tbuckley/cabot-search huggingface dataset:
Venous Stasis After Ligation of Femoral Veins or Inferior Vena Cava
Authors: Giorgio Agrifoglio
Journal: JAMA (1961)

The incidence and severity of venous stasis were assessed in 195 patients followed 1 to 10 years after ligation of the superficial or common femoral veins, or of the inferior vena cava. Edema was the most common manifestation. It diminished markedly in the early postoperative course. Surprisingly, it was greater after superficial femoral vein ligation. Edema and other stasis effects were most frequent and lasting after caval ligation. Seven instances of nonfatal pulmonary embolism occurred after 27 ligations at superficial femoral level, 8 after 144 at common femoral level, 4 after 15 unilateral superficial and contralateral common levels and none after caval ligation. Ligation for thromboembolic disease should be performed at common femoral or caval levels.
Treatment of the Gonococcal Arthritis-Dermatitis Syndrome
Authors: H. HUNTER HANDSFIELD
Journal: Annals of Internal Medicine (1976)

Ninety-eight patients with the gonococcal arthritis-dermatitis syndrome were prospectively treated with penicillin G, at least 10 million units intravenously per day, followed by ampicillin, 2.0 g orally per day, to complete at least 10 days of treatment (33 patients); ampicillin, 3.5 g orally plus probenecid 1.0 g, followed by ampicillin, 2.0 g per day orally for at least 7 days (29 patients); lower doses of parenteral penicillin G (20 patients); oral tetracycline (6 patients); parenteral cephalosporins (5 patients); and other regimens (5 patients). The response to treatment was equally rapid and complete in each group. At least 90% of the patients in each group had subjective improvement and defervescence within 2 days, and all patients followed for at least 2 weeks achieved complete clinical and bacteriologic cure. Patients with purulent synovial effusions improved significantly more slowly than patients with nonpurulent effusions or with no effusions, regardless of which treatment was used.
Articular Damage in Arthritis and Its Control
Authors: J. T. DINGLE
Journal: Annals of Internal Medicine (1978)

Erosion of joint surfaces in arthritic conditions is always associated with the degradation of the two principal matrix macromolecules of cartilage, proteoglycan and collagen. The major enzymes thought to be involved in articular catabolism have now been isolated, purified, and their properties studied, but precise spatial and temporal activities are still imperfectly understood. We are beginning to understand some aspects of cellular function in the control of catabolic enzyme function. Recent studies on molecular, cellular, and tissue mechanisms in this process are discussed here. Of particular interest is a possible natural control mechanism involving a recently discovered inhibitor of collagenase. A newly developed pharmacologic method of inflammation control utilizes the properties of liposomes in the closed environment of the joint cavity. Very low doses of modified steroids encapsulated within liposomes are capable of substantially reducing inflammation in experimentally arthritic animals and may be applicable to man.
1072-218 High prevalence in pharmacological responses mimic Brugada syndrome in Japanese—A pure Na channel blocker, pilsicainide challenge test in the normal heart
Authors: Takeshi Ueyama, Akihiko Shimizu, Masahiro Esato, Ryousuke Kametani, Masashi Kanemoto, Noriko Inoue, Akira Sawa, Masunori Matsuzaki
Journal: Journal of the American College of Cardiology (2004)
Segmental Responses of Dog Paw Vasculature
Authors: MARY C. HAMMOND, D. L. DAVIS, PHILIP DOW
Journal: Circulation Research (1968)

The production of constrictive responses limited to either arterial or venous segments of the vasculature of the dog paw was tested by stimulating various peripheral nerves of the hind leg. Resistance changes of the total vasculature of the paw, and of three of its component series-coupled segments (arterial, small vessel, and venous) were studied sequentially before and during stimulation of the sciatic nerve and of three of its branches (tibial, deep, and superficial fibular nerves). Stimulation characteristics (15 to 90 volts, 1-3 msec duration, 25/sec, and 30-second stimulation periods) were chosen to produce maximum vasoconstrictive responses. Tibial and deep fibular nerve stimulations produced constriction of the arterial segment but not of the venous segment. Superficial fibular nerve stimulation produced constriction of the venous segment but not of the arterial segment. All nerve stimulations produced constriction of small blood vessel segments. Thus, responses could be limited to either arterial (plus small vessel) or venous (plus small vessel) segments. Inability to localize response within small-vessel segments made it impossible to determine whether any peripheral nerve produced constrictive responses limited strictly to either pre- or postcapillary segments. No relationship was evident between control resistance values and the subsequent changes in resistance occurring in response to the standard stimulations.
Treating hepatitis C in the prison population is cost-saving
Authors: Jennifer A. Tan, Tom A. Joseph, Sammy Saab
Journal: Hepatology (2008)

The prevalence of chronic hepatitis C infection in U.S. prisons is 12% to 31%. Treatment of this substantial portion of the population has been subject to much controversy, both medically and legally. Studies have demonstrated that treatment of chronic hepatitis C with pegylated interferon (PEG IFN) and ribavirin is a cost-effective measure in the general population; however, no study has addressed whether the same is true of the prison population. The aim of this study was to determine the cost-effectiveness of hepatitis C treatment with PEG IFN and ribavirin in the U.S. prison population. Cost-effectiveness was determined via a decision analysis model employing Markov simulation. The cohort of prisoners had a distribution of genotypes and stages of fibrosis in accordance with prior studies evaluating inmate populations. The probability of transitioning from one health state to another, reinfection rates, in-prison and out-of-prison mortality rates, sustained viral response rates, costs, and quality of life weights were also obtained from the literature. Sensitivity analysis was performed. In a strategy without a pretreatment liver biopsy, treatment was cost-effective for all ages and genotypes. This model was robust to rates of disease progression, mortality rates, reinfection rates, sustained viral response rates, and costs. In a strategy employing a pretreatment liver biopsy, treatment was also cost-saving for prisoners of all ages and genotypes with portal fibrosis, bridging fibrosis, or compensated cirrhosis. Treatment was not cost-effective in patients between the ages of 40 and 49 with no fibrosis and genotype 1. Conclusion: Treatment of chronic hepatitis C with PEG IFN and ribavirin in U.S. prisons results in both improved quality of life and savings in cost for almost all segments of the inmate population. If the decision to treat hepatitis C is based on pharmaco-economic measures, this significant proportion of infected individuals should not be denied access to therapy. (HEPATOLOGY 2008.)
TREATMENT OF THE OPIUM NEUROSIS.Read before the Section of Medical Jurisprudence and Neurology, at the Forty-second Annual Meeting of the American Medical Association, held at Washington, D. C., May, 1891.
Authors: STEPHEN LETT
Journal: JAMA (1891)

It is not my intention to enter into elaborate statistics to prove the prevalence of the opium disease, or to discuss the causes which operate in its production; suffice it to say, that the habitual consumption of opium and its products does exist to a very alarming extent in this country, and that some of the causes which give rise to this malady are under our control; others are beyond our power. Nor do I purpose portraying the dire physical and mental manifestations resulting from the daily and prolonged use of the drug, interesting and instructive as the subject might prove to be, but rather do I wish to confine myself to a consideration of the treatment of this disease as it is presented to us, and indicate those methods which, in my hands, have proved most practicable, and, in my opinion, calculated to produce the best results. In that
Ketorolac versus morphine for severe pain
Authors: G. A Jelinek
Journal: BMJ (2000)

papers p 1247 

Morphine, titrated intravenously, is the gold standard analgesic for severe pain in emergencies. It is effective and cheap. But morphine has well documented side effects including drowsiness, nausea and vomiting, and respiratory depression. These side effects can be distressing for patients who are already in severe pain and can also interfere with the efficient flow of patients through emergency departments. Staff must spend time observing patients who are experiencing side effects; the length of the patient's stay in the emergency department is prolonged; and some patients need to be admitted for a short time while they recover from the side effects of morphine, thus adding to overall costs.

Non-steroidal anti-inflammatory drugs have had the potential to replace opioids in the treatment of severe pain since they became available for use by intravenous injection. The only Cochrane review on this subject shows that non-steroidal anti-inflammatory drugs relieve the pain of renal colic faster when given intravenously than when given by other routes.1 Ketorolac trometamol given intravenously is as effective as morphine in the management of surgical pain and pain …
Clinical applicability of preconditioning and postconditioning: The cardiothoracic surgeons's view☆
Authors: D RAMZY, V RAO, R WEISEL
Journal: Cardiovascular Research (2006)

“Any surgeon who operates upon the heart should lose the respect of his colleagues.” Theodor Billroth 

The field of cardiac surgery has progressed significantly since this 19th century quote from Dr Billroth. The ability to perform cardiac procedures was limited by the inability to support the circulation and to offer adequate myocardial protection. Cardiac surgery as a profession was made possible by our ability to translate experimental research into the clinical arena. Two major concepts allowed the feasibility of open-heart surgery: 1) the development of mechanical circulatory support and 2) our understanding of myocardial protection. Myocardial protection refers to all strategies that increase the myocardium's ability to withstand an ischemic insult. Ischemic and reperfusion injuries are principally responsible for cardiac failure, morbidity and mortality following cardiac surgery. Bigelow et al.'s original work on hypothermia, driven by the desire to protect the brain from ischemic insult, led to the discovery that the myocardium also benefited from hypothermia during cardiac surgery [1]. The next development in the field of myocardial protection was the use of cardioplegia. Melrose et al. first used their solution to initiate cardiac arrest as well as to cool the heart [2,3]. Their strategy combined two methods of myocardial protection: hypothermia and cardiac standstill. Both strategies reduce myocardial oxygen demand and therefore decreased ischemic injury.

The field of myocardial protection then shifted to providing oxygen to the myocardium while arrested. The use of blood was introduced as a method to increase myocardial oxygen delivery [4]. Cardiac surgeons quickly adopted blood cardioplegia as their myocardial protective strategy of choice. This strategy remains the mainstay of myocardial protection. Cardioplegia protects the myocardium by providing continuous or intermittent oxygen while simultaneously reducing cardiomyocyte oxygen demand through both hypothermia and cardiac arrest. Although an effective strategy, cardioplegia does not inherently …
Health chiefs review London's helicopter ambulance service
Authors: C. Court
Journal: BMJ (1995)

A study of London's helicopter ambulance service has concluded that two protocols exist for deciding when to bring in the helicopter and that they are not mutually consistent. The report, conducted on behalf of the chief executives of London's 16 health authorities, recommends that a new protocol be finalised and adopted “without delay.”

The report was called for by government ministers earlier this year after the death of Lady Margaret Elton. Lady Elton died as a result of an accident in Chelsea, south west London, and the coroner expressed concern that a ground ambulance had been at the scene for 40 minutes before the air ambulance was able to take the patient. The air ambulance then took Lady Elton to the Royal …
Reversible inhibition of urea exchange in rat hepatocytes.
Authors: R M Effros, E Jacobs, A Hacker, K Ozker, C Murphy
Journal: Journal of Clinical Investigation (1993)

Urea exchange is enhanced in renal collecting duct cells and erythrocytes by transporters which can be inhibited by phloretin and urea analogs such as thiourea. In this study, evidence for a comparable transporter was found in rat livers perfused with solutions which contained no red cells and in suspensions of hepatocytes. Bolus injections containing 125I-albumin (intravascular indicator), 99mTc-DTPA (extracellular indicator), 3HOH (water indicator), and [14C]urea were administered into the portal vein and fluid was collected from the hepatic vein. Under control conditions, [14C]urea and 3HOH emerged from the hepatic vein at nearly the same rate. However when the perfusate contained 2.5 mM phloretin (equivalent to 0.058 mM phloretin not bound to albumin), the amount of [14C]urea which had been recovered in the hepatic venous outflow by the time of peak 125I-albumin concentrations exceeded 3HOH recovery by a factor of 2.31 +/- 0.23 (n = 7). When the perfusate contained 200 mM thiourea, the comparable recovery of [14C]urea from the hepatic veins exceeded that of 3HOH by a factor of 3.48 +/- 0.44 (n = 7). These effects were at least partially reversible and suggested inhibition of urea transporters in hepatocytes. This conclusion was supported by studies of unloading of [14C]urea from hepatocytes which were exposed to unlabeled solutions: in the presence of phloretin, the amount of [14C]urea remaining within hepatocytes at 4 s was approximately twice that remaining in hepatocytes which had not been exposed to phloretin. Rapid transport of urea out of hepatocytes may increase urea synthesis and minimize cellular swelling due to urea accumulation.
Hospital Salt—Reply
Authors: JoAnne Arcand, Mary L’Abbe, Gary Newton
Journal: JAMA Internal Medicine (2013)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Patriotic Gore
Authors: Paul E. Steiner
Journal: JAMA (1967)

In 1861 the physicians of this country, North and South, contributed their patriotic ardor to the general pools. Eventually about 15,400 served as medical officers—12,000 Federal and 3,400 Confederate. Without any indoctrination in military medicine, and in some states without any examination for proficiency, they bought their uniforms, horses, and accoutrements, packed their surgical cases and medicine bags, and rode off to join their regiments in camp, field, or battle. Additional thousands enlisted as combatants. Some became medical officers; many, however, remained in the ranks or were promoted to be company or regimental officers, and at least 33 finally became combatant generals.<sup>1</sup>The two groups, the medical and nonmedical, contained a high proportion of the country's physicians. The regimental doctors were designated surgeons and assistant surgeons. One of each was assigned to a regiment, originally containing about a thousand men. The regiments were the basic, important units. They were recruited
Abstract B43: Role of activated SHP2 in high-risk neuroblastoma pathogenesis
Authors: (Jane) shizhen Zhu, Benjamin G. Neel, A. Thomas Look
Journal: Cancer Research (2014)

Abstract Neuroblastoma, an embryonic tumor of peripheral sympathetic nervous system (PSNS), accounts for 10% of all childhood cancer deaths. We recently developed a robust zebrafish model of neuroblastoma and demonstrated that activated ALK synergizes with MYCN by inhibiting a developmentally-timed apoptotic response that is otherwise induced by MYCN. Genomic studies show that PTPN11 (encoding SHP2) is the second most frequently mutated genes in high-risk neuroblastoma. We have now used our zebrafish model to ask whether mutationally activated SHP2 functions as an oncogene in neuroblastoma. We developed transgenic lines in which ptpn11E69K is overexpressed in the PSNS under control of the dopamine-beta-hydroxylase promoter. Interestingly, ptpn11E69Ksynergized with MYCN to accelerate the onset of neuroblastoma in the interrenal gland, the zebrafish analogue of the adrenal medulla. Tumors began to appear at 15 weeks in transgenic fish overexpressing MYCN alone, whereas latency was shortened to 7 weeks and the penetrance was increased more than four-fold in transgenic fish co-expressing MYCN and ptpn11E69K. Co-expression of ptpn11E69K and MYCN also induced ganglioneuroma in the sympathetic ganglia, an outcome that has not been observed in transgenic fish overexpressing MYCN and activated ALK. These results suggest that activated SHP2 can collaborate with MYCN in neuroblastoma tumorigenesis via mechanisms different from those of activated ALK. Thus, zebrafish appears to provide a robust model system for functional genomic analysis and for the investigation of the mechanisms and pathways underlying mutations identified in ongoing tumor resequencing studies. Citation Format: (Jane) shizhen Zhu, Benjamin G. Neel, A. Thomas Look. Role of activated SHP2 in high-risk neuroblastoma pathogenesis. [abstract]. In: Proceedings of the AACR Special Conference on Pediatric Cancer at the Crossroads: Translating Discovery into Improved Outcomes; Nov 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2013;74(20 Suppl):Abstract nr B43.
Phase II Study of Cediranib (AZD 2171), an Inhibitor of the Vascular Endothelial Growth Factor Receptor, for Second-Line Therapy of Small Cell Lung Cancer (National Cancer Institute #7097)
Authors: Suresh S. Ramalingam, Chandra P. Belani, Philip C. Mack, Everett E. Vokes, Jeffrey Longmate, Ramaswamy Govindan, Marianna Koczywas, S. Percy Ivy, David R. Gandara
Journal: Journal of Thoracic Oncology (2010)
People's cultural beliefs should be respected
Authors: P Q Shaw
Journal: BMJ (1996)

EDITOR,—David Berger should indeed lie down when he is in his canoe and sees something fiery coming at him, for some sea devils may be more rational than he realises.1 His description of Elizabeth's rash does not suggest the fern-like burns of lightning, but his nurse's description of the behaviour of Tamalokolo, the sea devil, fits …
Adjuvant Tamoxifen Treatment Outcome According to Cytochrome P450 2D6 (CYP2D6) Phenotype in Early Stage Breast Cancer: Findings from the International Tamoxifen Pharmacogenomics Consortium.
Authors: M. Goetz, D. Berry, T. Klein
Journal: Cancer Research (2009)

Abstract Background: An estimated 1.3 million women worldwide will be diagnosed this year with early stage breast cancer. The majority of women have estrogen receptor (ER) positive breast cancer and are candidates for endocrine therapy. Tamoxifen remains the most commonly employed agent worldwide and substantially reduces recurrence and mortality. Tamoxifen is a pro-drug. CYP2D6 converts tamoxifen to endoxifen, which is primarily responsible for inhibition of estrogen-stimulated breast cancer growth in vitro. There have been conflicting reports regarding the relationship between CYP2D6 genotype/phenotype and tamoxifen clinical outcome. The ITPC was established to collect the worldwide experience relating to genetic variation in CYP2D6 and the outcomes of women with ER positive breast cancer treated with adjuvant tamoxifen. Establishment of the predictive value of CYP2D6 would enable the a priori identification of patients that could be spared ineffective therapy.Methods: Individual patient data including tumor characteristics, genotype, medication data, and recurrence information were requested from all published and non-published reports of clinical outcomes related to CYP2D6 and deposited at PharmGKB. CYP2D6 genotype was available for the following null (*3, 4, 5 and 6) and IM (*10, 17 and 41) alleles. CYP2D6 inhibiting medication data was requested for weak and potent CYP2D6 inhibitors. The primary analysis was to determine the association of CYP2D6 phenotype (combined genotype and medication) with breast cancer recurrence in tamoxifen treated early stage, ER positive invasive breast cancer.Results: At this time, the ITPC has received patient data on 3432 patients from the U.S., Sweden, UK, Germany, Belgium, and Japan. Median age at diagnosis was 62 years. CYP2D6 genotype was available in 3,392 (99%). The allele frequency for CYP2D6*4, the most common allele associated with the CYP2D6 poor metabolizer phenotype, was q=0.23. A total of 1152 recurrences representing first events (either local, regional, distant, or contralateral breast cancer) were recorded. At the time of abstract submission, patient and genotype data from an additional 1300 tamoxifen treated patients were pending submission.Conclusions: The ITPC represents the largest collection of individual patient data in regard to the potential importance of CYP2D6 phenotype in adjuvant tamoxifen therapy. The findings from this consortium are expected to substantially improve the global understanding of CYP2D6 and tamoxifen clinical outcome. Final results will be presented at the meeting Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 33.