tbuckley/cabot-search huggingface dataset:
SPORT AND EXERCISE MEDICINE (SEM) IN PRIMARY CARE: A NOVEL DUAL ARMED APPROACH TO IMPROVING PHYSICAL ACTIVITY (PA) AND MUSCULOSKELETAL (MSK) SERVICES IN A HERTFORDSHIRE GENERAL PRACTICE
Authors: S Chew, J Noake
Journal: British Journal of Sports Medicine (2013)

Background With the advent of SEM as a recognised medical specialty in the United Kingdom, a number of service models have become apparent. 1 Despite government initiatives to increase for example PA promotion in the primary care setting, uptake, promotion and utilisation of these services has been poor or lacked longevity. 2 Schopwick General Practice has a patient population of over 12,000 and is a standard primary care service provider. Aim To develop a holistic reproducible dual armed model of SEM services in the primary care setting that is economically viable and sustainable. Methods Two SEM registrars in conjunction with the practice partners and manager, proposed, implemented and piloted a SEM service providing both musculoskeletal and physical activity interventions. Care provision included “one-stop” MSK clinics with capabilities for “see and treat” injection therapy, rehabilitation prescription &amp; allied priority physiotherapy appointments. Novel PA prescription templates to assist practitioners were embedded in consultation software, &amp; electronic ‘flag’ systems developed to highlight priority intervention patients. GPPAQ was made a mandatory component of the “new patient” registration procedure. Over a 12 month period audit of parameters including orthopaedic referral rates, frequency of physical activity interventions according to electronic note records, and patient service questionnaires were used to assess outcome measures of the service. Results Documented PA advice increased fourfold over a 9 month period. Use of GPPAQ Pre and Post January 2011 increased significantly. All use Vision Exercise Related Read Codes Pre and Post January 2011 increased fivefold. Orthopaedic referral rates were reduced by approximately 50%, MRI scan requests were reduced by over half and in-house physiotherapy waiting times were reduced from 8 to 6 weeks despite the introduction of service specific appointments. Conclusions Novel service models marrying both musculoskeletal and physical activity promotion services can make sound economical and patient satisfaction positive outcomes within primary care settings. We present a reproducible model that has recently been commissioned as a service by the local clinical commissioning group.
THE SIGNIFICANCE OF THE OCCURRENCE OF PATHOGENIC SPIRILLA IN THE WATERS OF THE DELAWARE AND SCHUYLKILL RIVERS AT PHILADELPHIA.
Authors: D. H. BERGEY
Journal: JAMA (1897)

As a result of a systematic study of the waters of the lower Schuylkill and Delaware along the city front during the past year, I have found over a hundred spirilla, many of which possess pathogenic properties when inoculated into the lower animals, notably pigeons and guinea pigs. A careful study of the morphologic and biologic characters of these organisms shows that many of them are very closely allied to the group of pathogenic spirilla with which we are already familiar, the most important member of that group being the spirillum choleræ Asiaticæ, or Koch's common bacillus. The resemblance in some instances is so close that one not expert in the exact differentiation of the members of this group of organisms would be unable to detect any differences. Others deviate slightly from this type, while a considerable number show more or less marked deviation from this type. A considerable number
Antibodies to opacity proteins (Opa) correlate with a reduced risk of gonococcal salpingitis.
Authors: F A Plummer, H Chubb, J N Simonsen, M Bosire, L Slaney, N J Nagelkerke, I Maclean, J O Ndinya-Achola, P Waiyaki, R C Brunham
Journal: Journal of Clinical Investigation (1994)

Acute salpingitis complicating cervical gonococcal infection is a significant cause of infertility. Relatively little data are available concerning the pathophysiologic mechanisms of this disease. A cohort of 243 prostitutes residing in Nairobi were followed between March 1985 and April 1988. Gonococcal cultures were performed at each visit, and acute salpingitis was diagnosed clinically. Serum at enrollment was tested by immunoblot for antibody to gonococcal outer membrane proteins. 8.6% (146/1689) of gonococcal infections were complicated by salpingitis. Increased risk of salpingitis was associated with younger age, shorter duration of prostitution, HIV infection, number of gonococcal infections, and episodes of nongonococcal salpingitis. Rmp antibody increased the risk of salpingitis. Antibody to Opa decreased the risk of salpingitis. By logistic regression analysis, antibody to Opa was independently associated with decreased risk of gonococcal salpingitis (adjusted odds ratio [OR], 0.35; 95% confidence interval [95%CI], 0.17-0.76); HIV infection (adjusted OR, 3.5; 95% CI, 0.96-12.8) and episodes of nongonococcal salpingitis (adjusted OR, 3.4; 95% CI, 1.8-6.4) were independently associated with an increased risk of salpingitis. Antibody to Opa appears to protect against ascending gonococcal infection, perhaps by interfering with Opa mediated adherence and endocytosis. The demonstration of natural immunity that protects against upper genital tract infection in women suggests that a vaccine to prevent gonococcal salpingitis is possible.
Abstract 2820: Vorinostat abrogates ridaforolimus-induced activation of Akt in synovial sarcoma cells: A possible rationale for their synergism
Authors: Sherif S. Morgan, Lee D. Cranmer
Journal: Cancer Research (2012)

Abstract Background: Curative treatments for patients with metastatic synovial sarcoma (SS) do not exist and such patients have a poor prognosis. Previously, we demonstrated that the combination of the mTOR inhibitor ridaforolimus and the HDAC inhibitor vorinostat exhibited synergism in a variety of cell lines. Here, we explore whether the Akt pathway is potentially involved in mediating the synergistic effects of ridaforolimus and vorinostat. Methods: Two SS cell lines (HS-SY-II and SYO-I) were treated with the single agents or with combinations of ridaforolimus and vorinostat. After 72 hours, cell viability was measured using the cell proliferation assay (MTS). Combination Indices (CI) were calculated to determine whether each combination was synergistic, additive, or antagonistic. Western Blot analysis assessed alterations in total and phospho-Akt protein levels in response to drug treatment. Results: Ridaforolimus IC50 was 10.9nM in HS-SY-II and 23.1nM in SYO-I; vorinostat IC50 was 440nM in HS-SY-II and 561nM in SYO-I. CI were 0.28 and 0.63 in HS-SY-II and SYO-I, respectively, indicating synergism between the two agents. The ridaforolimus/vorinostat combination was assessed in other tumor types, including osteosarcoma (U2OS), metastatic melanoma (Stew1 and Stew2), pancreatic cancer (Panc1 and BxPC3), and lung cancer (A549). The combination was synergistic in all cell lines: CI ranged from 0.37 to 0.77, except in Panc1, where it was additive (CI=0.92). As previously observed with other mTOR inhibitors, ridaforolimus alone increased pAkt-ser473 levels in SS cell lines; this effect was abrogated by the addition of vorinostat. Conclusions: The combination of ridaforolimus and vorinostat demonstrates in vitro synergism in SS as well as in a variety of other tumor types. The addition of vorinostat prevented ridaforolimus-induced Akt activation, a possible mechanism of resistance to mTOR inhibition. Adding HDAC inhibition to mTOR inhibitors may be a route to circumvent Akt-mediated resistance to mTOR inhibitors. Our results also indicate that this combination may demonstrate broad anti-neoplastic activity. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2820. doi:1538-7445.AM2012-2820
Hyperprolactinemia: still perplexing but eminently treatable
Authors: E. R. Gonzalez
Journal: JAMA (1979)

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
Bronchodilator action of inhaled nitric oxide in guinea pigs.
Authors: P M Dupuy, S A Shore, J M Drazen, C Frostell, W A Hill, W M Zapol
Journal: Journal of Clinical Investigation (1992)

The effects of inhaling nitric oxide (NO) on airway mechanics were studied in anesthetized and mechanically ventilated guinea pigs. In animals without induced bronchoconstriction, breathing 300 ppm NO decreased baseline pulmonary resistance (RL) from 0.138 +/- 0.004 (mean +/- SE) to 0.125 +/- 0.002 cmH2O/ml.s (P less than 0.05). When an intravenous infusion of methacholine (3.5-12 micrograms/kg.min) was used to increase RL from 0.143 +/- 0.008 to 0.474 +/- 0.041 cmH2O/ml.s (P less than 0.05), inhalation of 5-300 ppm NO-containing gas mixtures produced a dose-related, rapid, consistent, and reversible reduction of RL and an increase of dynamic lung compliance. The onset of bronchodilation was rapid, beginning within 30 s after commencing inhalation. An inhaled NO concentration of 15.0 +/- 2.1 ppm was required to reduce RL by 50% of the induced bronchoconstriction. Inhalation of 100 ppm NO for 1 h did not produce tolerance to its bronchodilator effect nor did it induce substantial methemoglobinemia (less than 2%). The bronchodilating effects of NO were additive with the effects of inhaled terbutaline, irrespective of the sequence of NO and terbutaline administration. Inhaling aerosol generated from S-nitroso-N-acetylpenicillamine also induced a rapid and profound decrease of RL from 0.453 +/- 0.022 to 0.287 +/- 0.022 cmH2O/ml.s, which lasted for over 15 min in guinea pigs broncho-constricted with methacholine. Our results indicate that low levels of inhaled gaseous NO, or an aerosolized NO-releasing compound are potent bronchodilators in guinea pigs.
Majocchi's disease in a newborn baby: a familial case
Authors: M. Honda, S. Saijo, H. Tagami
Journal: British Journal of Dermatology (1997)

Journal Article Majocchi's disease in a newborn baby: a familial case Get access M. Honda, M. Honda Department of Dermatology, Tohoku University School of Medicine, 1‐1 Seiryo‐machi, Aoba‐ku, Sendai 980‐77, Japan Search for other works by this author on: Oxford Academic Google Scholar S. Saijo, S. Saijo Department of Dermatology, Tohoku University School of Medicine, 1‐1 Seiryo‐machi, Aoba‐ku, Sendai 980‐77, Japan Search for other works by this author on: Oxford Academic Google Scholar H. Tagami H. Tagami Department of Dermatology, Tohoku University School of Medicine, 1‐1 Seiryo‐machi, Aoba‐ku, Sendai 980‐77, Japan Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 137, Issue 4, 1 October 1997, Pages 655–656, https://doi.org/10.1111/j.1365-2133.1997.tb03812.x Published: 01 October 1997
Effects of Deletion of the Tissue Inhibitor of Matrix Metalloproteinases-1 Gene on the Progression of Murine Thoracic Aortic Aneurysms
Authors: John S. Ikonomidis, William C. Gibson, Jessica E. Butler, David M. McClister, Sarah E. Sweterlitsch, Robert P. Thompson, Rupak Mukherjee, Francis G. Spinale
Journal: Circulation (2004)

Objective— The cause of thoracic aortic aneurysms (TAAs) is poorly understood. Previous work has suggested an association between development of aortic aneurysms and matrix metalloproteinase (MMP) activity. We hypothesized that removal of the primary endogenous aortic MMP inhibitor (TIMP) through TIMP-1 gene deletion will increase TAA progression. Methods and Results— The descending thoracic aortas of wild-type 129 SvE and TIMP-1 gene knockout (TIMP-1 −/− ) mice were exposed to 0.5 mol/L CaCl 2 for 15 minutes, with terminal studies performed at 4 or 8 weeks. TAA lumen diameter was measured using confocal microscopy and normalized to the ascending aorta. In addition, sections were studied with in situ zymography and immunohistochemistry staining for MMP-9. Both wild-type [TAA/ascending ratio (mean±SEM): control, 0.85±0.02 (n=14); 4 weeks, 1.00±0.03 (n=13); 8 weeks, 1.05±0.10 (n=9)] and TIMP-1 −/− [control, 0.98±0.04 (n=11); 4 weeks, 1.10±0.03 (n =21); 8 weeks, 1.22±0.09 (n=10)] groups developed aneurysms at 4 and 8 weeks compared with their respective controls ( P &lt;0.05). TIMP-1 −/− animals developed larger aneurysms than the corresponding wild-type group ( P &lt;0.05). Aneurysms in the TIMP-1 −/− group were larger at 8 weeks than at 4 weeks ( P &lt;0.05), which was not seen in the wild-type aneurysm groups. Both groups showed presence of MMP-9 in 4 and 8 weeks, most prominently in the adventitia and outer media. In situ zymographic activity was increased in the 8-week TIMP-1 −/− group compared with wild-type. Conclusions— Deletion of the TIMP-1 gene results in increased and continued progression of aneurysm formation compared with wild-type mice in a unique TAA model caused at least in part by an alteration in the balance between gelatinase activity and its endogenous inhibition. Therapeutic strategies aimed at modifying MMP activity may reduce or prevent the progression of TAAs.
Cutaneous lymphatic amyloid deposits in 'Hungarian-type' familial transthyretin amyloidosis: a case report
Authors: T. Harkany, F. Garzuly, G. Csanaky, P.G.M. Luiten, C. Nyakas, R.P. Linke, S. Viragh
Journal: British Journal of Dermatology (2002)

Multiple transthyretin (TTR) mutations have recently been identified and implicated in the development of familial systemic amyloidoses, but early diagnosis of these disorders is still largely unresolved. We investigated the presence and tissue distribution of TTR-derived amyloid in skin biopsies of a 59-year-old woman carrying the "Hungarian-type" mutation of TTR (Asp18Gly). Clinical symptoms involved severe central nervous system dysfunction without signs of polyneuropathy, also referred to as the "central form" of TTR-related systemic amyloidosis. Skin biopsy was also evaluated as a tool in order to diagnose this type of TTR amyloidosis. Biopsy samples were collected from the infra-axillary region. Light microscopy using Congo red and polarized light was used to diagnose amyloid deposits. Subsequently, electron microscopic analysis was performed to correlate the amyloid deposits with vicinal dermal structures. The amyloid class was determined by means of immunocytochemistry. TTR amyloid was primarily localized to lymphatic microvessels in the present case, whereas arterioles were devoid of TTR amyloid deposits. In addition, the well-known association of TTR amyloid with neural structures along the erector pilorum and around the sebaceous and serosal (sweat) glands was also evident. Electron microscopic analysis of amyloid deposits revealed characteristic amyloid fibrils that were irregular in shape, and exhibited a heterogeneous density and a random deposition pattern. Immunocytochemistry confirmed the cutaneous accumulation of TTR amyloid. In conclusion, amyloid deposits were abundantly present in the skin of a patient with "Hungarian-type" TTR amyloidosis; skin biopsy seems to be appropriate for the diagnosis of this disorder. We showed that besides the erector pilorum, sweat glands and nerve terminals, lymphatic microvessels are also severely infiltrated by TTR amyloid. Whether these pathological alterations can exclusively be found in "Hungarian-type" TTR amyloidosis should still be investigated. If such changes are not specific for the Asp18Gly mutation, they may be considered as diagnostic markers for "central" TTR amyloid disorders.
Atypical Paget's Disease With Quantitative Assessment of Tracer Kinetics
Authors: Gopinath Gnanasegaran, Amelia E. Moore, Glen M. Blake, Sanjay Vijayanathan, Susan E. Clarke, Ignac Fogelman
Journal: Clinical Nuclear Medicine (2007)

Introduction: Paget's disease of bone is characterized by alterations in skeletal metabolism, affecting a single or multiple bones. Paget's is usually confined to an individual bone and typically does not spread or extend across joints. A patient with an unusual pattern of disease is presented together with quantitative assessment of the tracer kinetics pre- and posttreatment. Material and Methods: A 75-year-old lady patient presented to her general practitioner in May 2002 with a history of lethargy. Clinical examination was unremarkable and further investigations such as blood tests (alkaline phosphatase levels), Tc-99m MDP bone scan, biopsy, and CT scan were carried out. Results: Alkaline phosphatase levels were greater than 2000 IU/L (Normal: 31–116 IU/L). The Tc-99m MDP bone scan showed strikingly increased uptake in the central skeleton involving the thoracic vertebrae and the adjoining ribs. The bone biopsy was inconclusive. CT scan revealed symmetrical expansion of the ribs with bridging osteophytes across the ribs and spine. The patient was treated with risedronate and quantitative analysis of the pre- and posttherapy bone scans showed reduced plasma clearance in the pagetic bones. Conclusions: This case illustrates an unusual distribution of bone lesions in Paget's disease, which we think could be due to the result of degenerative disease leading to bridging and allowing direct extension of disease from one bone to another.
The role and fate of rabbit and human transcobalamin II in the plasma transport of vitamin B12 in the rabbit.
Authors: R J Schneider, R L Burger, C S Mehlman, R H Allen
Journal: Journal of Clinical Investigation (1976)

Previous studies have shown that plasma transcobalamin II (TCII) facilitates the cellular uptake of [57Co] vitamin B12 (B12) by a variety of tissues, but the lack of an intrinsic label on the protein moiety of the TCII-B12 complex has made it impossible to determine the role and fate of TCII during this process. We have labeled homogensous rabbit and human TCII with 125I-labeled N-succinimidyl-3-(4-hydroxyphenyl) propionate and have performed in vivo experiments in rabbits. When 125I-labeled rabbit TCII-[57Co] B12 and 131I-labeled bovine albumin were simultaneously injected intravenously, we observed that 125Iand 57Co were cleared from plasma at a faster rate (t1/2 = 1 1/2 h) than 131I and that 125I and 57Co were present in excess of 131I in the kidney, liver, spleen, heart, lung, and small intestine 1/2 h after injection. Later, 57Co remained in excess of 131I, but the ratio of 125I to 131I decreased progressively in all of these plasma and were rapidly excreted in the urine. After 1 h following injection, 57Co was present in excess of 125I in the plasma...
Sensor Technology in Assessments of Clinical Skill
Authors: Shlomi Laufer, Elaine R Cohen, Calvin Kwan, Anne-Lise D D'Angelo, Rachel Yudkowsky, John R Boulet, William C McGaghie, Carla M Pugh
Journal: New England Journal of Medicine (2015)

To the Editor: Blair et al. (Dec.4 issue) 1 are thorough and insightful in their review of conduct disorder and related entities, except that there is no reference to sex, sex ratios, or male sex.Yet for childhood-onset conduct disorder that persists throughout life, there is consensus that there is a massive male predominance, by a factor of 10 to 15, whereas for conduct disorder generally, the ratio is still between 2:1 and 4:1. 2 Mounting evidence suggests that prenatal androgenization affects the brains of human male fetuses as it does the brains of many other mammals, resulting in a partially gendered brain. 3 The hypothalamus and amygdala, which Blair et al. identify as participating in hypothesized conduct disorder-related neural circuits, are affected by this organizational effect of androgens, and activational effects of pubertal and postpubertal androgens further influence their function.Violence, which is overwhelmingly used by young men, cannot be understood in terms of brain function, prevention, or treatment without reference to and investigation of sex differences and male-predominant neuroendocrine effects.
Congenital Lymphoid Hyperplasia with Persistent Hyperlymphocytosis
Authors: John M. M. Darte, Peter D. McClure, E. Fred Saunders, James L. Weber, William L. Donohue
Journal: New England Journal of Medicine (1971)

THE patient described below has had generalized lymphoid hyperplasia since birth, and a white-cell count in the range of 80,000; approximately 90 per cent of the peripheral leukocytes are lymphocytes. The lymphocytes and other cellular components of the blood are cytologically normal. There has been no disturbance of growth and development nor of ability to combat infection. He has not received any specific therapy.Case ReportJ.F., a 7 1/2-year-old boy of European parentage, had been seen at 7 months of age because of persistent splenomegaly and lymphocytosis. The past history revealed that he was born at 34 weeks' gestation . . .
Living organ donation needs debate on harm to donors
Authors: David W Evans
Journal: BMJ (2006)

EDITOR—Conspicuously absent from the article by Friedman et al,1 and from the rapid responses to it that have been published to date, is a detailed account of the inevitable morbidity and risk of serious harm that is inflicted on the donor by doctors in the course of their ordinary paid employment. The short term risks include life threatening haemorrhage, pulmonaryembolism, pneumothorax, infection, transfusion transmitted hepatitis, …
Drug treatments for rheumatoid arthritis: looking backwards to move forwards
Authors: P. Miossec
Journal: BMJ (2015)

New combinations of older drugs can be effective and affordable

Over the past 40 years the clinical picture has improved for patients with rheumatoid arthritis thanks to key steps in drug development and care strategy. These steps include the introduction of methotrexate in 1980 and the first inhibitors of tumour necrosis factor (TNF) in 2000. This was followed by the development of new biotechnology products to target other cytokines, cell subsets, and cell interaction pathways. All these products are expensive drugs with obvious consequences for health systems with limited resources. 

In parallel, trials have also continued to test old drugs used in new more modern ways, starting with the combination of methotrexate, sulfasalazine, and hydroxychloroquine. The real surprise came from a recent demonstration that this combination was as effective as the combination of methotrexate and the TNF inhibitor etanercept.1 2 The linked paper by Scott and colleagues (doi:10.1136/bmj.h1046) is another example of a trial of TNF inhibitors compared with intensive treatment comprising a combination of conventional disease modifying anti-rheumatic drugs.3 The primary objective of this non-inferiority trial was to examine whether the drug combination could achieve similar clinical benefits to a TNF inhibitor …