tbuckley/cabot-search huggingface dataset:
Pennyroyal Toxicity: Measurement of Toxic Metabolite Levels in Two Cases and Review of the Literature
Authors: Ilene B. Anderson
Journal: Annals of Internal Medicine (1996)

Background: Pennyroyal is a widely available herb that has long been used as an abortifacient despite its potentially lethal hepatotoxic effects. However, quantitative data for pennyroyal constituents and their metabolites in humans have not been previously reported. Objectives: To quantify pennyroyal metabolites in human overdose, to correlate these findings with clinical variables, and to place these findings in the context of previously reported cases of pennyroyal toxicity. Design: Clinical case series of pennyroyal ingestions; quantification of pennyroyal metabolites by gas chromatography and mass spectrometry; qualitative detection of protein-bound adducts of the metabolites of pennyroyal constituents in human liver by Western blot assay; and review of the literature based on a search of MEDLINE, Index Medicus, and the reference citations of all available publications. Results: We report four cases of pennyroyal ingestion. One patient died, one received N-acetylcysteine, and two ingested minimally toxic amounts of pennyroyal and were not treated with N-acetylcysteine. In the fatal case, postmortem examination of a serum sample, which had been obtained 72 hours after the acute ingestion, identified 18 ng of pulegone per mL and 1 ng of menthofuran per mL. In a serum sample from the patient treated with N-acetylcysteine, which had been obtained 10 hours after ingestion, the menthofuran level was 40 ng/mL. Review of 18 previous case reports of pennyroyal ingestion documented moderate to severe toxicity in patients who had been exposed to at least 10 mL of pennyroyal oil. Conclusion: Pennyroyal continues to be an herbal toxin of public health importance. Data on human metabolites may provide new insights into the toxic mechanisms and treatment of pennyroyal poisoning, including the potential role of N-acetylcysteine. Better understanding of the toxicity of pennyroyal may also lead to stricter control of and more restricted access to the herb.
Acute Gram-negative Bacillary Necrotizing Pneumonia: An Inquiry into Its Pathogenesis.
Authors: James A. Reinarz
Journal: Annals of Internal Medicine (1965)

s1 May 1965Acute Gram-negative Bacillary Necrotizing Pneumonia: An Inquiry into Its Pathogenesis.James A. Reinarz, Alan K Pierce, M.D., Jay P. Sanford, M.D.James A. ReinarzSearch for more papers by this author, Alan K Pierce, M.D.Search for more papers by this author, Jay P. Sanford, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-1086_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptGram-negative bacilli are assuming an increasing role in nosocomial infections, having surpassed staphylococci in frequency of occurrence. In addition to the well-recognized syndromes of pyelonephritis and gram-negative rod bacteremia, a characteristic necrotizing pneumonia caused by gram-negative bacilli has been identified at autopsy. Pathological characteristics include necrosis of alveolar walls and bronchioles, extensive polymorphonuclear infiltration, and large numbers of gram-negative bacilli. Its frequency in autopsies at Parkland Memorial Hospital increased from 3% in 1935 to 10% in 1963 (P < 0.01). This report describes a group of patients with fatal necrotizing pneumonia selected to illustrate potential factors in its pathogenesis.Greater... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: James A. Reinarz; Alan K Pierce, M.D.; Jay P. Sanford, M.D.Affiliations: Dallas, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1965Volume 62, Issue 5Page: 1086-1086KeywordsAutopsyBacteremiaBronchiolesNecrosisNosocomial infectionsPathogenesisPneumoniaPyelonephritis ePublished: 1 December 2008 Issue Published: 1 May 1965 PDF downloadLoading ...
Both inflammation and remodeling influence nitric oxide output in children with refractory asthma
Authors: Bruno Mahut, Christophe Delclaux, Isabelle Tillie-Leblond, Philippe Gosset, Christophe Delacourt, Françoise Zerah-Lancner, Alain Harf, Jacques de Blic
Journal: Journal of Allergy and Clinical Immunology (2004)
Anaphylactoid Reaction to an Initial Dose of Sodium Cephalothin
Authors: Sherwin A. Kabins
Journal: JAMA (1965)

CEPHALOTHIN, the sodium salt of 7-(thiophene2-acetamido) cephalosporanic acid, is a semisynthetic derivative of cephalosporin C, one of the naturally occurring cephalosporins, a family of antibiotics resembling the penicillins in antibiotic properties. Their chemical structure is similar to the penicillins, the major difference being the presence in the cephalosporins of the six-membered dihydrothiazine ring in place of the five-membered thiazolidine ring in the penicillins (Figure). It has been hoped that the dissimilarities in the chemistry of these ring structures would preclude the occurrence of cross-sensitivity between the penicillins and cephalosporins. This hope was strengthened by the failure to observe cross-reactions after intradermal tests with cephalosporin C in penicillin-sensitivepatients<sup>1</sup>and by the lack of reactions following administration of cephalothin to such patients.<sup>2-3</sup>The following case report suggests that cross-sensitivity between penicillins and cephalosporins, however rare, may occur to a clinically dangerous degree. <h3>Report of a Case</h3> A 47-year-old
Cutting to the Core: Exploring the Ethics of Contested Surgeries
Authors: Griffin Trotter
Journal: JAMA (2007)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Lehrbuch der inneren Medizin
Authors: Norman B. Roberg
Journal: JAMA (1970)

These two volumes, intended for students and practitioners, are up-to-date and international in content. The textual material (two thirds that of our popular textbooks) is supplemented by many charts, tables, and diagrams and by numerous splendid reproductions of roentgenograms and photographs. The presentations are concise and clear, and have a vividness reflecting the authors' experience as lecturers. Most of the sections, such as those on cardiovascular or digestive diseases, are written by only one of the 29 authors. This contributes to the critical choice of content and to the balance between basic and clinical sciences. The exellent printing, organization, format, and index invite continuous reading or quick reference. The 280-page section on neurology, exemplary in its succinct presentations and supported by 160 excellent diagrams and illustrations, answers the wants of students and clinicians. The newer fields of genetics, hereditary metabolic diseases, and drug-induced syndromes are well presented. The emphasis upon
Open Heart Surgery in Infective Endocarditis
Authors: DEV R. MANHAS, EUGENE A. HESSEL, LOREN C. WINTERSCHEID, DAVID H. DILLARD, K. ALVIN MERENDINO
Journal: Circulation (1970)

Fourteen patients with bacterial endocarditis had open heart surgery. Thirteen were operated upon because of congestive heart failure, and in one the indication for surgery was persistent infection. The aortic valve alone was involved in six patients; two patients had both aortic and mitral valve endocarditis. Five patients had infection of the mitral valve, and one patient had tricuspid valve involvement. All the patients received preoperative antibiotics for a variable period. Ten patients left the hospital and four died in the hospital. Of the 10 patients discharged, one died 9 months later of congestive heart failure. Seven patients developed valvular leaks either through the suture line or the homograft, and two deaths resulted. Nine patients are alive and in good functional status. Antibiotics were given for 5 to 10 days postoperatively; one patient, however, received antibiotics for 49 days. Early open heart surgery is recommended in bacterial endocarditis if heart failure is progressive. Shorter postoperative antibiotic therapy is proposed once the source of residual infection is removed.
Patient Self-management of Chronic Disease in Primary Care
Authors: Thomas Bodenheimer
Journal: JAMA (2002)

Patients with chronic conditions make day-to-day decisions about--self-manage--their illnesses. This reality introduces a new chronic disease paradigm: the patient-professional partnership, involving collaborative care and self-management education. Self-management education complements traditional patient education in supporting patients to live the best possible quality of life with their chronic condition. Whereas traditional patient education offers information and technical skills, self-management education teaches problem-solving skills. A central concept in self-management is self-efficacy--confidence to carry out a behavior necessary to reach a desired goal. Self-efficacy is enhanced when patients succeed in solving patient-identified problems. Evidence from controlled clinical trials suggests that (1) programs teaching self-management skills are more effective than information-only patient education in improving clinical outcomes; (2) in some circumstances, self-management education improves outcomes and can reduce costs for arthritis and probably for adult asthma patients; and (3) in initial studies, a self-management education program bringing together patients with a variety of chronic conditions may improve outcomes and reduce costs. Self-management education for chronic illness may soon become an integral part of high-quality primary care.
In vivo biocompatibility, sustained-release and stability of triptorelin formulations based on a liquid, degradable polymer
Authors: Lutz R. Asmus, Jean-Christophe Tille, Béatrice Kaufmann, Louise Melander, Torsten Weiss, Kerstin Vessman, Wolfgang Koechling, Grégoire Schwach, Robert Gurny, Michael Möller
Journal: Journal of Controlled Release (2012)
Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study
Authors: D. E. Smith
Journal: JAMA (1994)

To examine the longitudinal associations between a pregnancy and persistent changes in adiposity in young black and white women.Prospective cohort study with 5 years of follow-up.Participants recruited by community-based sampling (Birmingham, Ala; Chicago, Ill; and Minneapolis, Minn) and through the membership of a large prepaid health care plan (Oakland, Calif).A total of 2788 women (53% black) aged 18 through 30 years were assessed at baseline (1985 through 1986) and reassessed at examination 2 (91% retention; 1987 through 1988) and examination 3 (86% retention; 1990 through 1991). Women who remained nulliparous (n = 925) during the 5-year follow-up were compared with women who had a single pregnancy of 28 weeks' duration during that period and who were at least 12 months postpartum at follow-up (primiparas, n = 89; multiparas, n = 114).Change in body weight and in waist-to-hip ratio during the 5-year period. Analyses were adjusted for demographic factors (age and education), behavioral variables (smoking and physical activity), and baseline level of adiposity.Primiparas within both race groups gained 2 to 3 kg more weight during the 5-year period than did nulliparas in both adjusted and unadjusted analyses. Primiparas also had greater increases in waist-to-hip ratio that were independent of weight gain. Multiparas did not differ from nulliparas in adiposity change in either race group. At each level of parity, black women demonstrated greater adverse changes in adiposity than did white women.These data suggest that women experience modest but adverse increases in body weight and fat distribution after a first pregnancy and that these changes are persistent.
Prolonged Bleeding Times and Bleeding Diathesis Associated With Moxalactam Administration
Authors: Michael R. Weitekamp
Journal: JAMA (1983)

A reversible bleeding diathesis associated with marked prolongation of the bleeding time was recognized in five patients receiving the new antibiotic moxalactam disodium (Moxam). Platelet dysfunction secondary to interference with adenosine diphosphate-induced aggregation has been demonstrated in vitro. Clinically important hemorrhage consequent to the use of this antibiotic may be more common than previously thought. (<i>JAMA</i>1983;249:69-71)
Fish Oil and SI Units
Authors: William J. MacDonald
Journal: JAMA (1989)

To the Editor.—  I am a cardiologist who increasingly has turned to readingJAMAin recent years, and I thank you for presenting articles of wide interest to such a diverse population of physicians.  I was particularly interested in the article in the Aug 5 issue entitled Clinical Applications of Fish Oils.1  I regret that the author chose to report the triglyceride and cholesterol levels only in millimoles per liter. I have looked through the article twice and find no annotation to convert this to milligrams per deciliter. I likewise have no access to a conversion factor in my office.  This markedly diminishes the utility of the article to me and my patients.  Although the goal of conversion to a standardized chemistry reporting nomenclature may be laudable, I believe it is the responsibility of the journal to transmit information as simply and clearly as possible, and this SPECIAL COMMUNICATION
Out of hours service: the Danish solution examined
Authors: F. Olesen, J. V Jolleys
Journal: BMJ (1994)

In Denmark the provision of out of hours care by general practitioners came under increasing pressure in the 1980s because of growing demand for services by the public and increasing complaints from rural doctors about their heavy workload and disproportionately low remuneration in comparison with urban doctors. As a result, the out of hours service was reformed at the start of 1992: locally negotiated rota systems were replaced with county based services. Each county now has a coordination centre, where all patients' calls are received by a team of doctors. The doctors may give a telephone consultation, advise the patient to attend one of the emergency clinics strategically placed about the county, or arrange for a home visit. Doctors on home visiting duty are located at bases throughout the county and keep in touch with the coordination centre with mobile telephones. Graded fees mean that doctors are encouraged to give telephone consultations rather than arrange for clinic consultations or home visits. The reforms have reduced doctors' out of hours workload and the number of home visits made and have proved acceptable to patients, doctors, and administrators.
Periostin potently promotes metastatic growth of colon cancer by augmenting cell survival via the Akt/PKB pathway
Authors: Shideng Bao, Gaoliang Ouyang, Xuefang Bai, Zhi Huang, Chaoyu Ma, Ming Liu, Rong Shao, Ryan M Anderson, Jeremy N Rich, Xiao-Fan Wang
Journal: Cancer Cell (2004)
Management of Hodgkin's disease
Authors: S. Watkins
Journal: BMJ (1977)

mortality.It would simply mean that the cause of death would be different.Enabling people to live longer-perhaps for 20 years after retirement-would create economic problems no less great than at present.There would perhaps be the com- pensation that more and more of the un- employed could be used in looking after the aged.Or will you be proposing what the Archbishop of Canterbury hinted at when financial resources really dry up ?S ELLISON London NW6A cautionary tale SIR,-'Tis with a sense of grievous shock That one observed great Stephen Lock To perpetrate the awful sin Of leaving an unchecked reference in An article that bears his name.'This blot on editorial fame Though "For Debate" is clear to see At least to Belloc and to me: It was not Lundy's noble dad Who did advise the tearful lad It was his grandpapa the Duke -Sir, what a liberty you took!
Why is the outcome of transient ischaemic attacks different in different groups of patients?
Authors: G J Hankey, M S Dennis, J M Slattery, C P Warlow
Journal: BMJ (1993)

The outcomes of each of three large cohorts of patients with transient ischaemic attacks, which were studied in the same country at much the same time with the same methods, were compared and found to be quite different from each other. The differences in outcome were related not only to different strategies of treatment but also to differences in the prevalence and level of important prognostic factors (for example, case mix) and other factors such a the time delay from transient ischaemic attack to entry into the study and the play of chance. The implications for purchasers of health care are that they cannot rely solely on non-randomised comparisons of outcome of patients treated in competing units as a measure of the quality of care (which has only rather modest effects) without accounting for other factors that may influence outcome such as the nature of the illness, the case mix, observer bias, and the play of chance.
MISCONCEPTION, IN AMERICA, AS TO THE ROSE POSITION
Authors: WARREN STONE BICKHAM
Journal: JAMA (1931)

General misconception exists in America as to the exact meaning and correct production of the Rose position. The idea is prevalent that almost any dorsal decubitus of the patient, with his head hanging over the end of the table, the top of which is usually horizontal with the floor, constitutes the Rose position. The result is that operations performed in such a position are almost always unsatisfactory and that blood and other fluids, especially in difficult prolonged technics, are generally drawn into the trachea or esophagus, in spite of efforts at active suction-drainage. I have frequently been present when operators have announced to by-standers that they were operating in the Rose position. I have never seen the Rose position correctly, or even approximately, assumed in America. I have often been present at the operations of Mr. Rose, in London, and have been greatly impressed by Mr. Rose's unusually terse reply
Human blood and synovial fluid neutrophils cultured in vitro undergo programmed cell death which is promoted by the addition of synovial fluid.
Authors: A L Bell, M K Magill, R McKane, A E Irvine
Journal: Annals of the Rheumatic Diseases (1995)

To assess the influence of inflammatory synovial fluid (SF) on apoptosis of joint and blood neutrophils with particular reference to levels of colony stimulating factors (CSF) contained therein.Neutrophils were separated from fresh synovial fluid and from peripheral blood by density gradient centrifugation. Apoptosis was assayed by light microscope morphology and DNA degradation. CSFs were assayed using bone marrow bioassay and enzyme linked immunosorbent assays for granulocyte (G-) and granulocyte macrophage (GM-) CSF. Separated neutrophils were cultured in vitro and exposed to: varying concentrations of SF in which CSF levels were measured, recombinant G-CSF and GM-CSF, and hyaluronic acid control solutions. Numbers of apoptotic neutrophils and CSF levels were also measured in fresh SF samples.The addition of autologous or heterologous inflammatory SF to blood or joint cavity neutrophils cultured in vitro caused a significant dose dependent increase in the percentage of cells becoming apoptotic with time as measured morphologically and confirmed by DNA degradation. The effect bore no relationship to levels of CSF in joint fluid, despite our finding that GM-CSF produced inhibition of neutrophil apoptosis in vitro.These data suggest that SF contains a factor or factors capable of directly or indirectly promoting neutrophil apoptosis and normally powerful enough to overcome the apoptosis inhibiting effects of cytokines such as GM-CSF at concentrations usually found in inflammatory synovial fluids.
Hyperpolarization-Activated Inward Current in Ventricular Myocytes From Normal and Failing Human Hearts
Authors: Uta C. Hoppe, Erik Jansen, Michael Südkamp, Dirk J. Beuckelmann
Journal: Circulation (1998)

Background —The hyperpolarization-activated inward current (I f ) was found to be overexpressed in hypertrophied rat ventricular myocytes, indicating that I f might favor arrhythmias in hypertrophied or failing ventricular myocardium. In the present study, we evaluated whether I f is expressed in human ventricular myocardium, if it may be increased in human heart failure, and if its autonomic modulation may be altered. Methods and Results —The whole-cell patch-clamp technique was used to record I f in isolated ventricular myocytes from 34 failing (dilated [DCM] or ischemic [ICM] cardiomyopathy) and 13 donor hearts (NF). I f was observed in all myocytes showing typical current properties, ie, time and voltage dependence, block by [Cs + ] o , permeability for K + and Na + , and current increase with raising [K + ] o . There was a trend toward larger current densities in myopathic (at −130 mV in [K + ] o 25 mmol/L; DCM: −1.37±0.12 pA/pF, n=50; ICM: −1.39±0.24 pA/pF, n=30) than in nonfailing cells (−1.18±0.21 pA/pF, n=24), although this difference did not reach statistical significance ( P =.23). Boltzmann distributions yielded an activation threshold of −80 mV and half-maximal activation at −110.96±0.06 mV in myopathic and normal myocytes. Isoproterenol (10 −5 mol/L) shifted the current activation by 10 mV (31 myopathic, 5 NF). Carbachol and adenosine had no direct effect on I f (6 and 12 myopathic, 3 and 3 NF, respectively) but reversibly antagonized β-adrenergic stimulation (5 and 7 myopathic, 2 and 2 NF, respectively). Autonomic modulation was similar in failing and nonfailing cells. Conclusions —In end-stage heart failure, no significant change of I f could be found, although there was a trend toward increased I f . Together with an elevated plasma norepinephrine concentration and a previously reported reduction in I K1 in human heart failure, I f might favor diastolic depolarization in individual myopathic cells.
Correction: What Are the Benefits and Risks of Fitting Patients with Radiofrequency Identification Devices?
Authors: Mark Levine, Ben Adida, Kenneth Mandl, Isaac Kohane, John Halamka
Journal: PLoS Medicine (2008)

Correction for:

Levine M, Adida B, Mandl K, Kohane I, Halamka J (2007) What are the benefits and risks of fitting patients with radiofrequency identification devices? PLoS Med 4(11): e322. doi:10.1371/journal.pmed.0040322

John Halamka declared that he had no competing interests. While he has no financial relationship with the VeriChip Corporation, he serves as an unpaid adviser to the corporation on privacy, security, and standards issues, as well as strategy and future applications of the VeriChip radiofrequency identification implantable microchip technology.