tbuckley/cabot-search huggingface dataset:
Overruling the parents of child patients
Authors: L Delany
Journal: BMJ (1994)

EDITOR, - The trial of Dwight and Beverley Harris for the manslaughter by neglect of their 9 year old daughter, Nakhira,1 should alert medical staff to the danger of failing to overrule parental decisions and the corresponding need to be fully familiar with correct legal procedure. The failure of the hospital team that diagnosed Nakhira's diabetes to shield her from parental neglect must cause concern. The legal powers available to protect her were extensive. Perhaps the time …
VII. EFFECTS OF LOW OXYGEN PRESSURE ON THE PERSONALITY OF THE AVIATOR
Authors: STEWART PATON
Journal: JAMA (1918)

tympanic pressure was so great as to cause perforation of the drumhead.Practically all cases showed con- gestion of the drumhead following rapid descent.Occasionally the irritation and congestion resulting from rapid changes of altitude have been observed to cause acute otitis media.Observations on the effects of altitude on the motion-sensing function of the ear have revealed noth- ing in the nature of obtunded ability to perceive motion or alterations in eye reactions to motion stimulus.Certain individuals showed greater inability to tolerate motion stimulus at 16,000 to 18,000 feet than they had shown at the accustomed altitude, as evidenced by the onset of nausea and vomiting.This, however, may be regarded as indicative of the onset of altitude sickness (ordinary "mountain sickness") rather than of altered vestibular function.
Fanconi's Anemia and Dyskeratosis Congenita
Authors: G. Arthur Van Voolen
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Swift et al reported recently (<b>216</b>:325, 1971) that squamous cell carcinomas of the oral mucosa, esophagus, anus, and vulva occurred in adults with Fanconi's anemia. Dyskeratosis congenita (Zinsser-Engman-Cole syndrome) shares numerous features with Fanconi's anemia, including, with full expressivity, progressive refractory pancytopenia, cutaneous dyschromia, obliteration of puncta lacrimalia, atretic external auditory canals, mental retardation, overall frailty, hypogenitalism, and retardation of growth. Moreover, those afflicted with dyskeratosis congenita show strong propensities for development of squamous cell carcinomas (less often, adenocarcinomas) of mucosae and mucocutaneous junctions such as the sites mentioned above.<sup>1-5</sup> The karyotypic abnormalities of Fanconi's anemia have not been thus far recorded in dyskeratosis congenita.<sup>5-7</sup>However, there may be an inordinately high incidence of leukemia in families with dyskeratosis congenita.<sup>5,8</sup>Reported clinical findings plus our own evaluation of two brothers with dyskeratosis congenita indicate the following to be frequent in dyskeratosis congenita but
NEW LIGHT ON THE MECHANISM OF THE AURICULAR ARRHYTHMIAS—AN ADDENDUM
Authors: MAURICE C. PINCOFFS
Journal: Annals of Internal Medicine (1950)

Editorials1 August 1950NEW LIGHT ON THE MECHANISM OF THE AURICULAR ARRHYTHMIAS—AN ADDENDUMMAURICE C. PINCOFFSMAURICE C. PINCOFFSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-33-2-486 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince the publication in the April, 1950, issue of the ANNALS OF INTERNAL MEDICINE of the Editorial entitled "New Light on the Mechanism of the Auricular Arrhythmias," the Editor has received a number of letters pointing out that in this presentation inadequate recognition was given to the contributions in this field made by others prior to the recent publication of Prinzmetal and his coworkers. In particular the attention of the Editor was directed to the basic investigations of Scherf.Consideration of the evidence presented has convinced the Editor that, as correction of the impression evidently made by the original Editorial,...1 Scherf D: Versuche zur Theorie des Vorhofflatterns und Vorhofflimmerns, Ztschr. ges. exp. Med. 61: 30, 1928, and Ztschr. f. Kreislfg. 20: 432, 1928. CrossrefGoogle Scholar2 Scherf D: Response of focus of origin of experimental ventricular extrasystoles to warming or cooling, Proc. Exper. Biol. and Med. 51: 224, 1942. CrossrefGoogle Scholar3 Scherf D: Experimental digitalis and strophanthin extrasystoles, Exper. Med. and Surg. 2: 70, 1944. Google Scholar4 Scherf D: Studies on auricular tachycardia caused by aconitine administration, Proc. Soc. Exper. Biol. and Med. 64: 233, 1947. CrossrefMedlineGoogle Scholar5 Scherf D: Experiments on the origin of auricular flutter and fibrillation, Arquiv. Brasilieros de Cardiol. 1: 147, 1948. Google Scholar6 ScherfRomanoTerranova DFJR: Experimental studies on auricular flutter and auricular fibrillation, Am. Heart J. 36: 241, 1948. CrossrefMedlineGoogle Scholar7 Scherf D: The effect of sympathetic stimulation on auricular flutter, Am. Heart J. 37: 1069, 1949. CrossrefMedlineGoogle Scholar8 ScherfScharfGoklen DMMMF: Effects of stretch and pressure on stimulus formation in the dog's auricle, Proc. Soc. Exper. Biol. and Med. 70: 708, 1949. CrossrefMedlineGoogle Scholar9 ScherfTerranova DR: Mechanism of auricular flutter and fibrillation, Am. J. Physiol. 159: 137, 1949. CrossrefMedlineGoogle Scholar10 ScherfMorgenbesserNightingaleSchaeffeler DLJEJKT: Further studies on mechanism of auricular fibrillation, Proc. Soc. Exper. Biol. and Med. 73: 650, 1950. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1950Volume 33, Issue 2Page: 486-487KeywordsArrhythmia ePublished: 1 December 2008 Issue Published: 1 August 1950 PDF downloadLoading ...
Acute folate deficiency during peritoneal dialysis.
Authors: A J Watson, E Lawlor, J A Keogh
Journal: BMJ (1980)

inhibitors in the collecting tubes, minor aggregation of platelets and consequent release of TxB2 during sampling is largely unavoidable.The raised plasma TxB2 concentrations might therefore in part reflect the increased capacity of the platelets to produce TxB2 during aggregation.That there is an increased generation of TxB2 in re- sponse to thrombin-induced platelet aggregation during pregnancy and puerperium is, however, indisputable.What causes this stimula- tion remains to be investigated.
Breast cancer and pesticides in Hawaii: the need for further study.
Authors: R H Allen, M Gottlieb, E Clute, M J Pongsiri, J Sherman, G I Obrams
Journal: Environmental Health Perspectives (1997)

Only 30% of all breast cancer can be explained by known risk factors. Increases in breast cancer incidence rates in Hawaii over the past few decades cannot be attributed solely to improvements in screening and detection. Avoidable environmental factors may contribute to a proportion of the unexplained cases. Emerging evidence on endocrine disruption suggests that environmental chemicals may play a role in the development of breast cancer. Agricultural chemicals, including endocrine disruptors, have been used intensively in Hawaii's island ecosystem over the past 40 years leaching into groundwater, and leading to unusually widespread occupational and general population exposures. This paper discusses breast cancer patterns in Hawaii in the context of documented episodes of exposure to two endocrine-disrupting chemicals, chlordane/heptachlor and 1,2-dibromo-3-chloropropane (DBCP), at levels that sometimes exceeded federal standards by several orders of magnitude. In light of this history, detailed geographic-based studies should be undertaken in Hawaii to elucidate the potential role of environmental factors in the development of breast cancer and other diseases.
Standardization of definition, classification, and reporting in diabetes-related epidemiologic studies
Authors: Kelly M West
Journal: Diabetes Care (1979)

This working paper reviews some advantages and disadvantages of various alternative definitions and classification schemes. Certain of these alternatives were discussed by an international group of experts on the epidemiology of diabetes. It was recommended by the conferees that the following terms not be used as standard descriptors in epidemiologic reports: juvenile diabetes, juvenile-type diabetes, maturity-onset diabetes of youth (MODY), latent diabetes, subclinical diabetes, clinical diabetes, chemical diabetes, and J-type (Jamaica) diabetes. Alternative ways of describing these conditions were offered. Some, but not all, conferees favored abandonment or modification of the terms “secondary diabetes” and “pancreatic diabetes.” Two alternate approaches are described in classification. One is designed to classify all types of cases in a single scheme. In this system each case is described by indices that include etiology and special etiologic concomitants, fatness, severity, type of treatment, and, if present, special or peculiar manifestations, and morbidity. This system makes it possible to classify all cases by mutually exclusive categories. A disadvantage of this scheme is that the number of combinations of classifying indices and subindices is great. Another approach is to classify cases by syndromes, using in each class a mixture of indices (e.g., etiology, severity, fatness, etc.). The conferees failed to reach a consensus in the specifics of this approach. There was considerable disagreement on how certain terms should be defined, whether they should be used, and on the degree of need for specific definitions. These designations included the terms “insulin-dependent,” “idiopathic,” “insulin-requiring,” and “ketosis-prone.” The conferees agreed that in either of the two approaches to classification, the prime indices should be those that can be ascertained by ordinary clinical methods. Much progress could be accomplished, even in the absence of international standardized definitions and classification systems, provided that authors keep in mind the need to describe the major characteristics of their cases and define the sense in which they use terms such as insulin-dependent, ketosis-prone, obese, etc.
Postpartum Impact on Patients With Independently Diagnosed Affective Disorder
Authors: George Winokur
Journal: JAMA (1966)

Seventy-one women who suffered from primary affective disorder independent of the postpartum state were examined by a systematic interview concerned with pregnancies, deliveries, previous episodes of psychiatric illness, and coincidence of the postpartum state with psychiatric illness. Five patients who had affective illness independent of pregnancy had also had a total of six postpartum psychoses. Sixty-six patients with affective disorder had never suffered a postpartum psychiatric episode. Ten pregnancies preceded the index postpartum psychosis in the five women and these were not associated with postpartum illnesses. In four subsequent pregnancies, one was associated with postpartum illness. The specific morbidity risk for the development of an affective disorder in the postpartum state (10%) in the group of affectively disordered women was not significantly different from the morbidity risk at any other time during their life (6%).
Obstructive Sleep Apnea Is Independently Associated with Insulin Resistance
Authors: MARY S. M. IP, BING LAM, MATTHEW M. T. NG, WAH KIT LAM, KENNETH W. T. TSANG, KAREN S. L. LAM
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Epidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid factor in cardiovascular and cerebrovascular diseases. It is postulated that recurrent episodes of occlusion of upper airways during sleep result in pathophysiological changes that may predispose to vascular diseases. Insulin resistance is a known risk factor for atherosclerosis, and we postulate that OSA represents a stress that promotes insulin resistance, hence atherogenesis. This study investigated the relationship between sleep-disordered breathing and insulin resistance, indicated by fasting serum insulin level and insulin resistance index based on the homeostasis model assessment method (HOMA-IR). A total of 270 consecutive subjects (197 male) who were referred for polysomnography and who did not have known diabetes mellitus were included, and 185 were documented to have OSA defined as an apnea–hypopnea index (AHI) ⩾ 5. OSA subjects were more insulin resistant, as indicated by higher levels of fasting serum insulin (p = 0.001) and HOMA-IR (p < 0.001); they were also older and more obese. Stepwise multiple linear regression analysis showed that obesity was the major determinant of insulin resistance but sleep-disordered breathing parameters (AHI and minimum oxygen saturation) were also independent determinants of insulin resistance (fasting insulin: AHI, p = 0.02, minimum O2, p = 0.041; HOMA-IR: AHI, p = 0.044, minimum O2, p = 0.022); this association between OSA and insulin resistance was seen in both obese and nonobese subjects. Each additional apnea or hypopnea per sleep hour increased the fasting insulin level and HOMA-IR by about 0.5%. Further analysis of the relationship of insulin resistance and hypertension confirmed that insulin resistance was a significant factor for hypertension in this cohort. Our findings suggest that OSA is independently associated with insulin resistance, and its role in the atherogenic potential of sleep disordered breathing is worthy of further exploration.
Lipopolysaccharide binding protein enhances the responsiveness of alveolar macrophages to bacterial lipopolysaccharide. Implications for cytokine production in normal and injured lungs.
Authors: T R Martin, J C Mathison, P S Tobias, D J Letúrcq, A M Moriarty, R J Maunder, R J Ulevitch
Journal: Journal of Clinical Investigation (1992)

A plasma lipopolysaccharide (LPS)-binding protein (LBP) has been shown to regulate the response of rabbit peritoneal macrophages and human blood monocytes to endotoxin (LPS). We investigated whether LBP is present in lung fluids and the effects of LBP on the response of lung macrophages to LPS. Immunoreactive LBP was detectable in the lavage fluids of patients with the adult respiratory distress syndrome by immunoprecipitation followed by Western blotting, and also by specific immunoassay. In rabbits, the LBP appeared to originate outside of the lungs, inasmuch as mRNA transcripts for LBP were identified in total cellular RNA from liver, but not from lung homogenates or alveolar macrophages. Purified LBP enhanced the response of human and rabbit alveolar macrophages to both smooth form LPS (Escherichia coli O111B:4) and rough form LPS (Salmonella minnesota Re595). In the presence of LBP and LPS, the onset of tumor necrosis factor-alpha (TNF alpha) production occurred earlier and at an LPS threshold dose that was as much as 1,000-fold lower for both types of LPS. In rabbit alveolar macrophages treated with LBP and LPS, TNF alpha mRNA appeared earlier, reached higher levels, and had a prolonged half-life as compared with LPS treatment alone. Neither LPS nor LPS and LBP affected pHi or [Cai++] in alveolar macrophages. Specific monoclonal antibodies to CD14, a receptor that binds LPS/LBP complexes, inhibited TNF alpha production by human alveolar macrophages stimulated with LPS alone or with LPS/LBP complexes, indicating the importance of CD14 in mediating the effects of LPS on alveolar macrophages. Thus, immunoreactive LBP accumulates in lung lavage fluids in patients with lung injury and enhances LPS-stimulated TNF alpha gene expression in alveolar macrophages by a pathway that depends on the CD14 receptor. LBP may play an important role in augmenting TNF alpha expression by alveolar macrophages within the lungs.
Policies of Children’s Hospitals on Donation After Cardiac Death—Reply
Authors: Armand H. Matheny Antommaria
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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Recurrent Hepatitis and Halothane
Authors: Daniel N. Mohler
Journal: JAMA (1969)

To the Editor:—  InThe Journal( 209 :946, 1969) a question from a physician in Illinois concerns a patient with recurrent attacks of hepatitis. The answer raised the possibility, among others, of multiple viral exposures.  Another possibility occurred to me which would merit looking into. Is it possible that this patient has been having recurrent exposures to halothane at his place of work? It is mentioned in the case description that he is a hospital employee. A strikingly similar case was described by Klatskin and Kimberg ( New Eng J Med  280 :515, 1969). An anesthesiologist who had recurrent attacks of hepatitis which were found to be caused by exposure to halothane and cleared completely when he avoided halothane exposure. The recurrent hepatitis described inThe Journalquestion is consistent with recurrent exposure to a hepatotoxin, and it would be of great interest and possible therapeutic importance to determine whether the
Association of drug metabolism gene polymorphisms with toxicities, graft-versus-host disease and survival after HLA-identical sibling hematopoietic stem cell transplantation for patients with leukemia
Authors: V Rocha, R Porcher, J F Fernandes, A Filion, H Bittencourt, W Silva, G Vilela, D L Zanette, C Ferry, J Larghero, A Devergie, P Ribaud, Y Skvortsova, R Tamouza, E Gluckman, G Socie, M A Zago
Journal: Leukemia (2008)
Effect of Ca <sup>2+</sup> on GP IIb-IIIa Interactions With Integrilin
Authors: David R. Phillips, Willie Teng, Ann Arfsten, Lisa Nannizzi-Alaimo, Melanie M. White, Celia Longhurst, Sanford J. Shattil, Anne Randolph, Joseph A. Jakubowski, Lisa K. Jennings, Robert M. Scarborough
Journal: Circulation (1997)

Integrilin (eptifibatide), a potent inhibitor of the fibrinogen binding function of GP IIb-llla, has been shown to reduce the thrombotic complications of angioplasty and of acute coronary syndromes. The present study was designed to determine whether the reduced Ca2+ concentrations in plasma anticoagulated with citrate affect Integrilin binding to GP IIb-IIIa and the ex vivo pharmacodynamic measurements for this drug.Lower concentrations of Integrilin were found to inhibit platelet aggregation in plasma anticoagulated with citrate (for ADP, mean+/-SD IC(50)=140+/-40 nmol/L, n=6; Ca2+ =40 to 50 micromol/L) than with PPACK (IC(50)=570+/-70 nmol/L, P<.0001, n=6; Ca2+ approximately 1 mmol/L). Chelation of Ca2+ with EDTA or citrate caused a similar degree of enhancement in the inhibitory activity of Integrilin. Measurements of D3 LIBS epitope expression showed that the enhanced inhibitory activity was caused by enhanced GP IIb-IIIa occupancy by Integrilin. Citrate anticoagulation decreased the amounts of Integrilin required to inhibit the binding of PAC1, a monoclonal antibody that mimics the GP IIb-IIIa binding activity of fibrinogen. Reduced Ca2+ also increased Integrilin inhibition of the binding of biotinylated fibrinogen to purified, immobilized GP IIb-IIIa.These data suggest that citrate anticoagulation removes Ca2+ from GP IIb-IIIa and enhances the apparent inhibitory activity of Integrilin. This finding indicates that the inhibitory activity of Integrilin is overestimated in blood samples collected with citrate, suggesting that it may be possible to achieve greater antithrombotic efficacy beyond that observed in clinical trials to date with Integrilin.
Magnetic Resonance Imaging: Present Costs and Potential Gains
Authors: STEVEN A. SCHROEDER
Journal: Annals of Internal Medicine (1985)

Editorials1 April 1985Magnetic Resonance Imaging: Present Costs and Potential GainsSTEVEN A. SCHROEDER, M.D.STEVEN A. SCHROEDER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-4-551 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMagnetic Resonance Imaging (MRI) is a new diagnostic technique that relies on radio-frequency-induced nuclear resonance to chart physicochemical differences between tissues, rather than using ionizing radiation. This technique is the subject of a recent case study on medical technology by the Office of Technology Assessment (1). As with the previous reports in this series, which has covered such diverse technologies as computed tomographic (CT) scanning, screening for colon cancer, bone marrow transplantation, upper gastrointestinal endoscopy, psychotherapy, cimetidine and peptic ulcer disease, and treatment for alcoholism, this report provides a state-of-the-art analysis, including a cost-effectiveness study and a review of the...References1. STEINBERGCOHEN EA. Health Technology Case Study 27: Nuclear Magnetic Resonance Imaging Technology: A Clinical, Industrial, and Policy Analysis. Washington, D.C.: Office of Technology Assessment, U.S. Congress; 1984. (OTA publication no. OTA-HCS-27.) Google Scholar2. BAKERBERQUISTKISPERT HTD. Magnetic resonance imaging in a routine clinical setting. Mayo Clin Proc. 1985;60:75-90. CrossrefMedlineGoogle Scholar3. ROZANSKIDIAMONDBERMAN AGD. The declining specificity of exercise radionuclide ventriculography. N Engl J Med. 1983;309:518-22. CrossrefMedlineGoogle Scholar4. HENDEEMORGAN WC. Magnetic resonance imaging: Part II-Clinical applications. West J Med. 1984:141:638-48. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of California San Francisco; San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA portable single-sided magnetic-resonance sensor for the grading of liver steatosis and fibrosisPolyestersSubstitution of Magnetic Resonance Imaging for Computed Tomography: An Exploratory StudySHOULD GOVERNMENT REGULATE TECHNOLOGY TO REDUCE HEALTH EXPENDITURES? SOME AUSTRALIAN RESULTS FOR THE POLICY DEBATEMedical technology and health expenditure: An economic review and a proposalInfluence of surgical resection prior to chemotherapy on the long-term results in small cell lung cancer. A study of 150 operable patientsX-Ray CT and Magnetic Resonance ImagersMagnetic Resonance Imaging:Overview of the Technology and Medical Applications 1 April 1985Volume 102, Issue 4Page: 551-553KeywordsCancer screeningCancer treatmentChartsColorectal cancerComputed axial tomographyDiagnostic techniquesEndoscopyIonizing radiationMagnetic resonance imagingPeptic ulcers Issue Published: 1 April 1985 PDF downloadLoading ...