tbuckley/cabot-search huggingface dataset:
Fatigue and Chills in a 60-Year-Old Hypertensive Alcoholic
Authors: Peter Alan Kosovsky
Journal: JAMA (1986)

<h3>History</h3> A 60-year-old woman with a history of alcohol abuse and hypertension presented to the emergency room because of increasing fatigue and shaking chills. Her temperature was 39.7°C (103.4°F) and her blood pressure was 90/60 mm Hg. Tenderness was present in the left upper and lower quadrants of the abdomen with guarding. Crepitus was noted along the left lateral side of the abdominal wall. Laboratory findings included a white blood cell count of 20 000/mm<sup>3</sup>(20.0×10<sup>9</sup>/L) with a leftward shift, abnormal results on liver function tests, anemia, a serum urea nitrogen concentration of 44 mg/ dL (15.5 mmol/L), and a creatinine level of 1.6 mg/dL (140 μmol/L), in addition to a prolonged prothrombin time. Roentgenograms of the abdomen and chest were obtained (Fig 1). <h3>Diagnosis</h3> Pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema secondary to sigmoid diverticulitis with extraperitoneal perforation. A plain x-ray film of the abdomen showed a calcified
HEAVY METALS IN SYPHILIS-Reply
Authors: John H. Stokes
Journal: JAMA (1934)

<h3>To the Editor:—</h3> Attention should be called first to the fact that the statement as rendered by the inquirer is a misquotation. The actual wording reads: The modern system for the treatment of early syphilis must be continuous; it must employ an arsphenamine and a bismuth compound, the latter intramuscularly; it must call for not less than twenty and unless special resistiveness is encountered, hardly more than thirty injections of the arsphenamine; and in accordance with the principles generally recognized in the treatment of the disease the system should call for continued treatment with heavy metal for one year after all symptoms and signs of the disease have disappeared. Taken in its entirety, this statement means that treatment should be continuous during the period when arsphenamine and bismuth compounds are being used. If, after the thirty injection arsphenamine requirement with alternating courses of a bismuth compound is satisfied, symptoms of
Abstract LB-205: Using cell-delivered nanoparticles to cause local hyperthermia increases survival in a murine metastatic pancreatic cancer model
Authors: Matthew T. Basel, Sivasai Balivada, Hongwang Wang, Tej B. Shrestha, Gwi Moon Seo, Marla M. Pyle, Gayani Abayaweera, Raj Dani, Viktor Chikan, Stefan Bossmann, Deryl Troyer
Journal: Cancer Research (2011)

Abstract Hyperthermia has been a method for cancer treatment for several decades now because cancer cells are slightly more susceptible to hyperthermia than healthy cells. Unfortunately, whole body hyperthermia has prohibitive side effects limiting its use or usefulness. Local hyperthermia, directed only to tumor tissue, could alleviate this problem and prove to be a potent cancer treatment. One method of generating local hyperthermia is to deliver magnetic nanoparticles to the tumor site and then generate heat using an alternating magnetic field (AMF). Here we demonstrate a system that uses tumor homing cells to actively carry iron/iron oxide nanoparticles into tumor tissue for AMF treatment. Paramagnetic iron/iron oxide nanoparticles were synthesized that absorb and convert AMF energy into heat very efficiently. These nanoparticles were loaded into Raw264.7 cells (mouse monocyte/macrophage like cells, Mo/Ma), that we have previously shown to be tumor homing cells. Test showed that the nanoparticles loaded at high concentration in the cells with very low toxicity. To test the system, a murine pancreatic cancer model was generated by injection of Pan02 cells i.p. After tumor development, Mo/Ma loaded with iron/iron oxide nanoparticles were injected i.p. and allowed to crawl into the tumor. Three days after injection, mice were exposed to an alternative magnetic field for twenty minutes to cause the cell-delivered nanoparticles to generate heat. This treatment regimen was repeated three times. A survival study demonstrated that this system can significantly increase survival in a murine pancreatic cancer model, with an average post-diagnosis life expectancy increase of 33%. Thus, for the first time, a cell-delivered nanoparticle system for generating localized hyperthermia has been demonstrated that can significantly prolong the life of i.p. pancreatic tumor bearing mice. This system has the potential to become a useful method for specifically and actively delivering nanoparticles for local hyperthermia treatment of cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-205. doi:10.1158/1538-7445.AM2011-LB-205
Maternal-infant transmission of hepatitis C virus infection
Authors: Eve A. Roberts, Latifa Yeung
Journal: Hepatology (2002)

Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 10(6) copies per mL). The rate of mother-to-infant transmission is 4% to 7% per pregnancy in women with HCV viremia. Co-infection with human immunodeficiency virus (HIV) increases the rate of transmission 4 to 5 fold. The actual time and mode of transmission are not known. Elective Cesarean section is not recommended for women with chronic HCV infection alone. The role of treatment to prevent transmission is limited by the fetal toxicity of currently available medications for hepatitis C. Breast feeding poses no important risk of HCV transmission if nipples are not traumatized and maternal hepatitis C is quiescent. Pregnant women at high risk for HCV infection should be screened for anti-HCV, and HCV RNA testing should be performed if anti-HCV is positive. Infants of women with hepatitis C should be tested for HCV RNA on two occasions, between the ages of 2 and 6 months and again at 18 to 24 months, along with serum anti-HCV. The natural history of mother-to-infant hepatitis C remains uncertain, especially the course in the first year of life when some infants appear to have spontaneous resolution.
Telephone-Delivered Collaborative Care for Treating Post-CABG Depression
Authors: Bruce L. Rollman, Bea Herbeck Belnap, Michelle S. LeMenager, Sati Mazumdar, Patricia R. Houck, Peter J. Counihan, Wishwa N. Kapoor, Herbert C. Schulberg, Charles F. Reynolds
Journal: JAMA (2009)

Depressive symptoms commonly follow coronary artery bypass graft (CABG) surgery and are associated with less positive clinical outcomes.To test the effectiveness of telephone-delivered collaborative care for post-CABG depression vs usual physician care.Single-blind effectiveness trial at 7 university-based and community hospitals in or near Pittsburgh, Pennsylvania. Participants were 302 post-CABG patients with depression (150, intervention; 152, usual care) and a comparison group of 151 randomly sampled post-CABG patients without depression recruited between March 2004 and September 2007 and observed as outpatients until June 2008.Eight months of telephone-delivered collaborative care provided by nurses working with patients' primary care physicians and supervised by a psychiatrist and primary care physician from this study.Mental health-related quality of life (HRQL) measured by the Short Form-36 Mental Component Summary (SF-36 MCS) at 8-month follow-up; secondary outcome measures included assessment of mood symptoms (Hamilton Rating Scale for Depression [HRS-D]), physical HRQL (SF-36 PCS), and functional status (Duke Activity Status Index [DASI]); and hospital readmissions.The intervention patients reported greater improvements in mental HRQL (all P < or = .02) (SF-36 MCS: Delta, 3.2 points; 95% confidence interval [CI], 0.5-6.0), physical functioning (DASI: Delta, 4.6 points; 95% CI, 1.9-7.3), and mood symptoms (HRS-D: Delta, 3.1 points; 95% CI, 1.3-4.9); and were more likely to report a 50% or greater decline in HRS-D score from baseline (50.0% vs 29.6%; number needed to treat, 4.9 [95% CI, 3.2-10.4]) than usual care patients (P < .001). Men with depression were particularly likely to benefit from the intervention (SF-36 MCS: Delta, 5.7 points; 95% CI, 2.2-9.2; P = .001). However, the mean HRQL and physical functioning of intervention patients did not reach that of the nondepressed comparison group.Compared with usual care, telephone-delivered collaborative care for treatment of post-CABG depression resulted in improved HRQL, physical functioning, and mood symptoms at 8-month follow-up.clinicaltrials.gov Identifier: NCT00091962.
Disclosure and use of personal health information
Authors: B. Woodward
Journal: BMJ (1996)

Lord Walton's Disclosure and Use of Personal Health Information Bill received its second reading in the House of Lords this week. The bill illustrates the difficulty of legislating in the subject of medical confidentiality. The basic principle of medical confidentiality is simply stated: “patients have a right to expect that you will not pass on any personal information which you learn in the course of your professional duties, unless they agree.”1 Difficulties arise when there is an attempt to list the exceptions to this simple principle. The focus then tends to shift from protecting the patient's right to confidentiality and providing the patient with strong tools for preserving confidentiality to licensing disclosure and providing health professionals, medical researchers, and the police with permission to gain access to personal health information in a wide variety of circumstances.

A right which is easily …
Cost-effectiveness of Hepatitis B Virus Immunization
Authors: Paul Wise
Journal: JAMA (1996)

<h3>To the Editor.</h3> —Dr Margolis and colleagues<sup>1</sup>seek to determine the most cost-effective way to protect a single birth cohort from HBV over the course of their lives. They answer the question: "What is the best strategy to reduce hepatitis B infections 30 years from now?" But they do not fully address the problem: "What is the best strategy to fight hepatitis B infections among all ages today?" The answer to the latter problem certainly includes both universal infant and adolescent immunization, as Margolis et al suggest in their discussion. But equally important is a third strategy: renewed emphasis on vaccinating older adolescents and adults who have risk factors for imminent HBV infection. Such risk factors include a history of more than two sexual partners in the last 6 months, a recent sexually transmitted disease (STD), or intravenous drug use.<sup>2</sup> Aggressive strategies for finding and vaccinating these high-risk
Purchase of Managed Care: Informed Consumers or a Distorted Market?
Authors: James P. Farrell
Journal: JAMA (1997)

To the Editor.  —I cannot disagree with the focused content of the article by Dr Drake. 1 However, I believe the title is somewhat misleading in that it implies that the phenomenon of managed care can be interpreted in a fashion analogous to other markets. Although market forces are at work, this is a distorted solution to a distorted market.  The growing frustration of  with health care inflation is not meaningful in and of itself. For example, employers are not frustrated with the incredible increasing expense of computerization. Computerization is an expense they feel has value. However, they are frustrated that they have no control over the expense of health care, and they could not trade off this expense for another because of the link that had been established between health care coverage and employment. Through government intervention, health care premiums became deductible, and wage freezes made health care
Surgical Techniques of the Shoulder, Elbow, and Knee in Sports Medicine
Authors: Andrew S. Rokito
Journal: JAMA (2009)

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
Divergent pathways mediate the induction of ANF transgenes in neonatal and hypertrophic ventricular myocardium.
Authors: K U Knowlton, H A Rockman, M Itani, A Vovan, C E Seidman, K R Chien
Journal: Journal of Clinical Investigation (1995)

To determine whether similar or divergent pathways mediate atrial natriuretic factor (ANF) induction in neonatal and hypertrophied adult ventricular myocardium, and to assess whether studies using an in vitro model system of hypertrophy have fidelity to the in vivo context during pressure overload hypertrophy, we generated transgenic mice which harbor either 638 or 3,003 bp of the rat ANF 5' flanking region ligated upstream from a luciferase reporter. Luciferase activity in the ventricles of day 1 transgenic neonates was 8-24-fold higher than the levels expressed in the ventricles of adult mice. Adult mice expressed the luciferase reporter in an appropriate tissue-specific manner. Transverse aortic constriction of adult mice harboring ANF reporter transgenes demonstrated no significant increase in reporter activity in the ventricle. These findings demonstrate that distinct regions of the ANF 5'-flanking region are required for inducible expression of the ANF gene in the hypertrophic adult ventricle compared with those required for atrial-specific and developmentally appropriate expression in the intact neonatal heart. Furthermore, the cis regulatory elements necessary for induction of ANF expression in endothelin-1 or alpha 1-adrenergically stimulated cultured neonatal ventricular myocytes are not sufficient for induction in the in vivo context of pressure overload hypertrophy.
Clinical Features and Outcome of Primary Effusion Lymphoma in HIV-Infected Patients: A Single-Institution Study
Authors: Cecilia Simonelli, Michele Spina, Roberta Cinelli, Renato Talamini, Rosamaria Tedeschi, Annunziata Gloghini, Emanuela Vaccher, Antonino Carbone, Umberto Tirelli
Journal: Journal of Clinical Oncology (2003)

Purpose: To describe the clinical features and outcome of HIV-associated primary effusion lymphoma (PEL) and to compare them with those of the other HIV-associated non-Hodgkin’s lymphomas (NHLs). Patients and Methods: From April 1987 to June 2002, 277 patients with HIV infection and systemic NHL were diagnosed and treated in our institution. Clinical features and outcome of PEL patients were compared with the features and outcomes of 162 patients belonging to the following histologic subtypes: plasmoblastic lymphoma of oral cavity (PBLOC, n = 11), immunoblastic lymphoma (IBL, n = 76), and centroblastic B-cell lymphoma (CBCL, n = 75). Results: Among the 277 NHL patients, PEL was diagnosed in 11 patients (4%). Eight of 11 patients were treated with a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)–like regimen. Complete remission was reached in 42% of patients, with a median survival time of 6 months. When the clinical features and outcome of 11 PEL patients were compared with the other three groups of patients affected by NHL, at the onset of the disease, no statistically significant differences were observed in demographic data, CD4 absolute number, HIV viremia plasma levels, and clinical characteristics. When we compared the outcome of PEL patients with the CBCL group, a statistically significant worse outcome was observed; however, the clinical outcome of PEL patients was not significantly different from the outcome observed in the other two groups (PBLOC and IBL groups). Conclusion: PEL is a rare HIV-associated NHL type occurring as a late manifestation of HIV infection with a poor clinical outcome and a shorter overall survival compared with CBCL patients.
Aggressive Cholesterol Lowering Delays Saphenous Vein Graft Atherosclerosis in Women, the Elderly, and Patients With Associated Risk Factors
Authors: Lucien Campeau, Donald B. Hunninghake, Genell L. Knatterud, Carl W. White, Michael Domanski, Sandra A. Forman, James S. Forrester, Nancy L. Geller, Fredarick L. Gobel, J. Alan Herd, Byron J. Hoogwerf, Yves Rosenberg
Journal: Circulation (1999)

Background —The NHLBI Post Coronary Artery Bypass Graft trial (Post CABG) showed that aggressive compared with moderate lowering of low-density lipoprotein-cholesterol (LDL-C) decreased obstructive changes in saphenous vein grafts (SVGs) by 31%. 1 Using lovastatin and cholestyramine when necessary, the annually determined mean LDL-C level ranged from 93 to 97 mg/dL in aggressively treated patients and from 132 to 136 mg/dL in the others ( P &lt;0.001). Methods and Results —The present study evaluated the treatment effect in subgroups defined by age, gender, and selected coronary heart disease (CHD) risk factors, ie, smoking, hypertension, diabetes mellitus, high-density lipoprotein cholesterol (HDL-C) &lt;35 mg/dL, and triglyceride serum levels ≥200 mg/dL at baseline. As evidenced by similar odds ratio estimates of progression (lumen diameter decrease ≥0.6 mm) and lack of interactions with treatment, a similar beneficial effect of aggressive lowering was observed in elderly and young patients, in women and men, in patients with and without smoking, hypertension, or diabetes mellitus, and those with and without borderline high-risk triglyceride serum levels. The change in minimum lumen diameter was in the same direction for all subgroup categories, without significant interactions with treatment. Conclusions —Aggressive LDL-C lowering delays progression of atherosclerosis in SVGs irrespective of gender, age, and certain risk factors for CHD.
Non-cirrhotic portal hypertension – Diagnosis and management
Authors: Rajeev Khanna, Shiv K. Sarin
Journal: Journal of Hepatology (2013)

<h2>Summary</h2> NCPH is a heterogeneous group of liver disorders of vascular origin, leading to PHT with near normal HVPG. NCPF/IPH is a disorder of young adults or middle aged women, whereas EHPVO is a disorder of childhood. Early age acute or recurrent infections in an individual with thrombotic predisposition constitute the likely pathogenesis. Both disorders present with clinically significant PHT with preserved liver functions. Diagnosis is easy and can often be made clinically with support from imaging modalities. Management centers on control and prophylaxis of variceal bleeding. In EHPVO, there are additional concerns of growth faltering, portal biliopathy, MHE and parenchymal dysfunction. Surgical shunts are indicated in patients with failure of endotherapy, bleeding from sites not amenable to endotherapy, symptomatic hypersplenism or symptomatic biliopathy. Persistent growth failure, symptomatic and recurrent hepatic encephalopathy, impaired quality of life or massive splenomegaly that interferes with daily activities are other surgical indications. Rex-shunt or MLPVB is the recommended shunt for EHPVO, but needs proper pre-operative radiological assessment and surgical expertise. Both disorders have otherwise a fairly good prognosis, but need regular and careful surveillance. Hepatic schistosomiasis, CHF and NRH have similar presentation and comparable prognosis.
Randomized double‐blind, placebo‐controlled trial of sublingual immunotherapy with a Pru p 3 quantified peach extract
Authors: M. Fernández‐Rivas, S. Garrido Fernández, J. A. Nadal, M. D. Alonso Díaz de Durana, B. E. García, E. González‐Mancebo, S. Martín, D. Barber, P. Rico, A. I. Tabar
Journal: Allergy (2009)

Peach allergy is highly prevalent in the Mediterranean area; it is persistent and potentially severe, and therefore a prime target for immunotherapy. We aimed to study the efficacy and safety of sublingual immunotherapy (SLIT) with a peach extract quantified in mass units for Pru p 3, the peach lipid transfer protein.Randomized, double-blind, placebo-controlled (DBPC) clinical trial. The main efficacy outcome was the change in the response to a DBPC food challenge (DBPCFC) with peach. Secondary efficacy outcomes were the changes in skin prick test (SPT), and in specific immunoglobulin E (IgE) and IgG(4) to Pru p 3. Tolerance was assessed with a careful recording of adverse events.After 6 months of SLIT, the active group tolerated a significantly higher amount of peach (three- to ninefold), presented a significant decrease (5.3 times) in SPT, and a significant increase in IgE and IgG(4) to Pru p 3. No significant changes were observed within the placebo group. Statistically significant inter-group differences were only observed in the SPT and IgG(4) responses. No serious adverse events were reported. Systemic reactions were mild, and observed with a similar frequency in both groups. Local reactions were significantly more frequent in the active group (three times) and 95% of them restricted to the oral cavity.In this first exploratory clinical trial, SLIT for peach allergy seems to be a promising therapeutic option that could modify the clinical reactivity of the patients to peach intake and the underlying immunological response with a good tolerance.
Phenindione-induced Haemorrhagic Ulcerative Colitis
Authors: A. R. Tanser, E. C. B. Keat
Journal: BMJ (1966)

Thirst Fever in Infants-Shaker are in the habit of giving extra fluids to their infants right from birth. SummarySeventeen cases of "nocturnal" thirst fever in infants aged 3 to 10 months are described.The only presenting symptom was fever with a characteristic temperature pattern, being very high in the morning and gradually dropping to normal towards the evening.This particular temperature patterp is diag- nostic.It helps in the early administration of the proper treatment-extra fluids-without recourse to unnecessary drugs or tedious investigations.