tbuckley/cabot-search huggingface dataset:
Recurrent fevers in the presence of multiple autoimmune diseases and antibody deficiency
Authors: E Drewe
Journal: Annals of the Rheumatic Diseases (2002)

A 37 year old white South African woman presented with a two week history of fevers, rigors, and watery diarrhoea up to six times a day.She had a complex past medical history, developing insulin dependent diabetes mellitus aged 2 years and hypothyroidism aged 11 years.At 13 years she was diagnosed with idiopathic thrombocytopenic purpura (ITP) and two years later underwent splenectomy, with a partial response.At 25 years, she developed haemolytic anaemia.Initial treatment with azathioprine was withdrawn owing to thrombocytopenia and she was subsequently treated for three years with oral cyclophosphamide.On moving to the United Kingdom, treatment was changed to a combination of danazol, hydroxychloroquine, and 10-30 mg oral prednisolone a day.At the age of 33 she was diagnosed with primary antibody deficiency on the basis of recurrent pneumonia, autoimmune disease, borderline low and falling total IgG, low IgG2 subclass, and failure to produce a specific IgG response to tetanus and pneumovax immunisations.Intravenous immunoglobulin replacement treatment was startedIn the six years before the above presentation she had also described intermittent watery diarrhoea, controlled with loperamide and on several occasions remitted when the steroid dose for ITP was increased.Stool culture and parasitology, abdominal ultrasound scan, gastroscopy and duodenal biopsy, flexible sigmoidoscopy, barium meal and follow through, and barium enema were all normal.Biopsies of the rectum and sigmoid colon showed a chronic inflammatory cell infiltrate compatible with immunodeficiency.Other problems included hypoadrenalism attributed to either prolonged steroid use or autoimmune disease, and premature ovarian failure.She also had an autonomic neuropathy presumed to be secondary to her diabetes.At age 35 her ITP became more problematic and although treatment with cyclosporin and, subsequently, tacrolimus resulted in improvement, these agents were withdrawn owing to uncontrolled hypertension.Shortly before her above presentation she had visited South Africa and returned with a penicillin resistant Streptococcus pneumoniae pneumonia that responded to intravenous cefuroxime.At presentation, clinical examination showed a small unwell woman with mild icterus.She had fever of 39°C, tachycardia, normal blood pressure but an ejection systolic murmur.Bilateral coarse crepitations were audible in the chest.Liver was palpable 4 cm below the costal margin and a splenectomy scar was notable.Laboratory investigations disclosed haemoglobin 109 g/l, leucocyte count 11.1×10 9 /l, platelets 253×10 9 /l , erythrocyte sedimentation rate 26 mm/1st h, and C reactive protein 129 mg/l, renal function normal but liver function mildly deranged.There was a polyclonal increase in IgM of 8.8 g/l with normal IgA and preinfusion IgG.A chest radiograph suggested mild bronchiectasis.Gram negative Morganella mor-. . . .
Harnessing the Fcμ Receptor for Potent and Selective Cytotoxic Therapy of Chronic Lymphocytic Leukemia
Authors: Bérengère Vire, Martin Skarzynski, Joshua D. Thomas, Christopher G. Nelson, Alexandre David, Georg Aue, Terrence R. Burke, Christoph Rader, Adrian Wiestner
Journal: Cancer Research (2014)

Chronic lymphocytic leukemia (CLL) is a B-cell malignancy in need of new, effective, and safe therapies. The recently identified IgM receptor FcμR is overexpressed on malignant B cells in CLL and mediates the rapid internalization and lysosomal shuttling of IgM via its Fc fragment (Fcμ). To exploit this internalization and trafficking pathway for targeted drug delivery, we engineered an IgM-derived protein scaffold (Fcμ) and linked it with the cytotoxic agent monomethylauristatin F. This Fcμ-drug conjugate was selectively toxic for FcμR-expressing cell lines in vitro and for CLL cells but not autologous normal T cells ex vivo. Notably, the cytotoxic activity of the Fcμ-drug conjugate was maintained in CLL cells carrying a 17p deletion, which predicts resistance to standard chemotherapy. Next, we tested the possible therapeutic application of the Fcμ-drug conjugate in immunodeficient NOD/SCID/IL-2Rγ(null) (NSG) mice engrafted with peripheral blood cells from patients with leukemia. Three intravenous injections of the Fcμ-drug conjugate over a 10-day period were well tolerated and selectively killed the human CLL cells but not the coengrafted autologous human T cells. In summary, we developed a novel strategy for targeted cytotoxic therapy of CLL based on the unique properties of FcμR. FcμR-targeted drug delivery showed potent and specific therapeutic activity in CLL, thus providing proof of concept for FcμR as a valuable therapeutic target in CLL and for IgM-based antibody-drug conjugates as a new targeting platform.
Rapid HIV Testing at Home: Does It Solve a Problem or Create One?
Authors: Rochelle P. Walensky, A. David Paltiel
Journal: Annals of Internal Medicine (2006)

The U.S. Food and Drug Administration (FDA) is considering approval of an over-the-counter, rapid HIV test for home use. To date, testimony presented before the FDA has been overwhelmingly supportive. Advocates have argued enthusiastically that there is value in empowering individuals to manage their HIV risks and have suggested that the availability of a rapid home HIV test will dramatically increase rates of disease detection in communities that have proven difficult to reach and to link to appropriate care. The authors offer a more cautious perspective. According to what is already known about the market demand for over-the-counter HIV testing kits, their costs, and the performance of rapid HIV tests in that market, the authors do not anticipate that the rapid home test will have a profound impact either on the HIV public health crisis or on the populations in greatest need. Home HIV testing will attract a predominantly affluent clientele, composed disproportionately of HIV-uninfected new couples and "worried well" persons, as well as very recently infected persons with undetectable disease. The authors illustrate how testing in these populations may have the perverse effect of increasing both false-positive and false-negative results. A poorly functioning home HIV test may thereby undermine confidence in the reliability of HIV testing more generally and weaken critical efforts to expand HIV detection and linkage to lifesaving care for the estimated 300 000 U.S. citizens with unidentified HIV infection.
More Than Ramps: A Guide to Improving Health Care Quality and Access for People With Disabilities
Authors: Margaret A. Nosek
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 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
Temporal Patterns in Long-Term Survival After Resuscitation From Out-of-Hospital Cardiac Arrest
Authors: Thomas D. Rea, Matthew Crouthamel, Mickey S. Eisenberg, Linda J. Becker, Ann R. Lima
Journal: Circulation (2003)

During the past quarter century, advances in treatment of cardiovascular disease have occurred that might potentially benefit survivors of sudden cardiac arrest (SCA). Little is known, however, about the temporal patterns in long-term survival among persons resuscitated from SCA. We hypothesized that long-term survival would improve over time and that this temporal pattern would be most evident for cardiac causes of death.The investigation was a retrospective cohort study of survival among persons who were discharged alive from the hospital after resuscitation from out-of-hospital SCA due to heart disease in King County, Wash, between May 1, 1976, and December 31, 2001 (n=2035). Calendar time was divided into four 5-year intervals: 1976 to 1980, 1981 to 1985, 1986 to 1990, and 1991 to 1995, and one 6-year interval, 1996 to 2001. Age-adjusted survival curves were constructed, and Cox proportional-hazards regression was used to compute hazard ratios (HRs) for the association between mortality and time period. During 11 201 person-years of follow-up, 1334 persons died. Compared with the initial time period, the HR for total mortality was 0.86 (95% confidence interval, 0.73 to 1.01) for 1981 to 1985, 0.82 (0.69 to 0.96) for 1986 to 1990, 0.66 (0.55 to 0.79) for 1991 to 1995, and 0.58 (0.47 to 0.71) for 1996 to 2001 (HR for trend=0.87 [0.84 to 0.91] for each successive time period). In analyses that assessed cardiac mortality, an even stronger temporal association was evident (HR for trend=0.79 [0.75 to 0.84]).Long-term survival after resuscitation from SCA improved steadily over time in this cohort. To continue this trend, future studies should identify circumstances in which proven treatments are underutilized as well as investigate new therapies that might benefit survivors of SCA.
Dietary alcohol, calcium, and potassium. Independent and combined effects on blood pressure.
Authors: M H Criqui, R D Langer, D M Reed
Journal: Circulation (1989)

To determine whether or not the previously reported association between alcohol intake and high blood pressure is influenced by differential intake of calcium and potassium in drinkers compared with nondrinkers and to assess the magnitude of the independent contributions of alcohol, calcium, and potassium to blood pressure, these associations were evaluated in 7,011 men of Japanese descent. Categorical analyses and multiple linear regression techniques were used to test the hypotheses that alcohol, calcium, and potassium were independent predictors of blood pressure. Alcohol consumption above a threshold of approximately 20 ml/day was found to be positively, strongly, and independently correlated with systolic and diastolic pressures, and this effect was completely independent of the effects of calcium and potassium. Calcium and potassium intake were highly correlated (r = 0.59) and were inversely related to blood pressure, and their combined effect was greater than the effect of either alone. However, in the subgroup of moderate and heavier drinkers, only potassium was inversely related to blood pressure. This finding is compatible with previous reports of malabsorption and increased excretion of calcium at higher levels of alcohol intake, and it indicates that a small portion of the alcohol-induced blood pressure elevation may be mediated through calcium depletion. In the range of dietary intake in this cohort, the effect of alcohol on blood pressure was stronger than was either the separate or combined effects of calcium and potassium.
Anti‐IgE autoantibodies and bee‐sting allergy
Authors: Y. Yu, A. L. de Weck, B. M. Stadler, U. Müller
Journal: Allergy (1995)

Serum anti‐IgE autoantibodies (aaIgE) were investigated by dot immunobinding assay in bee‐allergic patients in comparison with nonallergic beekeepers, healthy blood donors, and atopic subjects. Elevated serum levels of aaIgE — either free or combined with IgE — were found in both bee‐allergic patients and atopic subjects as compared with beekeepers and healthy donors. With regard to a possible significance of aaIgE for the protective mechanism induced by specific allergen immunotherapy, we estimated aaIgE in bee‐allergic patients before, during, and after bee‐venom immunotherapy (BVIT) in relation to the outcome of a provocation test with a living bee (PT). During the first year of BVIT, there was no significant change in either free or combined aaIgE, but aaIgE decreased during protracted BVIT over 3–7 years. By using two monoclonal anti‐IgE antibodies with different epitope specificity (Le27 and BSW17), we were able to detect two kinds of IgE/aaIgE immune complexes. Our data show that during and after BVIT the levels of one kind of IgE‐aaIgE immune complex (the non‐BSW17 type) tended to decrease in PT‐negative patients but stayed elevated in PT‐positive patients. The levels of the other kind of immune complex (the non‐Le27 type) were similar in treatment failures and successfully treated patients. These data suggest that there are various kinds of aaIgE with different in vivo functions related to their epitope specificity. Some of them (non‐BSW17 type) might be associated with BVIT failure.
Effects of withdrawal of sustained‐release theophylline in patients with chronic obstructive lung disease
Authors: T. Aamodt, R. Dahle, O. Horgen
Journal: Allergy (1988)

In a double‐blind, cross‐over study, sustained‐release theophylline was withdrawn to determine whether the drug was still effective after long‐term treatment. Twenty adult out‐patients with stable, chronic obstructive lung disease and who had been on continuous long‐term treatment for at least 6 months, were studied. Lung function, plasma theophylline concentration, symptom score, number of nocturnal dyspnoea attacks, requirement for additional beta 2 ‐stimulant aerosol, and side effects, were recorded before withdrawal, after withdrawal and after reinstitution of treatment. When theophylline was withdrawn, all parameters were significantly worsened, but after reinstitution of treatment they all improved .significantly. The results show that sustained‐release theophylline remains effective after at least 6 months' continuous treatment in adult patients.
Treatment of Gonorrheal Urethritis Evaluated in 230 Men
Authors: B. Eugene Berry
Journal: JAMA (1967)

During a recent eight-month deployment of an aircraft carrier to the western Pacific, 230 cases of acute gonorrheal urethritis were encountered. Patients were randomly assigned to one of four treatment schedules: (1) procaine penicillin G for ten days; (2) procaine penicillin G in a large single dose; (3) penicillin G potassium for three days; and (4) oxytetracycline. Eradication of the gonococcus was highest with regimens 2 and 4. Cure of gonorrhea and prevention of nongonorrheal urethritis was highest with the oxytetracycline regimen.
Prescribing of nutritional supplements is increasing in general practice
Authors: J Norwood, D Short, N Dakhill
Journal: BMJ (1999)

EDITOR—Potter et al state that making nutritional supplementation a routine part of hospital prescribing has cost implications.1 Although we agree with this statement, we believe that the issue is far wider than that of hospital prescribing. Prescribing of enteral feed products in primary care is one of the most rapidly increasing areas of drug expenditure.

As part of a study for the NHS Executive,2 we analysed prescribing analysis and cost (PACT) data for the …
Evidence, Preferences, Recommendations — Finding the Right Balance in Patient Care
Authors: Timothy E. Quill, Robert G. Holloway
Journal: New England Journal of Medicine (2012)

Interview with Dr. Timothy Quill on balancing evidence-based medicine and patient-centered care. (14:02)Download Much progress has been made in applying scientific evidence to medical practice; less progress has been made in rendering care "patient-centered." A five-step framework for reconciling the tension between "evidence-based" and "preference-based" medicine may help.
METHODS FOR THE CHARACTERIZATION AND COMPARISON OF ROTATIONAL GAMMA CAMERA SYSTEMS
Authors: Joseph Areeda, Dennis Chapman, Kenneth Van Train, James Bietendorf, Christopher Wong, Daniel Berman, Alan Waxman, Ernest Garcia
Journal: Clinical Nuclear Medicine (1983)

Areeda, Joseph; Chapman, Dennis; Train, Kenneth Van; Bietendorf, James; Wong, Christopher; Berman, Daniel; Waxman, Alan; Garcia, Ernest Author Information
Airway Smooth Muscle in Asthma — Not Just More of the Same
Authors: Stephanie A. Shore
Journal: New England Journal of Medicine (2004)

Airway smooth-muscle mass is increased in patients with asthma. This increase in muscle mass is quite marked in lung sections from patients who have died of asthma, but bronchial-biopsy studies indicate that even persons with mild-to-moderate asthma have increased airway smooth-muscle mass. Both hypertrophy and hyperplasia appear to contribute to this increase, and it is possible that airway smooth-muscle hyperplasia in asthma stems from the inflammatory milieu surrounding the asthmatic muscle. There are numerous smooth-muscle growth factors present in the asthmatic airway. Indeed, in culture, serum or bronchoalveolar-lavage fluid from patients with asthma causes greater proliferation of human airway smooth-muscle . . .
Association Between Blood Pressure Variability and Neutrophil/lymphocyte ratio (NLR in Hypertensive and Normotensive Patients)
Authors: Barış Kılıçaslan, Hüseyin Dursun, Sermin Kaymak, Mehmet Aydın, Cenk Ekmekçi, İbrahim Susam, Öner Özdoğan
Journal: Journal of the American College of Cardiology (2013)
Congestive jejunopathy in portal hypertension.
Authors: A S Nagral, A S Joshi, S J Bhatia, P Abraham, F P Mistry, I M Vora
Journal: Gut (1993)

Twenty six patients with portal hypertension of different aetiologies were studied for endoscopic evidence of congestive gastroduodenopathy and histological evidence of congestive gastropathy and jejunopathy. Per oral biopsies of jejunum were taken by Watson9s capsule. Normal biopsy tissues obtained from the antrum (26), fundus (10), and jejunum (26) were used as controls. Endoscopy showed congestive changes in the fundus (17 cases), antrum (17), and duodenum (4). Duodenopathy correlated with changes in the antrum but not in the fundus. Histology showed an increase in the size and number of vessels in the jejunal villi (9congestive jejunopathy9) in 22 patients. These correlated with histological evidence of gastropathy in the fundus but not in the antrum. The incidence of congestive jejunopathy did not correlate with the Child-Pugh score in patients with cirrhosis or with the number of sclerotherapy sessions received. Congestive jejunopathy is part of the spectrum of congestive gastroenteropathy and occurs at least as frequently as changes in the stomach and duodenum. The clinical import of these jejunal changes remains to be explained.
The Impact and Nature of Inflammation in the Olfactory Cleft On Olfaction in Patients with Chronic Rhinosinusitis
Authors: Jennifer Lavin, Eric Meen, Kent Lam, Atsushi Kato, He Huang, James Norton, Lydia Suh, Roderick Carter, Mahboobeh Mahdavinia, Kathryn E. Hulse, David Conley, Rakesh Chandra, Robert Kern, Robert P. Schleimer, Bruce Tan
Journal: Journal of Allergy and Clinical Immunology (2013)
Head of WHO to stand down
Authors: G. Yamey
Journal: BMJ (2002)

Dr Gro Harlem Brundtland is to stand down as director general of the World Health Organization (WHO) in July 2003, after only one term.

This will be the first time that a WHO director general has not been in office for at least two consecutive terms.

In an interview with the BMJ immediately after the announcement, she said that her decision reflected the fact that she would be 69 at the end of a second term. “I don't want to get into a situation in my life where …
Abstract 5157: Ubiquitin-dependent regulation of AKT by NEDD4-1.
Authors: Xinjiang Wang, Chuan-Dong Fan, Michelle A. Lum, Chao Xu, Jennifer D. Black
Journal: Cancer Research (2013)

Abstract Several E3 ligases have been reported to regulate AKT stability and activation through ubiquitination. We found that NEDD4-1 is a novel E3 ligase involved in ubiquitin-dependent regulation of AKT. NEDD4-1 physically interacts with AKT and mediates AKT ubiquitination in vitro and in vivo. NEDD4-1 catalyzes K63-type polyubiquitin chain formation on AKT in an in vitro ubiquitination assay. AKT ubiquitination by NEDD4-1 in vivo requires plasma membrane binding but not phosphorylation of AKT. Ubiquitination of AKT or pAKT by NEDD4-1 promotes AKT nucleus-oriented translocation. IGF-1 signaling stimulates NEDD4-1-mediated ubiquitination of pAKT but not total AKT. A cancer-derived plasma membrane-philic mutant AKT(E17K) is more effectively ubiquitinated by NEDD4-1 and more efficiently trafficked into the nucleus compared with AKT. This study revealed a novel function of AKT ubiquitination by NEDD4-1 in its nuclear trafficking, a step that contributes to AKT activation process in IGF-1 response. Citation Format: Xinjiang Wang, Chuan-Dong Fan, Michelle A. Lum, Chao Xu, Jennifer D. Black. Ubiquitin-dependent regulation of AKT by NEDD4-1. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5157. doi:10.1158/1538-7445.AM2013-5157
Acute and Chronic Effects of Normothermic Anoxia on Canine Hearts
Authors: L. MAXIMILIAN BUJA, SIDNEY LEVITSKY, VICTOR J. FERRANS, SHERMAN G. SOUTHER, WILLIAM C. ROBERTS, ANDREW G. MORROW
Journal: Circulation (1971)

In order to evaluate the acute and chronic effects of normothermic cardiac anoxia, structural and functional observations were made on the hearts of 29 dogs subjected to total cardiopulmonary bypass. Elective, normothermic cardiac arrest was induced by aortic cross-clamping for 30 minutes in 7 dogs and for 45 minutes in 16 dogs. The remaining six dogs, which served as controls, were placed on bypass without aortic cross-clamping. The six control dogs and six of seven dogs subjected to 30 minutes of cardiac anoxia showed excellent cardiac function and minimal myocardial damage; one dog in the latter group that died 6 to 12 hours after bypass showed no myocardial damage. All 16 dogs subjected to 45 minutes of cardiac anoxia showed extensive myocardial damage. Depressed cardiac function was demonstrated in three of five dogs that survived for eight days or longer after bypass. The acute cardiac damage was of the myofibrillar degeneration type and progressed to replacement fibrosis; this damage was selectively localized in the left ventricular papillary muscles and subendocardium.
Participatory Management in Psychiatry
Authors: DAVID E. RASKIN
Journal: American Journal of Psychiatry (1973)

In psychiatry, the concept of participatory management has been developed in the therapeutic community and elsewhere. The industrial management literature reveals that, although scientific management and human relations theorists saw no necessary conflict between management and worker, more recent writers have noted great conflict between organizational and individual needs. The author attempts to translate the industrial experience to psychiatric bureaucracies and highlights the basic conflicts between participatory management and authority, responsibility, and conflicting value systems.