longstreth
Journal: Annals of Internal Medicine (2004)

Background: Whether carotid artery disease is a cause of cognitive impairment in persons who have not had stroke is unknown. If this is the case, diminished performance on the Modified Mini-Mental State Examination should be more common in persons with left carotid artery disease than in those with right carotid artery disease. Objective: To determine whether left carotid artery disease is associated with cognitive impairment. Design: Cross-sectional and cohort study. Setting: Four U.S. communities participating in the Cardiovascular Health Study. Patients: 4006 right-handed men and women 65 years of age or older without history of stroke, transient ischemic attack, or carotid endarterectomy. Measurements: Internal carotid artery stenosis and intima–media thickness of the common carotid artery were assessed by using duplex ultrasonography. Cognitive impairment was defined as a score less than 80 on the Modified Mini-Mental State Examination, and cognitive decline was defined as an average decrease of more than 1 point annually in Modified Mini-Mental State Examination score during up to 5 years of follow-up. Multivariate logistic regression models were used to estimate the risk for cognitive impairment and decline associated with left internal carotid artery stenosis and intima–media thickness, after adjustment for measures of right-sided disease and risk factors for vascular disease. Results: After adjustment for right-sided stenosis, high-grade (≥ 75% narrowing of diameter) stenosis of the left internal carotid artery (32 patients) was associated with cognitive impairment (odds ratio, 6.7 [95% CI, 2.4 to 18.1] compared with no stenosis) and cognitive decline (odds ratio, 2.6 [CI, 1.1 to 6.3]). Intima–media thickness of the left common carotid artery was associated with cognitive impairment and decline in univariate analysis, but this effect did not persist after adjustment. Conclusions: Cognitive impairment and decline are associated with asymptomatic high-grade stenosis of the left internal carotid artery. The persistence of the association after adjustment for right-sided stenosis indicates that the association is not due to underlying vascular risk factors or atherosclerosis in general.
EVALUATION OF SIDE BRANCH OPENING USING THREE DIMENSIONAL VISUALIZATION OF NEW GENERATION OPTICAL COHERENCE TOMOGRAPHY AFTER BIOABSORBABLE EVEROLIMUS ELUTING STENT IMPLANTATION
Authors: Takayuki Okamura, Yoshinobu Onuma, Evelyn Regar, Patrick W. Serruys
Journal: Journal of the American College of Cardiology (2010)
T cell determinants of myelin basic protein include a unique encephalitogenic I-E-restricted epitope for Lewis rats.
Authors: H Offner, G A Hashim, B Celnik, A Galang, X B Li, F R Burns, N Shen, E Heber-Katz, A A Vandenbark
Journal: The Journal of Experimental Medicine (1989)

The major encephalitogenic epitope for Lewis rats is the 72-89 sequence of guinea pig basic protein (GP-BP) or rat basic protein (Rt-BP). T cells responsive to this epitope are I-A restricted and preferentially express the V alpha 2:V beta 8 gene combination in their TCR. In this work, we describe for the first time the delayed appearance of T cells specific for additional discrete determinant of BP, the nonencephalitogenic 55-68 sequence of GP-BP restricted by I-A, and the encephalitogenic 87-99 sequence of Rt-BP restricted by I-E. The TCR V alpha 2:V beta 8 gene combination was expressed by both encephalitogenic GP-BP S72-89 and Rt-BP S87-99 T cell specificities but not by GP-BP 44-68-specific T cells. This is the first demonstration of I-E-restricted encephalitogenic T cells in Lewis rats and supports the conclusion that the I-E class II locus is involved in autoimmune diseases.
Hypersensitivity and desensitization to antineoplastic agents: outcomes of 189 procedures with a new short protocol and novel diagnostic tools assessment
Authors: R. Madrigal‐Burgaleta, M. P. Berges‐Gimeno, D. Angel‐Pereira, R. Ferreiro‐Monteagudo, C. Guillen‐Ponce, C. Pueyo, E. Gomez de Salazar, E. Alvarez‐Cuesta
Journal: Allergy (2013)

Abstract Background Desensitization to antineoplastic agents is becoming a standard of care. Efforts to establish and improve these techniques are being made at many institutions. Our aims are to evaluate a new rapid desensitization protocol designed to be shorter (approximately 4 h) and safer (reducing hazardous drugs exposure risks) and to assess the oxaliplatin‐specific immunoglobulin E ( I g E ) as a novel diagnostic tool. Methods Prospective, observational, longitudinal study with patients who, for a 1‐year period, suffered reactions to antineoplastic agents and were referred to the D esensitization P rogram at R amon y C ajal U niversity H ospital ( RCUH ). Patients were included or excluded as desensitization candidates after anamnesis, skin testing, risk assessment, and graded challenge. Specific I g E was determined in oxaliplatin‐reactive patients. Candidate patients were desensitized using the new RCUH rapid desensitization protocol. Results Of 189 intravenous rapid desensitizations, 188 were successfully accomplished in the 23 patients who met inclusion criteria for desensitization (of 58 referred patients). No breakthrough reactions occurred in 94% of desensitizations, and most breakthrough reactions were mild. In 10 oxaliplatin‐reactive patients, 38 desensitizations were successfully accomplished. Sensitivity for oxaliplatin‐specific I g E was 38% (0.35 UI /l cutoff point) and 54% (0.10 UI /l cutoff point); specificity was 100% for both cutoff points. Conclusions In the hands of a D esensitization P rogram, managed by drug desensitization experts, this new protocol has proven an effective therapeutic tool for hypersensitivity to several antineoplastic agents (oxaliplatin, carboplatin, paclitaxel, docetaxel, cyclophosphamide, and rituximab); moreover, it improves safety handling of hazardous drugs. We report the first large series of oxaliplatin desensitizations. O xaliplatin‐specific I g E determination could be helpful.
Indian doctors hope kidney scandal will spur cadaver donation programme
Authors: Ganapati Mudur
Journal: BMJ (2008)

India’s health ministry, in the wake of a racket involving illegal kidney transplantations, has announced plans to promote donations from cadavers. It will allow more hospitals to harvest organs from brain stem dead patients and offer incentives to relatives of dead donors.

Police have arrested a doctor, Amit Kumar, and his associates, for allegedly performing hundreds of clandestine kidney transplantations in Gurgaon, an industrial town near New Delhi. Police claim that Dr Kumar used a network of touts to lure poor people into giving up their kidneys for payments of about 60 000 rupees (£770; €1030; $1510) and that the organs were transplanted into patients from India, Europe, and the United States.

India outlawed trade in human organs in 1994, but transplantation surgeons have said that organ sales have persisted because of a shortage of cadaver donors and collusion among donors, doctors, and patients waiting for a transplant.

But the scale of …
FDG PET/CT Findings in a Case of Nontuberculous Abscess of Adrenal Gland
Authors: Prathamesh Joshi, Vikram Lele
Journal: Clinical Nuclear Medicine (2013)

Abscesses in the adrenal gland are extremely rare in adults with few cases reported in literature. We report FDG PET/CT findings in a unilateral adrenal abscess in a case of hepatocellular carcinoma. Though rare, this diagnosis should be kept in mind while evaluating cystic lesions of adrenal gland on PET/CT. Correlation with clinical picture and blood investigations is useful in such cases.
Neurology: A Concise Clinical Textbook
Authors: Robert E. McMasters
Journal: JAMA (1968)

The announcement of a new text of clinical neurology may bring some misgivings, since so many adequate volumes are currently available; however, the author has presented us with what should prove to be a useful addition to our neurologic armamentarium. The preface clearly indicates that the book was designed primarily for the needs of medical students and residents and represents an expansion of a series of lectures given to undergraduates over a number of years. We are indeed fortunate that Dr. Luhan has agreed to share his accumulated knowledge, especially since his use of the English language is so refreshing in this beautifully written text. The book consists of 29 chapters and is divided by a brief anatomic supplement into two parts: the shorter first portion deals with the interpretation of symptoms and signs, ie, systems, whereas the remaining chapters deal with specific disease entities in the classic manner. Most
Glimepiride and Serum Adiponectin Level in Type 2 Diabetic Subjects
Authors: Keiji Yoshioka, Toshihide Yoshida, Toshikazu Yoshikawa
Journal: Diabetes Care (2003)

We read with interest the article by Nagasaka et al. (1) reporting that glimepiride, a new agent of sulfonylurea, has an increasing effect on circulating adiponectin concentration, which may play a role in mediating insulin sensitivity. The authors demonstrated that serum adiponectin concentration increased significantly from 22.1 ± 2.7 to 28.5 ± 2.8 μg/ml after 3 months’ glimepiride treatment. However, their baseline level of serum adiponectin was markedly higher than that of the Japanese type 2 diabetic subjects reported by Tsunekawa et al. (2) (22.1 ± 2.7 vs. 6.61 ± 3.06 μg/ml) in spite of higher BMI (26.5 ± 0.9 vs. 21.2 ± 2.2 kg/m2) and greater homeostasis model assessment of insulin resistance (5.0 ± 0.8 vs. 2.54 ± 2.25), although both groups measured serum adiponectin levels with …
Three vs 10 Days of Trimethoprim/Sulfamethoxazole for Acute Maxillary Sinusitis
Authors: Eyal Shahar
Journal: JAMA (1995)

In Reply.  —We agree that statistical power is a critical issue for our study and for any clinical trial showing equivalent outcomes for competing therapies. When designing this study, we knew that the existing literature showed a high placebo  rate that was improved only modestly by decongestants and antibiotics. Given these data, we chose  to clinical response as the primary outcome variable, thinking that antibiotic therapy may shorten the intensity and duration of symptoms. We chose 2.5 days as a clinically meaningful difference in duration of symptoms, and computed a priori that 40 patients per group would exclude a difference greater than 2.5 days with 80% power (one-sided α=.05). We observed a 0.5-day difference between groups (favoring the 10-day treatment group), and bootstrap estimation of the 95% confidence interval (CI) showed that the 3-day treatment group might experience as much as 2.0 days longer median time to clinical
His Bundle Rhythm
Authors: ANTHONY N. DAMATO, SUN H. LAU
Journal: Circulation (1969)

Traditionally the site of impulse formation in so-called A-V nodal rhythms has been considered to be within the upper, middle, and lower portions of the A-V node. In this study, evidence obtained supports the concept that the His bundle and not the A-V node is the pacemaker site in nodal rhythms. His bundle activity was recorded in clinical cases of nodal rhythms and A-V dissociation by using an electrode catheter positioned at the tricuspid valve. In these studies a single His deflection preceded each QRS complex. From the results of this study, it is suggested that in so-called lower and middle nodal rhythms the pacemaker site is within the His bundle. It is further suggested that so-called upper nodal rhythms may represent a coronary sinus or inferior left atrial rhythm.
PISTOL-GRIP NEEDLE FORCEPS FOR ABDOMINAL SURGERY.
Authors: EDGAR CALVIN SEIBERT
Journal: JAMA (1905)

The placing of sutures in the deeper regions of the abdominal cavity has always been a matter of especial difficulty in abdominal surgery. Owing to the prevailing straight construction of needle forceps, the operator's hand not only must be held at an uncomfortable angle, but also greatly obscures his vision. For surgical work in the nasal, aural and vaginal cavities, great advantage and perfect visual control is derived from the use of curved or angular instruments. Having this in mind, I have had constructed a "pistolgrip" needle forceps whose jaws are at an angle of thirty degrees to the handles, which permits a full unobstructed view of the operative field and gives perfect control of the needle even in the deeper and less accessible regions of the abdomen. In order to provide the power necessary to hold the needle securely, two levers are used, one acting on the other, thus greatly increasing the grasping force of the jaws.
Health reform divides German coalition government
Authors: Annette Tuffs
Journal: BMJ (2006)

Germany's chancellor, Angela Merkel, has been struggling for weeks to reach an agreement on her ambitious health reform plans with her Social Democrat coalition partners, as well as the powerful state premiers from her own Christian Democrat party. She wants to reach a stable compromise by the end of October.

The health reform plan is aimed at reducing the German healthcare budget, the third highest in the world. Under the proposal healthcare insurance fees paid by employees and their employers will rise by around 0.5% by 2007.

And for the …
CELLULAR ORIGIN OF RHEUMATOID FACTOR
Authors: Robert C. Mellors, Ralph Heimer, Josué Corcos, Leonhard Korngold
Journal: The Journal of Experimental Medicine (1959)

Fluorescein-labelled aggregated human gamma-globulin was found to react in precipitin-type tests with serums of individuals with rheumatoid arthritis. This reagent was also highly reactive and specific for the localization of rheumatoid factor in frozen sections of synovial membranes, lymph nodes, and subcutaneous nodules. In synovial membranes from patients with active rheumatoid arthritis, rheumatoid factor was present in the cytoplasm of plasma cells at various stages of development and maturity. The appearance of the cytoplasm and the occasional presence nearby of extracellular particles suggested the possibility of a secretory process. All other cells were devoid of rheumatoid factor. Some plasma cells contained 7S and/or 19S gamma-globulin and many lacked detectable gamma-globulin. In lymph nodes from a patient with active rheumatoid arthritis, rheumatoid factor was present in approximately one in ten germinal centers as well as in internodular plasma cells. The rheumatoid factor was localized in the cytoplasm and the characteristic protoplasmic processes of the germinal-center cells. All other cells were devoid of rheumatoid factor. 7S and/or 19S gamma-globulin was demonstrated in approximately eight in ten germinal centers in these lymph nodes. Plasma cells with rheumatoid factor were also seen on occasion in rheumatoid subcutaneous nodules. Tissue sections of comparable structure prepared from normal and pathological control material did not contain rheumatoid factor. Staining for rheumatoid factor was blocked by pretreatment of sections either with unlabelled aggregated human gamma-globulin or with rabbit antiserum against 19S human gamma-globulin.
Treating Insomnia in Older Adults
Authors: Charles F. Reynolds III, Daniel J. Buysse, David J. Kupfer
Journal: JAMA (1999)

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
Diabetic Retinopathy and Diabetic Macular Edema
Authors: Thomas A. Ciulla, Armando G. Amador, Bernard Zinman
Journal: Diabetes Care (2003)

Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of blindness in the working-age population of most developed countries. The increasing number of individuals with diabetes worldwide suggests that DR and DME will continue to be major contributors to vision loss and associated functional impairment for years to come. Early detection of retinopathy in individuals with diabetes is critical in preventing visual loss, but current methods of screening fail to identify a sizable number of high-risk patients. The control of diabetes-associated metabolic abnormalities (i.e., hyperglycemia, hyperlipidemia, and hypertension) is also important in preserving visual function because these conditions have been identified as risk factors for both the development and progression of DR/DME. The currently available interventions for DR/DME, laser photocoagulation and vitrectomy, only target advanced stages of disease. Several biochemical mechanisms, including protein kinase C-beta activation, increased vascular endothelial growth factor production, oxidative stress, and accumulation of intracellular sorbitol and advanced glycosylation end products, may contribute to the vascular disruptions that characterize DR/DME. The inhibition of these pathways holds the promise of intervention for DR at earlier non-sight-threatening stages. To implement new therapies effectively, more individuals will need to be screened for DR/DME at earlier stages-a process requiring both improved technology and interdisciplinary cooperation among physicians caring for patients with diabetes.
Hepatitis C virus inhibits intracellular interferon alpha expression in human hepatic cell lines
Authors: Ting Zhang, Rong-Tuan Lin, Yuan Li, Steven D. Douglas, Catherine Maxcey, Chun Ho, Jian-Ping Lai, Yan-Jian Wang, Qi Wan, Wen-Zhe Ho
Journal: Hepatology (2005)

Abstract The chronicity of hepatitis C virus (HCV) infection raises the question of how HCV is able to persist in hepatic cells. We show that human primary hepatocytes and human hepatic cell lines (Huh7 and HepG2) spontaneously produce interferon (IFN)-α that is inhibited in the HCV replicon cells (Huh.8 and FCA-1). Silencing IFN-α gene expression by IFN-α small interfering RNA (siRNA) in the HCV replicon cells resulted in increased HCV replicon expression. The activation of IFN-α expression by interferon regulatory factor (IRF-7) led to the inhibition of HCV replicon expression, whereas the anti–IFN-α receptor antibody could partially block IRF-7–mediated HCV replicon inhibition. In addition, the blockade of IFN-α receptor by anti–IFN-α receptor antibody on the replicon cells increased HCV replicon expression. Among the HCV nonstructural (NS) proteins tested, NS5A is the most potent inhibitor of IFN-α expression by the hepatic cells. Investigation of the mechanism of HCV action on IFN-α showed that IRF-7–induced IFN-α promoter activation was inhibited in the HCV replicon cells. Furthermore, IRF-7 expression was restricted in the HCV replicon cells. In conclusion , we provide direct evidence that HCV undermines the intracellular innate immunity of the target cells, which may account for HCV persistence in hepatic cells. (Hepatology 2005;42:00–00.) (Hepatology 2005;42:819–827.)
Intense Muscle Uptake of Ga-67 Citrate In a Patient With Hypercoagulable State After Exercise
Authors: MORDECHAI LORBERBOYM, ELMER SAN PEDRO
Journal: Clinical Nuclear Medicine (1995)

A 34-year-old man had a history of inferior vena cava ligation at the age of 14 due to a hypercoagulable state. He was admitted with iliac and femoral deep vein thrombosis. The anticardiolipin antibody was not significantly elevated and a Ga-67 scan was obtained to exclude a lung or mediastinal mass. The Ga-67 scan showed intense uptake in the muscles of the anterior chest wall and upper arms and was confirmed by SPECT of the chest. No intrathoracic uptake was noticed.
Scottish GPs want to be more involved in developing out of hours services
Authors: B. Christie
Journal: BMJ (2010)

Family doctors in Scotland should be much more involved in the planning and development of out of hours services, recommends a report on the future of general practice in Scotland.

Out of hours care is one of six key areas examined in the report, General Practice in Scotland: The Way Ahead, produced by the BMA in Scotland . Although reviews have shown that out of hours services in Scotland are of high quality, the report says that accessing the right service still causes uncertainty, anxiety, and frustration among patients. It calls for action …
Characterization of Uterine Leiomyomas by Whole-Genome Sequencing
Authors: Miika Mehine, Eevi Kaasinen, Netta Mäkinen, Riku Katainen, Kati Kämpjärvi, Esa Pitkänen, Hanna-Riikka Heinonen, Ralf Bützow, Outi Kilpivaara, Anna Kuosmanen, Heikki Ristolainen, Massimiliano Gentile, Jari Sjöberg, Pia Vahteristo, Lauri A. Aaltonen
Journal: New England Journal of Medicine (2013)

Uterine leiomyomas are benign but affect the health of millions of women. A better understanding of the molecular mechanisms involved may provide clues to the prevention and treatment of these lesions.We performed whole-genome sequencing and gene-expression profiling of 38 uterine leiomyomas and the corresponding myometrium from 30 women.Identical variants observed in some separate tumor nodules suggested that these nodules have a common origin. Complex chromosomal rearrangements resembling chromothripsis were a common feature of leiomyomas. These rearrangements are best explained by a single event of multiple chromosomal breaks and random reassembly. The rearrangements created tissue-specific changes consistent with a role in the initiation of leiomyoma, such as translocations of the HMGA2 and RAD51B loci and aberrations at the COL4A5-COL4A6 locus, and occurred in the presence of normal TP53 alleles. In some cases, separate events had occurred more than once in single tumor-cell lineages.Chromosome shattering and reassembly resembling chromothripsis (a single genomic event that results in focal losses and rearrangements in multiple genomic regions) is a major cause of chromosomal abnormalities in uterine leiomyomas; we propose that tumorigenesis occurs when tissue-specific tumor-promoting changes are formed through these events. Chromothripsis has previously been associated with aggressive cancer; its common occurrence in leiomyomas suggests that it also has a role in the genesis and progression of benign tumors. We observed that multiple separate tumors could be seeded from a single lineage of uterine leiomyoma cells. (Funded by the Academy of Finland Center of Excellence program and others.).