tbuckley/cabot-search huggingface dataset:
Exaggerated pressor response to treadmill exercise in chronic cocaine abusers with left ventricular hypertrophy.
Authors: C G Cigarroa, J D Boehrer, M E Brickner, E J Eichhorn, P A Grayburn
Journal: Circulation (1992)

BACKGROUND Chronic cocaine abuse has been associated with a high prevalence of left ventricular hypertrophy (LVH) in normotensive individuals at rest. This study was conducted to determine whether chronic cocaine abusers with LVH would manifest an exaggerated pressor response to treadmill exercise. METHODS AND RESULTS Forty-nine normotensive chronic cocaine abusers underwent Bruce protocol treadmill exercise testing until they attained 85% maximum predicted heart rate. A peak exercise systolic blood pressure greater than or equal to 210 mm Hg was defined as abnormal. In addition, they underwent two-dimensional echocardiography and had left ventricular mass determined by the area-length method. LVH was defined as left ventricular mass greater than or equal to 105 g/m2 and a posterior wall thickness greater than or equal to 1.2 cm. Age- and race-matched control subjects also underwent echocardiography and exercise testing. Group differences in peak exercise blood pressure in cocaine abusers with LVH, cocaine abusers without LVH, and control subjects were assessed by ANOVA: Groups were similar concerning age, race, heart rate, resting blood pressure, body surface area, and exercise duration. LVH was present in 16 of 49 (33%) cocaine abusers and three of 30 (10%) control subjects (p = 0.02). Of the 16 cocaine abusers with LVH, 10 (63%) had peak exercise blood pressures greater than or equal to 210 mm Hg, and three others had exercise blood pressures of 200 mm Hg. Therefore, peak exercise systolic blood pressure was significantly higher in cocaine abusers with LVH than in all other groups (p = 0.0001). CONCLUSIONS Chronic cocaine abusers with LVH manifest an exaggerated pressor response to treadmill exercise. These data suggest that chronic cocaine abuse predisposes a subset of individuals to a heightened pressor response to a given sympathetic stimulus such as exercise and that this may contribute to the pathogenesis of LVH in chronic cocaine abusers.
Mantle cell lymphoma: 2013 Update on diagnosis, risk‐stratification, and clinical management
Authors: Julie M. Vose
Journal: American Journal of Hematology (2013)

Disease Overview Mantle cell lymphoma (MCL) is a non‐Hodgkin lymphoma characterized by involvement of the lymph nodes, spleen, blood, and bone marrow with a short remission duration to standard therapies and a median overall survival of 4–5 years. Diagnosis Diagnosis is based on lymph node, bone marrow, or tissue morphology of centrocytic lymphocytes, small cell type, or blastoid variant cells. A chromosomal translocation t(11:14) is the molecular hallmark of MCL, resulting in the overexpression of cyclin D1. Cyclin D1 is detected by immunohistochemistry in 98% of cases. The absence of SOX‐11 or a low Ki‐67 may correlate with a more indolent form of MCL. The differential diagnosis of MCL includes small lymphocytic lymphoma, marginal zone lymphoma, and follicular lymphoma. Risk Stratification The Mantle Cell Lymphoma International Prognostic Index (MIPI) is the prognostic model most often used and incorporates ECOG performance status, age, leukocyte count, and lactic dehydrogenase. A modification of the MIPI also adds the Ki‐67 proliferative index if available. The median overall survival (OS) for the low risk group was not reached (5‐year OS of 60%). The median OS for the intermediate risk group was 51 months and 29 months for the high risk group. Risk‐Adapted Therapy For selected indolent, low MIPI MCL patients, initial observation may be appropriate therapy. For younger patients with intermediate or high risk MIPI MCL, aggressive therapy with a cytarabine containing regimen ± autologous stem cell transplantation should be considered. For older MCL patients with intermediate or high risk MIPI, combination chemotherapy with R‐CHOP, R‐Bendamustine, or a clinical trial should be considered. At the time of relapse, agents directed at activated pathways in MCL cells such as bortezomib (NFkB inhibitor) or lenalidamide (anti‐angiogenesis) are approved agents. Clinical trials with Ibruitinib (Bruton's Tyrosine Kinase inhibitor) or Idelalisib (PI3K inhibitor) have demonstrated excellent clinical activity in MCL patients. Autologous or allogeneic stem cell transplantation can also be considered in young patients. Am. J. Hematol. 88:1083–1088, 2013. © 2013 Wiley Periodicals, Inc.
Mechanisms of allergic pulmonary eosinophilia in the mouse
Authors: Ted T. Kung, Dawn Stelts, Jackie A. Zurcher, Arthur S. Watnick, Howard Jones, Peter J. Mauser, Xiomara Fernandez, Shelby Umland, William Kreutner, Richard W. Chapman, Robert W. Egan
Journal: Journal of Allergy and Clinical Immunology (1994)
A Complication Of Circumcision
Authors: Andrew J. McGowan
Journal: JAMA (1969)

<h3>To the Editor:—</h3> A serious complication of circ[ill]cision unmentioned in the refere[ill]s given by Lackey et al (<b>206</b>:2318, 1968) is that of surgically bivalving either the dorsal or ventral half of the glans penis. This is caused by inadvertent placement of one limb of the scissors into the urethra rather than between the foreskin and the glans prior to performing either the dorsal or ventral slit in the prepuce. These fortunately rare cases are those with pinpoint openings in the phimotic foreskin with the glandular meatus just beneath. If the adhesions of the inner surface of the foreskin and glans penis are not reduced, the line of least resistance to placement of instrument within the foreskin is the urethra itself. Once the incision is made, the glans penis is bivalved and the urethra laid open. In effect, a first degree hypospadius or epispadius has been produced. While avoidance of
Development and application of a robust speciation method for determination of six arsenic compounds present in human urine.
Authors: Lisa S Milstein, Amal Essader, Edo D Pellizzari, Reshan A Fernando, James H Raymer, Keith E Levine, Olujide Akinbo
Journal: Environmental Health Perspectives (2002)

Six arsenic species [arsenate, arsenite, arsenocholine, arsenobetaine, monomethyl arsonic acid, and dimethyl arsinic acid] present in human urine were determined using ion-exchange chromatography combined with inductively coupled plasma mass spectrometry (IC-ICP-MS). Baseline separation was achieved for all six species as well as for the internal standard (potassium hexahydroxy antimonate V) in a single chromatographic run of less than 30 min, using an ammonium carbonate buffer gradient (between 10 and 50 mM) at ambient temperature, in conjunction with cation- and anion-exchange columns in series. The performance of the method was evaluated with respect to linearity, precision, accuracy, and detection limits. This method was applied to determine the concentration of these six arsenic species in human urine samples (n = 251) collected from a population-based exposure assessment survey. Method precision was demonstrated by the analysis of duplicate samples that were prepared over a 2-year analysis period. Total arsenic was also determined for the urine samples using flow injection analysis coupled to ICP-MS. The summed concentration of the arsenic species was compared with the measured arsenic total to demonstrate mass balance.
The Capsule and Colorectal-Cancer Screening — The Crux of the Matter
Authors: Michael Bretthauer
Journal: New England Journal of Medicine (2009)

In the United States and other countries, colonoscopy has emerged as the primary screening test for colorectal cancer. Colonoscopy is believed to prevent colorectal cancer because polyps are removed during the procedure, but randomized trials have not been conducted to show this benefit. Because colonoscopy is an invasive, uncomfortable procedure, with a small but finite risk of complications, there is a demand for less invasive techniques.Imagine a small capsule with a built-in camera, the size of a tablet, that is easily swallowed and can detect cancer and polyps in your large bowel. It causes no discomfort while it travels . . .
NECROBACILLOSIS OF THE LUNG
Authors: F. W. Shaw
Journal: JAMA (1934)

Necrobacillosis is an acute infectious disease due to Actinomyces necrophorus and is characterized by a coagulation necrosis followed by caseation. Infection of the lung by Actinomyces necrophorus has been reported but once. This was by Cunningham,<sup>1</sup>and the organism was isolated from the lung abscess at necropsy. The case reported here is of special interest because of the fact that the organism was isolated from the living patient and also because of the apparent rarity of necrobacillosis of the lung in human beings. <h3>REPORT OF CASE</h3> J. S., a Negro, aged 38, admitted to the St. Philip Hospital, Nov. 11, 1932, complained of a cough, expectoration of a large amount of foul sputum, weakness and loss of appetite. The patient dated the onset of his illness to the latter part of August, 1932, at which time he was working as a gardener in New Hampshire. An infection of the
A Comparison of the Effects of Hydrochlorothiazide and Captopril on Glucose and Lipid Metabolism in Patients with Hypertension
Authors: Thomas Pollare, Hans Lithell, Christian Berne
Journal: New England Journal of Medicine (1989)

It has been suggested that the metabolic side effects of antihypertensive drugs are responsible for their failure to reduce cardiovascular morbidity in patients with hypertension. Therefore, in 50 patients with essential hypertension, we performed a randomized, double-blind, crossover study comparing the effects of carbohydrate and lipid metabolism of captopril (mean [+/- SD] dose, 81 +/- 24 mg per day) and hydrochlorothiazide (40 +/- 12 mg per day) over two four-month treatment periods. Captopril increased the insulin-mediated disposal of glucose, as compared with placebo, from 5.7 +/- 2.4 to 6.3 +/- 2.5 mg per kilogram of body weight per minute (P less than 0.05), whereas hydrochlorothiazide caused a decrease from 6.4 +/- 2.0 to 5.7 +/- 1.9 (P less than 0.01). Captopril had no effect on the basal insulin concentration, but it decreased the late (30- to 90-minute) insulin response to glucose and increased the early (2- to 6-minute) insulin peak. Hydrochlorothiazide increased the basal insulin concentration and the late insulin response to glucose. These findings may be explained by an increase in insulin sensitivity with captopril and a decrease with hydrochlorothiazide. Little or no change was seen in serum lipid or lipoprotein levels during treatment with captopril, whereas hydrochlorothiazide caused significant increases in serum total (5 percent) and low-density lipoprotein (6 percent) cholesterol levels and total (15 percent) and very-low-density lipoprotein (25 percent) triglyceride levels, as compared with placebo (P less than 0.01 for all comparisons). We conclude that hydrochlorothiazide for the treatment of essential hypertension has adverse effects on glucose and lipid metabolism. It is possible, but not proved in this study, that these changes may contribute to the risk for diabetes mellitus and coronary heart disease. In contrast, captopril appears to have beneficial or no effects on glucose and lipid metabolism.
Betamethasone 17-valerate: a new alcoholic formulation for psoriasis of the scalp.
Authors: D. I. Williams, J. Warner, L. C. Wilson
Journal: BMJ (1967)

The treatment of dermatoses of the scalp is often made more difficult by the unpleasantness of the preparations commonly in use. Women in particular are loath to apply creams and ointments which leave the hair darkened, greasy, smelly, and in need of frequent washing. Psoriasis of the scalp, a frequent and sometimes the only manifestation of the disease, can often be treated successfully with ointments containing tar. However, the application of tar ointments results in all the cosmetic disadvantages we have mentioned. Betamethasone 17-valerate (Betnovate) has been shown to be the most effective topical steroid in the treatment of psoriasis (Williams et al., 1964), and McKenzie and Atkinson (1964) have demonstrated that this steroid is highly active in an alcoholic solution. It was felt that an alcoholic formulation of betamethasone 17-valerate would thus provide a more acceptable treatment for psoriasis of the scalp. A double-blind clinical trial was carried out with a lotion containing 0.1% betamethasone 17-valerate in 50% isopropyl alcohol. The alcohol was slightly gelled, to render the lotion less mobile and thus easier for the patient to control when applying it to the scalp. As it was thought that the cosmetic advantages of this preparation might in part be offset by the patient's having to wear a dressing on the head at night, the formulation was not used under polyethylene occlusion.
Guarded Endorsement for Lyme Disease Vaccine
Authors: Charles Marwick
Journal: JAMA (1998)

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
P318 PEAK SERUM CREATININE LEVEL FOLLOWING ACUTE KIDNEY INJURY PREDICTS MORTALITY IN HOSPITALIZED PATIENTS WITH ALCOHOLIC HEPATITIS
Authors: H.Y. Kim, J. Byun, W. Kim, Y.J. Jung, J.-H. Lee, S.J. Yu, B.G. Kim, Y.J. Kim, J.-H. Yoon, K.L. Lee, H.-S. Lee
Journal: Journal of Hepatology (2014)
A CLINICAL AND ELECTROENCEPHALOGRAPHIC SURVEY OF PSYCHOPATHIC PERSONALITY
Authors: R. G. S. ARTHURS, E. B. CAHOON
Journal: American Journal of Psychiatry (1964)

Considering the 87 cases without epilepsy or deterioration, we have found an abnormal or borderline EEG in 55% of this series of psychopathic personality. The type of abnomality is not specific, but has been seen in post-traumatic cases, adolescents and epileptics. The distribution and nature of the abnormalities is quite different from that found in a series of epileptics and there is no significant family history of epilepsy in these cases. The intellectual level and normal neurological findings of this group of patients is against birth trauma or organic cerebral disease. Parental history of psychopathic behaviour is consistent with either a hereditary predisposition or psychological stress, or both as causative factors. The early onset of these personality disorders is more consistent with hereditary or constitutional factors although it must be recognized that environmental factors may well produce this type of disorder at an early age where a relevant history is not available.
The Reliability of the Male North American Frog (<i>Rana pipiens</i>) in the Diagnosis of Pregnancy
Authors: S. L. Robbins, F. Parker
Journal: New England Journal of Medicine (1949)

WITHIN the past two years many reports summarized by Galli–Mainini1 have appeared describing a new technic for diagnosis of pregnancy utilizing male amphibia. A great many species of frogs and toads have been described as useful for this procedure, and it is highly probable that many varieties of amphibia have equal value. At the present time two species have received the greatest attention. Galli–Mainini,2 working in South America, has used a toad indigenous to that area—the Bufo arenarum. His recent report on the results of approximately 1000 tests using this amphibian indicates a high degree of accuracy, approximately 98 . . .
Abuse of OTC drugs rising in South Asia
Authors: G. Mudur
Journal: BMJ (1999)

Pharmaceutical preparations available without prescriptions (over the counter drugs) have emerged as drugs of serious misuse across India, Bangladesh, and Nepal, a report released last week in New Delhi warned.

The report from the United Nations International Drug Control Programme also said that intravenous drug use and addiction to multiple drugs are escalating.

Processed and synthetic drugs are replacing traditional plant products, such as cannabis and opium, as substances of misuse, according to the South Asia Drug Demand Reduction report. The biggest threat now comes from the mounting misuse of pharmaceutical agents like buprenorphine, diazepam, antihistamines, and cough syrups containing codeine, it said. 

The report estimates that there are 4 million drug misusers in the South Asian region, with India accounting for nearly 3 million and Bangladesh another 500000.

The All India Institute of Medical Sciences in New Delhi, which receives over 2500 new patients at its addiction treatment centre, has recorded a decline in patients dependent on opiates from 72%in 1989 to around 43%in the mid 1990s. Since 1993, however, buprenorphine has accounted for 20%of drug abuse and benzodiazepines for another 17%.

India’s pharmaceutical industry produces large amounts of psychotropic substances for medicinal purposes. But, the report said, they are sold without valid prescriptions, illegally transported to neighbouring countries, and sold for profit.

“Ironically, this shift towards pharmaceutical preparations is the result of stringent anti-narcotics initiatives by governments,” said Dr Rajat Ray, a professor at the institute's addiction treatment centre and the principal author of the report.

“They are far easier to obtain and cheaper than heroin,” he said.

The South Asia Drug Demand Reduction Report is available from: UNDCP Regional Office for South Asia, India International Centre, 40, Max Mueller Marg, 55 Lodi Estate, New Delhi, India 110003.
Evidence, not conjecture, should guide clinical practice and policies on e-cigarettes
Authors: C. Bullen, O. Knight-West, B. O'Brien, N. Walker
Journal: BMJ (2014)

The BMJ recently published two letters raising concerns about patients using e-cigarettes in the perioperative setting that we believe are based on speculation and misinformation rather than evidence.1 2 Roberts and Davies’s letter should have been framed as a question because they provide no evidence that e-cigarette use is dangerous. Perioperative “acute nicotine intoxication” is attributed to e-cigarette use, but the authors provide no evidence this has occurred in clinical practice. Their use of …
Photopenic Areas on Bone Scanning Associated with Childhood Leukemia
Authors: STUART C. MORRISON, LEE P. ADLER
Journal: Clinical Nuclear Medicine (1991)

Photopenic areas on bone scintigraphy is a rare presentation of childhood leukemia. This includes the more common acute lymphocytic leukemia as well as the far less common myelomonocytic leukemia. Other causes of photopenia on bone scintigraphy in these patients include relapse with marrow replacement and associated bone necrosis. Methotrexate therapy has also previously been described as showing similar photopenic areas secondary to bone necrosis.
Fish Intake May Limit the Increase in Risk of Coronary Heart Disease Morbidity and Mortality Among Heavy Smokers
Authors: Beatriz L. Rodriguez, Dan S. Sharp, Robert D. Abbott, Cecil M. Burchfiel, Kamal Masaki, Po-Huang Chyou, Boji Huang, Katsuhiko Yano, Jess David Curb
Journal: Circulation (1996)

Research has shown that fish consumption limits damage to the lungs caused by cigarette smoking, possibly by the effects of fish on arachidonic acid metabolism. We explored this fish-smoking interaction using coronary heart disease (CHD) incidence and mortality as the outcome.The Honolulu Heart Program began in 1965 to follow a cohort of 8006 Japanese-American men aged 45 to 65 years who lived on Oahu, Hawaii, in 1965. Fish intake was measured at baseline by use of a questionnaire. For current smokers at baseline (n = 3310) who reported low fish intake (< 2 times/wk), age-adjusted 23-year CHD mortality rates increased with the number of cigarettes smoked per day (2.3, 3.1, and 6.9 per 1000 person-years for men who smoked < 20, 20 to 30, and > 30 cigarettes/d, respectively; trend test P < .0001). Among current smokers whose fish intake was high (> or = 2 times/wk), CHD mortality rates showed no relation with cigarettes/d (3.7, 3.2, and 3.7 per 1000 person-years for the corresponding levels of smoking). A Cox proportional hazards model based on current smokers, adjusted for age, years in Japan, calories/d, alcohol intake, physical activity index, years smoked, hypertension, and serum cholesterol, blood glucose, and uric acid levels, was examined. In the high-smoking group, the risk factor-adjusted relative risk (RR) for CHD mortality among those with high fish intake was half that of those with low fish consumption (RR = 0.5, 95% confidence interval = 0.28 to 0.91). A Cox model that adjusted for similar risk factors confirmed a significant interaction of cigarettes/d and fish intake (P < .01) on CHD mortality. Analyses for CHD incidence showed similar results.Despite the findings of this investigation, the public health message for smokers continues to be to stop smoking. However, an interaction between fish intake and cigarette smoking is biologically plausible and deserves further investigation. The study of this phenomenon may shed light on the biological mechanisms by which cigarette smoking leads to CHD.
Duodenal and Gastric Ulcer Prevention with Misoprostol in Arthritis Patients Taking NSAIDs
Authors: David Y. Graham
Journal: Annals of Internal Medicine (1993)

Objectives: To determine the efficacy of misoprostol for the prevention of nonsteroidal anti-inflammatory drug (NSAID)-induced duodenal and gastric ulcers in arthritis patients receiving NSAID therapy. Design: A randomized, double-blind, multicenter, placebo-controlled trial. Setting: Six hundred thirty-eight private, Veterans Affairs, health maintenance, and academic practices. Patients: Six hundred thirty-eight patients with chronic inflammatory or noninflammatory arthritis who were taking an NSAID but who did not have a gastric or duodenal ulcer on screening endoscopy received treatment with ibuprofen, piroxicam, naproxen, sulindac, tolmetin, indomethacin, or diclofenac daily for 3 months. Four hundred fifty-five (71%) patients completed the trial. Interventions: Patients meeting the entry criteria were randomized to receive either misoprostol, 200 g, or placebo, four times a day for 12 weeks. Main Outcome Measures: The endoscopy was repeated at 4, 8, and 12 weeks. The development of a duodenal or gastric ulcer (defined as a circumscribed mucosal defect 0.5 cm in diameter and with perceptible depth) was regarded as prophylactic failure. Results: By 12 weeks, a duodenal ulcer developed in 2 of 320 (0.6%; 95% CI, 0.2% to 3.9%) patients randomized to receive misoprostol, compared with 15 of 323 (4.6%; CI, 2.8% to 8%) patients receiving placebo (P = 0.002). A gastric ulcer developed in 6 of 320 (1.9%; [CI, 0.8% to 4.4%] patients, compared with in 25 of 323 (7.7%; CI, 5.1% to 11.4%), respectively. Conclusion: Misoprostol significantly lowers the frequency of both duodenal and gastric ulcer development in patients who require long-term therapy with NSAIDs.