tbuckley/cabot-search huggingface dataset:
Preventing Transplant Rejection Without Drugs
Authors: Mike Mitka
Journal: JAMA (2002)

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
An actor's sense of timing
Authors: Patrick Harrold
Journal: BMJ (2004)

A 47 year old woman had had severe idiopathic pulmonary arterial hypertension since 1988.The patient declined treatment with prostanoids or lung transplantation.Her clinical course was extraordinarily stable with merely acenocoumarol and metolazone.In June 2002 right heart catheterisation was performed (mean pulmonary arterial pressure 68 mm Hg, cardiac index 2.0 l/min/m 2 , mixed venous oxygen saturation 51%, no vasoreactivity).Treatment with bosentan 62.5 mg twice daily was started, and spironolactone was added.Four weeks later, the patient could walk a distance of 380 metres in six minutes, compared with 338 metres before treatment.The bosentan dosage was increased to 125 mg twice daily.Four days later the patient experienced itching of both legs.Within another three days typical vasculitic skin lesions appeared on both legs (figure).A skin biopsy showed leucocytoclastic vasculitis and negative immune complex staining.Haematology, blood chemistry, and immunological variables were unremarkable.Bosentan was stopped immediately.Diuretics and acenocoumarol were continued.The vasculitic skin lesions improved slowly over the following weeks.Bosentan is an endothelin receptor antagonist approved for the treatment of pulmonary arterial hypertension. 1 2On the basis of a review of the data from the World Health Organization and the manufacturer's safety database we found that vasculitis has not been reported so far. 3 4 Known side effects of the drug include liver toxicity, which was not present in this case.Vasculitis is well described as an adverse drug reaction to metolazone.This drug, however, had been used by our patient for years, and the vasculitis improved despite the continuation of metolazone.History and immunology evaluation showed no other causes of the vasculitis, and the skin changes improved after discontinuation of bosentan (positive de-challenge).A re-challenge to corroborate coherency was not considered feasible because of the severity of the skin disorder.The vasculitic skin lesions in our patient are most probably attributable to bosentan treatment alone or to some hitherto unknown interaction.We recommend that clinicians be alert in patients complaining about pruritus and discontinue the drug if a skin rash appears.
Guidelines for Idiopathic Thrombocytopenic Purpura
Authors: James N. George
Journal: Annals of Internal Medicine (1997)

Letters1 October 1997Guidelines for Idiopathic Thrombocytopenic PurpuraJames N. George, MD and Gary E. Raskob, MScJames N. George, MDUniversity of Oklahoma Health Sciences Center; Oklahoma City, OK 73190Search for more papers by this author and Gary E. Raskob, MScUniversity of Oklahoma Health Sciences Center; Oklahoma City, OK 73190Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-7-199710010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Caldwell and colleagues emphasize the important clinical point that chronic liver disease must be carefully considered as a possible cause of unexplained thrombocytopenia. Because idiopathic thrombocytopenic purpura can be diagnosed only by excluding other causes of thrombocytopenia [1], exclusion of chronic liver disease is essential. This has been emphasized in more comprehensive reviews on the condition.The initial goal of the practice guideline on idiopathic thrombocytopenic purpura developed by the American Society of Hematology [1] was to evaluate the strength of the evidence supporting the value of diagnostic procedures and treatments. Evidence is lacking; thus, recommendations were based ...References1. George JN, Woolf SH, Raskob GE, Wasser JS, Aledort LM, Ballem PJ, et al. Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. Blood. 1996; 88:3-40. Google Scholar2. Kajiwara E, Akagi K, Azuma K, Onoyama K, Fujishima M. Evidence for an immunological pathogenesis of thrombocytopenia in chronic liver disease. Am J Gastroenterol. 1995; 90:962-6. Google Scholar3. George JN. Platelet immunoglobulin G: is significance for the evaluation of thrombocytopenia and for understanding the origin of α-granule proteins. Blood. 1990; 76:859-70. Google Scholar4. Berchtold P, Muller D, Beardsley D, Fujisawa A, Kaplan C, Kekomaki R, et al. International study to compare antigen-specific methods used for the measurement of antiplatelet autoantibodies. Br J Haematol. 1997; 96:477-83. Google Scholar5. Lescale KB, Eddleman KA, Cines DB, Samuels P, Lesser ML, McFarland JG, et al. Antiplatelet antibody testing in thrombocytopenic pregnant women. Am J Obstet Gynecol. 1996; 174:1014-8. Google Scholar Author, Article, and Disclosure InformationAuthors: James N. George, MD; Gary E. Raskob, MScAffiliations: University of Oklahoma Health Sciences Center; Oklahoma City, OK 73190 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1997Volume 127, Issue 7Page: 573KeywordsAntiplatelet antibodiesChronic liver diseaseHematology and oncologyIdiopathic thrombocytopenic purpuraPathogenesisPlasma proteinsPlateletsResearch laboratoriesSpecificityTreatment guidelines ePublished: 15 August 2000 Issue Published: 1 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Safety, efficacy, tolerability, and pharmacokinetics of a new liquid intravenous immunoglobulin (IVIG) in comparison to Sandoglobulin® in patients with primary immunodeficiencies (PID)
Authors: M. Borte, U. Wahn, C. Farber, E. Bernatowska, C. Adams, I. Andresen, K. Bender
Journal: Journal of Allergy and Clinical Immunology (2003)
Regulating the use of antibiotics in the community
Authors: C. Carbon, R. P Bax
Journal: BMJ (1998)

All parties perceive antibiotic resistance as a global threat.1 We examined the literature on the use of antibiotics in the community to establish how the issue of antibiotic resistance might be managed. We chose illustrative examples from recent important publications.

#### Summary points

The world market for antibiotics in 1997 was $17bn (£10.6bn), of which $12bn was for community use, with about 818 billion prescriptions for respiratory tract infections. Although the value is rising (the 1993 market was $15bn), the number of prescriptions is now static. From 1980 to 1991, however, the overall increase in prescriptions for antibiotics in England was 46%—but still below the rate of growth over the same period in France. 2 3

Several factors may influence the increase in antibiotic costs. 1 3 4 Recently, two characteristics of antibiotics prescribing — that is, use of doses that are too small or treatments that are too long — have been shown to increase the risk of selection of resistance.5 The ecological impact of poor compliance or of the use of highly selective agents remains to be established.

Respiratory tract infection accounts for …
Relation of arterial geometry to luminal narrowing and histologic markers for plaque vulnerability: the remodeling paradox
Authors: Gerard Pasterkamp, Arjan H Schoneveld, Allard C van der Wal, Christian C Haudenschild, Ruud J.G Clarijs, Anton E Becker, Berend Hillen, Cornelius Borst
Journal: Journal of the American College of Cardiology (1998)
Internal Medicine and Family Medicine
Authors: John Saultz
Journal: Annals of Internal Medicine (1996)

Letters15 September 1996Internal Medicine and Family MedicineJohn Saultz, MDJohn Saultz, MDOregon Health Sciences University, Portland, OR 97201Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-6-199609150-00049 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The responses to my paper on internal medicine and family medicine underscore the substantial national interest in the relationship between the two disciplines. The above letters reflect the content of other correspondence I have received.Dr. Feiner points out the history of collaboration between the two disciplines in geriatrics training. If the basis of this collaboration could be extended into primary care training, much benefit might be realized. I am gratified to hear of Dr. Davis' report of a successful experience at the University of Vermont many years ago. Similar stories exist on a local basis, but these ... Author, Article, and Disclosure InformationAuthors: John Saultz, MDAffiliations: Oregon Health Sciences University, Portland, OR 97201 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1996Volume 125, Issue 6Page: 526KeywordsForecastingGeriatricsHealth carePediatricsResidency ePublished: 15 August 2000 Issue Published: 15 September 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A Comparison between Scheimpflug Imaging and Optical Coherence Tomography in Measuring Corneal Thickness
Authors: Jinhai Huang, Xixia Ding, Giacomo Savini, Chao Pan, Yifan Feng, Dan Cheng, Yanjun Hua, Xiuli Hu, Qinmei Wang
Journal: Ophthalmology (2013)
Atheromatous Disease of the Thoracic Aorta: Pathologic and Clinical Implications
Authors: Itzhak Kronzon
Journal: Annals of Internal Medicine (1997)

Purpose: To review recent developments in the diagnosis, clinical epidemiology, pathology, and management of atherosclerosis of the thoracic aorta, especially atherosclerosis of the thoracic aorta as a source of embolization. Data Sources: MEDLINE searches, bibliographies of published papers, and consultation with experts in the field. Study Selection: English-language publications on atherosclerosis of the thoracic aorta were selected. Data Synthesis: During the last 6 years, the increasing use of transesophageal echocardiography has shown that atherosclerotic plaque in the thoracic aorta is a source of otherwise unexplained embolic events, including stroke, transient ischemic attack, and peripheral emboli. Retrospective studies have documented a strong independent association between larger lesions (4 mm to 5 mm) and previous embolic disease, and prospective studies have shown that patients with these lesions have a high risk for future events (in one study, the risk for stroke was 12%; in another, the risk for cerebral or peripheral events was 33% in a follow-up period of just 14 months). These lesions also pose a serious risk for embolization caused by manipulation of the aorta during catheterization, intra-aortic balloon-pump placement, and cannulation of the aorta for heart surgery. Pathologic examination has shown atherosclerotic plaque, often with superimposed thrombi that account for the mobile components seen on transesophageal echocardiography. The management of patients who have atherosclerotic lesions in the thoracic aorta has not been determined prospectively. However, anticoagulation may help prevent emboli, as it does for patients who have thrombi in other locations, such as the left atrium and the left ventricle. Conclusions: Protruding atherosclerotic lesions in the thoracic aorta, often with superimposed mobile thrombi, are an important cause of embolic disease. Transesophageal echocardiography should be considered in the work-up of patients who have unexplained embolic events.
Estrogen-mediated protection against HIV Tat protein-induced inflammatory pathways in human vascular endothelial cells
Authors: Y LEE, S EUM, A NATH, M TOBOREK
Journal: Cardiovascular Research (2004)

Objective: It has been proposed that human immunodeficiency virus (HIV) infection-induced inflammatory environment may contribute to the pathogenesis of cardiovascular diseases. Recent studies have also demonstrated the potential role of estrogen as therapeutic agents in the prevention or treatment of cardiovascular diseases. In the present study, we assessed the hypothesis that estrogen may attenuate the HIV Tat protein-induced inflammatory pathways in human vascular endothelium. Methods: Expression of inflammatory mediators in human endothelial cells was analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Electrophoretic mobility shift assay (EMSA) also was performed to investigate the DNA-binding activities of several transcription factors, which are known to regulate expression of these inflammatory genes. Results: Acute exposure of human endothelial cells to Tat markedly induced the mRNA and protein expression of IL-1β, MCP-1, VCAM-1, and E-selectin. Tat also stimulated the adherence of inflammatory cells to endothelial cell monolayers. Significant and dose-dependent increases in NF-κB DNA-binding activity were observed in human endothelial cells treated with Tat. However, Tat did not affect DNA-binding activities of AP-1, CREB, and STAT1. Pretreatment with 17β-estradiol dramatically blocked the activation of NF-κB in human endothelial cells exposed to Tat. In addition, 17β-estradiol selectively inhibited the Tat-induced expression of IL-1β. Conclusion: Our results suggest that estrogen may protect against Tat-induced inflammatory reactions in human vascular endothelium via blocking the NF-κB-mediated molecular signaling pathways. These data may contribute to understanding the pathogenesis of cardiovascular complications and development of therapeutic strategies for HIV-infected patients.
A Measure of Malpractice: Medical Injury, Malpractice Litigation, and Patient Compensation
Authors: Frank T. Flannery
Journal: JAMA (1994)

For many years, proponents of alternative medical malpractice liability systems would illustrate the shortcomings of the present system with anecdotal evidence. However compelling these individual examples were, they could not and do not form a basis for intelligent discourse on malpractice policy considerations. <i>A Measure of Malpractice</i>recounts the Harvard Medical Practice Study and meets the need for such a systematic, empirical investigation. In dispassionate, painstaking detail, the specifics of a large number of hospital admissions in New York are recounted, along with subsequent medical negligence allegations and the response of both the medical and legal systems. Inpatient medical records documenting the care afforded to 30 000 hospitalized individuals were examined. Criteria were developed to identify not only adverse events, but also the subset of injuries that were the result of substandard medical care. The varying severity of injury in these adverse incidents was described, and comparative data were collected
INTRACORONARY CARDIOSPHERE–DERIVED CELLS (ICCDCS) PRODUCE MICROCIRCULATORY REMODELING BUT DO NOT INCREASE CORONARY FLOW RESERVE IN SWINE WITH HIBERNATING MYOCARDIUM
Authors: Abdallah Kamouh, Brian Weil, Merced Leiker, John Canty, Gen Suzuki
Journal: Journal of the American College of Cardiology (2013)
Aldehydes in Exhaled Breath Condensate of Patients with Chronic Obstructive Pulmonary Disease
Authors: Massimo Corradi, Israel Rubinstein, Roberta Andreoli, Paola Manini, Andrea Caglieri, Diana Poli, Rossella Alinovi, Antonio Mutti
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

The aims of the present study were (1) to evaluate whether individual aldehydes resulting from lipid peroxidation can be measured in exhaled breath condensate, (2) to assess the influence of sampling procedures on aldehyde concentrations, and (3) to compare aldehyde levels of patients with stable, moderate to severe, chronic obstructive pulmonary disease with those of smoking and nonsmoking control subjects. Aldehydes (malondialdehyde, hexanal, heptanal, and nonanal) were measured by liquid chromatography-tandem mass spectrometry in all samples and overlapping results were obtained by different sampling procedures. Malondialdehyde (57.2 +/- 2.4 nmol/L), hexanal (63.5 +/- 4.4 nmol/L), and heptanal (26.6 +/- 3.9 nmol/L) were increased in patients as compared with nonsmoking control subjects (17.7 +/- 5.5 nmol/L, p < 0.0001; 14.2 +/- 3.5 nmol/L, p = 0.004; and 18.7 +/- 0.9 nmol/L, p = 0.002, respectively). Only malondialdehyde was increased in patients compared with smoking control subjects (35.6 +/- 4.0 nmol/L, p = 0.0007). In conclusion, different classes of aldehydes were identified in exhaled breath condensate of humans. Whereas all aldehydes but nonanal were lower in control subjects as compared with other groups, only malondialdehyde distinguished smoking control subjects from patients with chronic obstructive pulmonary disease and could be envisaged as a biomarker potentially useful to monitor the disease and its response to therapy.
The Practice of Medicine for Animals
Authors: T. Hare
Journal: BMJ (1953)

You have invited me to talk about the practice of medicine for animals and to compare it with your own.Please allow me to avoid the abstract and to talk of such living things as doctors and veterinary surgeons; how they learn the one body of knowledge, exploit the same discoveries, meet with the same problems, and use the same methods in trying to solve them.The veterinary schools are in the Universities of Lon- don, Edinburgh, Dublin, Glasgow, Liverpool, Cambridge, and Bristol.Among the medical and veterinary students I find little if any difference in social origin, upbringing, dress, deportment, and contributions to university life.In their hobbies possibly more of the city clings to the medical and more of the country to the veterinary.
Letter by Pieroni et al Regarding Article, “Contrast-Enhanced Magnetic Resonance Imaging of a Patient With Chloroquine-Induced Cardiomyopathy Confirmed by Endomyocardial Biopsy”
Authors: Maurizio Pieroni, Fulvio Bellocci, Filippo Crea
Journal: Circulation (2007)

To the Editor:We read with interest the article by Reffelmann et al 1 describing a case of chloroquine-induced cardiomyopathy.Regarding the images provided by the authors, we would like to emphasize that magnetic resonance and mostly ultrastructural findings cannot univocally be referred to as chloroquine toxicity, because they might also represent typical pathological features of cardiac Fabry disease. 2 In fact, both disorders are characterized by ineffective lysosomal metabolism caused by inherited genetic defects in Fabry disease or induced by chloroquine through an increase in pH, leading to accumulation of lysosomal glycosphingolipids and thickening of cardiac walls.Comparison of ultrastructural findings in Fabry disease and chloroquine-induced cardiomyopathy has shown that concentric lamellar pseudomyeloid bodies are a common finding in both cardiomyopathies, suggesting that the only distinctive feature of chloroquine damage is represented by curvilinear bodies 3 that are not evident in the images provided.Despite the clinical history of long-lasting chloroquine assumption, in the absence of typical pathognomonic histological features, Fabry disease should have been excluded by enzymatic and genetic tests and also through familial history, mostly in the presence of renal failure, a typical feature of Fabry disease.Differential diagnosis between the 2 entities is clinically relevant because chloroquine withdrawal and enzyme-replacement ther-apy may be effective in reverting chloroquine-induced and Fabry disease cardiomyopathy, respectively.We agree with the authors that cardiac magnetic resonance may be useful in the noninvasive evaluation of patients with long-lasting chloroquine intake, and we suggest that Fabry disease cardiomyopathy should always be considered in the differential diagnosis of idiopathic cardiac-wall thickening.
A CASE OF GANGRENOUS NECROSIS OF THE MAMMARY GLAND.Read in the Section on Obstetrics and Diseases of Women, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: J. SCHNECK
Journal: JAMA (1894)

On Dec. 3, 1891, I visited Mrs. C., who lives three miles in the country. She is a large, healthy woman with a good family history as to health, morals and cleanliness; has always lived on a farm. The house in which she lives is a large, new frame building, situated in a healthy location. She was then, at the age of 39 years, nursing her second child, which was healthy and in its seventeenth month. The mammæ were of medium size, and had never given her any trouble previous to this attack. The family had not been using rye bread or buckwheat cakes. I found a deep gangrenous ulcer on the left breast, extending from near the nipple toward the median line; irregular in outline and about three inches in diameter. The margin of the ulcer was a black color, the bottom being covered by the characteristic ashy-gray coat.
P-Glycoprotein Expression as a Predictor of the Outcome of Therapy for Neuroblastoma
Authors: Helen S.L. Chan, George Haddad, Paul S. Thorner, Gerrit DeBoer, Yun Ping Lin, Nancy Ondrusek, Herman Yeger, Victor Ling
Journal: New England Journal of Medicine (1991)

Multidrug resistance in chemotherapy for cancer is characterized by increased genetic expression of P-glycoprotein, which acts as an ATP-dependent drug-efflux pump. To determine whether P-glycoprotein levels are of prognostic value in such cases, we measured these levels immunohistochemically in a retrospective study of sequential tumor samples from 67 children with neuroblastoma.
HYPNOTICS, ANALGESICS AND RESULTANT DRUG ADDICTIONS.
Authors: SMITH ELY JELLIFFE
Journal: JAMA (1903)

Insomnia and pain are the banes of existence of the patient with any nervous affection, and from his stand-point are in themselves the maladies from which he is suffering. He prays his physician for relief from one or both, knowing, alas too well, that the market is full of drugs that will bring him relief. It does not often occur to him that the physician has any more complicated mental process to go through than merely to choose the right drug to bring healthful sleep and to banish pain. Insomnia and pain may each be the cause of the other, or they may be the outward symptoms of an exceedingly complex condition of derangement. <h3>CLASSIFICATION OF INSOMNIA.</h3> In trying to study the causes of sleeplessness I have found it helpful to remember the classification of insomnia that Sir James Sawyer lays down in his "Contributions