tbuckley/cabot-search huggingface dataset:
Managing communication with young people who have a potentially life threatening chronic illness: qualitative study of patients and parents
Authors: B. Young
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objectives:</b> To examine young people9s and parents9 accounts of communication about cancer in childhood. <b>Design:</b> Semistructured interviews analysed using the constant comparative method. <b>Setting:</b> Paediatric oncology unit. <b>Participants:</b> 13 families, comprising 19 parents (13 mothers, six fathers) and 13 patients aged 8–17 years, recruited from one paediatric oncology unit. The patients had cancer or brain tumour. <b>Results:</b> Most parents described acting in an executive-like capacity, managing what and how their children were told about their illness, particularly at the time of diagnosis. Their accounts were shaped by concerns to manage their identity as strong and optimistic parents and to protect their child9s wellbeing. The patients identified elements of their parents9 role that both facilitated and constrained their communication, and while they welcomed their parents9 involvement, some expressed unease with the constraining aspects of their parents9 role. Some young people described feeling marginalised in consultations and pointed to difficulties they experienced in encounters with some doctors. <b>Conclusions:</b> There are difficulties in managing communication with young people who have a chronic, life threatening illness. Health professionals need to be aware of how the social positioning of young people (relative to adults) and the executive role of parents can contribute to the marginalisation of young people and hamper the development of successful relationships between themselves and young patients. <h3>What is already known on this topic</h3> The BMA has supported the principle of open communication with young patients Young people are sometimes excluded from participating in consultations and parents are reluctant to communicate openly with their seriously ill children <h3>What this study adds</h3> Parents take on an executive-like role, managing what and how their children are told about their illnesses This role both facilitates and constrains communication with young people Some young people feel marginalised in consultations—they described unease with this and problems in their relationships with some doctors
Relationship between gastric emptying of a solid meal and emptying of the gall bladder before and after vagotomy.
Authors: J N Baxter, J S Grime, M Critchley, S A Jenkins, R Shields
Journal: Gut (1987)

Little is known of the temporal and quantitative relationships between emptying of the stomach and of the gall bladder in patients with duodenal ulcer before and after vagotomy. A non-invasive double isotope technique was used to investigate these relationships in 27 patients with a duodenal ulcer, before and after operation-truncal vagotomy and pyloroplasty (TV + P; n = 15) and highly selective vagotomy (HSV; n = 12). A further 25 patients were studied after operation (TV + P, n = 20: HSV, n = 5). 99Tcm-EHIDA was used as the biliary tracer and 113Inm bran as the gastric content tracer. In patients with a duodenal ulcer before surgery and in 16 of the 17 patients studied after HSV, the patterns of gall bladder emptying were similar to those previously found in normal subjects. In 60% of patients after TV + P, patterns of gall bladder emptying were altered and the onset of gall bladder emptying was significantly delayed (p less than 0.001) compared with unoperated patients and patients with a HSV. The rate of gall bladder emptying did not correlate with the rate of gastric emptying in any of the patients studied. These observations suggest that TV + P, but not HSV, causes considerable alteration in coordination of gall bladder and gastric emptying.
Study of Luminal Coronary Collateral Circulation in the Beating Canine Heart
Authors: OTTO HAUSWIRTH
Journal: Circulation Research (1969)

The action of halothane on sinoatrial, ventricular, and Purkinje fibers was studied by means of intracellular microelectrodes. Rabbit atrial fibers were not very sensitive to even high (2%) concentrations of halothane. Sheep Purkinje fibers showed a significant hyperpolarization from 82 mv to 87 mv, a marked shortening of the duration of the action potential from 370 msec to 233 msec, and a diminution of the overshoot from 30 mv to 21 mv under the influence of 1% halothane. The rate of rise was now significantly rchanged with this concentration. In the presence of 2% halothane the resting potential did not differ significantly from the value obtained with 1% halothane. The duration of the action potential and of the refractory period were further diminished to 165 msec and to 109 msec, respectively. The rate of rise was now significantly reduced to 245 v/sec and the overshoot further decreased to 17 mv. Conduction time was increased by about 20% with 1% halothane and more than twofold with 2% halothane. Ventricular fibers of sheep did not show significant changes of the resting potnetial under the influence of 2% halothane. However, the duration of the action potential was markedly shortened from 338 msec to 231 msec, the effective refractory period was significantly reduced from 295 msec to 208 msec, and the overshoot decreased from 21 mv to 11 mv. Possible mechanisms underlying these changes and which may cause arrhythmias are discussed.
Ureteroceles in Children
Authors: Lowell R. King, James M. Kozlowski, Mark J. Schacht
Journal: JAMA (1983)

This review documents the success that we have experienced in treating most ureteroceles that present in children by heminephroureterectomy. If excision of the ureterocele is required, or reimplantation of a ureter other than the ureter obstructed by the ureterocele, this is deferred until the degree of hydronephrosis is reduced or bladder thickening and trabeculation have returned toward normal. In instances where there is function in the upper pole segment obstructed by the ureterocele, ureteropyelostomy has enabled us to preserve renal function by removing the obstructed ureter to permit the ureterocele to collapse. (<i>JAMA</i>1983;249:1461-1465)
Inhibition of ischemic cardiomyocyte apoptosis through targeted ablation of Bnip3 restrains postinfarction remodeling in mice
Authors: Abhinav Diwan, Maike Krenz, Faisal M. Syed, Janaka Wansapura, Xiaoping Ren, Andrew G. Koesters, Hairong Li, Lorrie A. Kirshenbaum, Harvey S. Hahn, Jeffrey Robbins, W. Keith Jones, Gerald W. Dorn
Journal: Journal of Clinical Investigation (2007)

Following myocardial infarction, nonischemic myocyte death results in infarct expansion, myocardial loss, and ventricular dysfunction. Here, we demonstrate that a specific proapoptotic gene, Bnip3, minimizes ventricular remodeling in the mouse, despite having no effect on early or late infarct size. We evaluated the effects of ablating Bnip3 on cardiomyocyte death, infarct size, and ventricular remodeling after surgical ischemia/reperfusion (IR) injury in mice. Immediately following IR, no significant differences were observed between Bnip3–/– and WT mice. However, at 2 days after IR, apoptosis was diminished in Bnip3–/– periinfarct and remote myocardium, and at 3 weeks after IR, Bnip3–/– mice exhibited preserved LV systolic performance, diminished LV dilation, and decreased ventricular sphericalization. These results suggest myocardial salvage by inhibition of apoptosis. Forced cardiac expression of Bnip3 increased cardiomyocyte apoptosis in unstressed mice, causing progressive LV dilation and diminished systolic function. Conditional Bnip3 overexpression prior to coronary ligation increased apoptosis and infarct size. These studies identify postischemic apoptosis by myocardial Bnip3 as a major determinant of ventricular remodeling in the infarcted heart, suggesting that Bnip3 may be an attractive therapeutic target.
Ability to distinguish whisky (uisge beatha) from brandy (cognac)
Authors: E J M. Campbell, D. M E Campbell, R. S Roberts
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To assess ability to distinguish between first rate malt whisky and brandy and between different brands of each. <b>Design</b>: Crossover with two sessions of 12 blindfold tastings of two whiskies and two brandies before and after supper, repeated not more than seven days later. <b>Setting</b>: Dundas, Ontario. Participants—4 volunteers aged 50-68 years, all moderate drinkers of alcohol and members of a wine club. <b>Main outcome measures</b>: Proportion of samples correctly identified (whisky v brandy) and, of those, the proportion of brands correctly identified. <b>Results</b>: Only one participant produced irrefutable statistical evidence (P&lt;0.0001) of being able to distinguish between whisky and brandy, correctly identifying 50/51 (98%) samples. Two participants achieved some success in identification (72%, P=0.0031 and 65% P=0.031). The fourth participant9s responses reflected pure guesswork. Brandy was no easier to identify than whisky (P=0.84). The participant who was best able to distinguish between whisky and brandy was also best able to identify correctly the brand of whisky (100%, P&lt;0.0001). <b>Conclusion</b>: Despite the fact that not all participants completed the full number of tastings the results show that some participants could distinguish neither between malt whisky and brandy nor between different brands of whisky and brandy. However, the success of one participant shows that "it can be done" and that his whisky specific ability is acquired not innate.
Engaging Physicians and Leveraging Professionalism
Authors: Patrick H. Conway, Christine K. Cassel
Journal: JAMA (2012)

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
Transpapillary Microwave Coagulation Therapy for Recanalizing Self-Expandable Metallic Stents Occluded by Tumor Ingrowth: Initial Experience
Authors: I. Maetani, T. Ukita, H. Inoue, Y. Igarashi, H. Hoshi, Y. Sakai
Journal: Endoscopy (2001)

Percutaneous microwave coagulation for recanalizing stents occluded by tumor ingrowth has been reported. With this technique, however, the percutaneous drain diminishes the quality of life in patients with unresectable tumors and a limited prognosis. Transpapillary microwave ablation was attempted in three patients with occluded stents. After a sheath had been inserted into the proximal hepatic duct across the occluded region, a microwave electrode was introduced into the intrahepatic duct via the sheath. We used microwave therapy with an output power of 40 W, based on our previous in vitro study. Except in one patient, the stents were successfully recanalized with one or two attempts. In one patient who underwent ablation in the intrahepatic duct, a 1.8-mm electrode enabled recanalization of the stent. In another who underwent ablation in the extrahepatic duct, however, a larger electrode was required. There were no procedure-related complications. Transpapillary microwave coagulation of occluded stents appears to be an alternative to percutaneous microwave coagulation with an electrode fitting the stent size. The technique might be easier with the use of a redesigned electrode with a guide wire lumen.
Errors in the Diagnosis of Visual Field Progression in Normal-tension Glaucoma
Authors: Michael Schulzer, P. Juhani Airaksinen, Wallace L. Alward, Marcel Amyot, Douglas R. Anderson, Gordon Balazsi, Pierre Blondeau, L. Frank Cashwell, John S. Cohen, Daniel Desjardins, Christopher Dickens, Gordon R. Douglas, Stephen M. Drance, Frederick Feldman, H. Caroline Geijssen, Alana Grajewski, Erik Greve, John Hetherington, Dale Heuer, Elizabeth Hodapp, H. Dunbar Hoskins, Andrew Iwach, Henry Jampel, Oscar Kasner, Yoshiaki Kitazawa, Rauni Komulainen, Ralph Levene, Jeffrey Liebmann, Frederick S. Mikelberg, Richard Mills, Donald Minckler, Michael Motolko, Todd Perkins, Irvin Pollock, Harry Quigley, Robert Ritch, E. George Rosanelli, Arthur Schwartz, Shiroki Shirato, Geoji Tomita, Graham Trope, Anja Tuulonen, Jacob Wilensky
Journal: Ophthalmology (1994)
Commentary: Controversies in NICE guidance on infective endocarditis
Authors: Mark Connaughton
Journal: BMJ (2008)

Overcoming barriersThis guideline represents an important change to accepted clinical practice in limiting the role of antibiotic prophylaxis for those at risk of infective endocarditis.The evidence shows that everyday activities such as regular tooth brushing almost certainly present a greater risk of infective endocarditis than a single dental procedure because they can cause repetitive bacteraemias with oral flora.Furthermore no consistent association has been shown between having an interventional procedure and the development of infective endocarditis.Effective implementation of this guideline will require the education and training of healthcare staff to ensure that consistent information is given by different professional groups.Patient information and education will be important.NICE has developed tools to help organisations implement the guideline. 2
Renal Hemosiderosis in Patients with Prosthetic Aortic Valves
Authors: WILLIAM C. ROBERTS, ANDREW G. MORROW
Journal: Circulation (1966)

Seven patients with prosthetic aortic valves and anemia are described. In six, the Teflon valves had become incompetent as a result of perforations or tears in the prosthetic cusps, and in the seventh the valve was severely stenotic as well as regurgitant. The anemia in each patient was secondary to intravascular hemolysis resulting from damage to the erythrocytes traversing the malfunctioning valve. Severe renal hemosiderosis, the anatomic indicator of severe intravascular hemolysis, was present in each patient. Although deposits of iron in the kidney in these circumstances may be extreme, no significant renal damage nor impairment of renal function appears to occur as a result of this deposition.
Potassium Depletion in Hepatic Cirrhosis
Authors: Stephen Podolsky, Hyman J. Zimmerman, Belton A. Burrows, John A. Cardarelli, Catherine G. Pattavina
Journal: New England Journal of Medicine (1973)

Abstract Seven of 17 patients with cirrhosis and impaired carbohydrate tolerance were found to have potassium depletion as judged by rises of body potassium from 12.7 to 35.8 per cent of the initial value during potassium chloride administration. Plasma insulin and growth-hormone response to the administration of glucose or arginine was initially below normal in the potassium-depleted patients but elevated above normal in those without potassium depletion. Administration of 180 mEq of potassium chloride daily for a period of two or more weeks resulted in increased body potassium, improved glucose tolerance and increased insulin and growth-hormone responses in the seven potassium-depleted cirrhotic patients, but no significant change in any of these measurements in the others. These observations indicate that potassium depletion in cirrhotic patients is associated with a diabetic glucose tolerance test and reduced output of both insulin and growth hormone and that potassium repletion may be accompanied by ...
Elevated urokinase‐type plasminogen activator level and bleeding in amyloidosis: Case report and literature review
Authors: David C. Sane, Salvatore V. Pizzo, Charles S. Greenberg
Journal: American Journal of Hematology (1989)

Abstract Hyperfibrinolytic states are reported to be a cause of bleeding in patients with amyloidosis. We reviewed the literature on excessive fibrinolysis in association with amyloidosis and report our findings from a patient with idiopathic amyloidosis who developed a bleeding diathesis. Coagulation laboratory studies indicated elevated plasminogen activator levels associated with a reduction of plasminogen and α 2 ‐plasmin inhibitor (α 2 ‐PI) levels. The level of tissue‐type plasminogen activator (t‐PA) inhibitor and t‐PA antigen were normal. However, the patient did have a five‐ to sevenfold increase in amidolytic activity for the urokinase substrate pyro‐Glu‐Gly‐Arg‐pNA (S‐2444). This case therefore represents a novel example of a hyperfibrinolytic state associated with amyloidosis caused by elevated urokinase‐type plasminogen activator (u‐PA). Epsilon‐amino caproic acid (EACA) therapy resulted in an increase in α 2 ‐PI and plasminogen levels and effectively reduced the blood loss. Hyperfibrinolytic states in amyloidosis have now been reported to be due to elevated t‐PA and u‐PA and depleted t‐PA inhibitor.
Increased vasoconstrictor response to noradrenaline in femoral vascular bed of diabetic dogs. Is thromboxane A2 involved?
Authors: M. Z. Koltai, P. Rosen, G. Ballagi-Pordany, P. Hadhazy, G. Pogatsa
Journal: Cardiovascular Research (1990)

The aim was to determine the role of cyclo-oxygenase products in the vasoconstrictor response of femoral arterial bed to noradrenaline and to analyse the role of vascular adrenoceptors in the synthesis of cyclo-oxygenase products.The influence of intra-arterially injected cyclo-oxygenase inhibitors indomethacin and acetylsalicylic acid on alterations in conductance of femoral arterial bed induced by noradrenaline was compared in metabolically healthy and alloxan diabetic dogs. PGI2 and TXA2 synthesising ability of isolated femoral arterial rings was measured with and without inhibition of alpha adrenoceptors by phentolamine.18 metabolically healthy and 18 alloxan (560 mumol.kg-1) diabetic dogs of either sex, weight 16-28 kg, were studied.Noradrenaline produced greater (p less than 0.01) pressor effects in the femoral arterial bed of alloxan diabetic dogs than in the hind limb of control animals. Blockade of cyclo-oxygenase either by indomethacin 10 mumol.kg-1 or by acetylsalicylic acid 140 mumol.kg-1 markedly reduced the response to noradrenaline in alloxan treated animals, but not in controls, thereby eliminating the different responsiveness of the two groups. Femoral arterial rings from diabetic animals synthesised similar amounts of PGI2 as control rings but formed more TXA2 (p less than 0.05). Phentolamine pretreatment (5 mumol.litre-1) markedly reduced the production of TXA2, but not of PGI2, in diabetic vessels.The results show an increased release of TXA2 by isolated diabetic femoral arteries. It is therefore suggested that an alpha adrenoceptor mediated increase in TXA2 biosynthesis may play a part in the vascular hyperreactivity of the diabetic femoral arterial bed.
The Emerging Genetics of Human Cancer
Authors: Franklin H. Epstein, Theodore G. Krontiris
Journal: New England Journal of Medicine (1983)

THE most enduring hypothesis concerning the origin of cancer is that some genetic alteration — induced by the environment, by predisposition, or by both factors acting in concert — results in the unregulated and remorseless proliferation of cells. Therefore, researchers have sought an understanding of how the altered expression of cellular genes leads to unregulated growth. The endeavor has always seemed formidable, because we view the malignant process as one that requires the interaction of many factors acting in multiple stages. Lately, we have achieved some simplification of our concepts (if not, perhaps, the reality), largely through very productive research . . .
Polyol pathway mediates high glucose-induced collagen synthesis in proximal tubule
Authors: Anthony J. Bleyer, Peter Fumo, Edward R. Snipes, Stanley Goldfarb, David A. Simmons, Fuad N. Ziyadeh
Journal: Kidney International (1994)

The polyol pathway in diabetes is activated in tissues that are not dependent on insulin for glucose uptake. To examine the role of the polyol pathway in renal extracellular matrix accumulation, we incubated murine proximal tubule cells in either normal or high glucose concentration in the presence or absence of the aldose reductase inhibitor sorbinil. Rising medium glucose from 100 to 450 mg/dl for 72 hours increased cell sorbitol levels sevenfold. Addition of 0.4 mM sorbinil reduced sorbitol content to virtually undetectable levels as measured by gas chromatography. Sorbinil (0.1 to 0.2 mM) also reduced the secretion of collagens types IV and I in the high glucose concentration after 48 to 72 hours but had no appreciable effect in the normal glucose concentration. Concordantly, 0.1 mM sorbinil inhibited the high glucose-induced stimulation of alpha 1(IV) and alpha 2(I) mRNA levels without affecting levels in normal glucose concentration. To study the role of transcriptional activation of collagen genes, we transfected proximal tubule cells with a chloramphenicol acetyltransferase (CAT) reporter gene linked to the promoter and regulatory elements of alpha 1(IV) gene. CAT activity increased several-fold in the cells grown in the high versus normal glucose concentration; this transcriptional activation in culture media containing high glucose concentration was reduced by treatment of the cells with 0.1 mM sorbinil. Thus, high ambient glucose activates the polyol pathway in proximal tubule cells, and may mediate the high glucose-induced stimulation of gene expression for collagens types IV and I.(ABSTRACT TRUNCATED AT 250 WORDS)