tbuckley/cabot-search huggingface dataset:
Pharmacological manipulation of gastric juice: thrombelastographic assessment and implications for treatment of gastrointestinal haemorrhage.
Authors: S E Patchett, D P O'Donoghue
Journal: Gut (1995)

The impairment of formation and maintenance of a formed fibrin clot contributes to the prolonged bleeding and high incidence of rebleeding in upper gastrointestinal haemorrhage. To investigate the basis for the use of drug therapy in gastric bleeding, this study used thrombelastography to determine the effects of pharmacological manipulation of gastric juice on coagulation and fibrinolysis. The thrombelastograph is a mechanical device that provides a visual assessment of all stages of coagulation and fibrinolysis. The effects of fresh and pharmacologically changed gastric juice was assessed after its addition to fresh whole blood in the thrombelastograph cuvette. Pharmacological manipulation was achieved through alkalisation or through addition of tranexamic acid, aprotinin, or sucralfate. Fresh gastric juice delayed clot formation, decreased maximum clot amplitude, and stimulated clot lysis. Alkalisation inhibited the lytic effects of fresh gastric juice and improved the induced abnormalities in coagulation. Tranexamic acid partially inhibited gastric juice induced clot lysis but did not exhibit a beneficial effect on coagulation. Sucralfate, and to a lesser extent aprotinin significantly inhibited fibrinolysis but exacerbated the detrimental effect of gastric juice on the parameters of coagulation. Alkalisation of gastric juice reduces the adverse effect on coagulation and fibrinolysis. Tranexamic acid, aprotinin, and sucralfate can all reduce or inhibit clot lysis, but the adverse effects on clot formation may outweigh any potential benefit in the treatment of gastrointestinal bleeding.
1236 Prognostic evaluation of hepatocellular carcinoma: a comparative analysis of four different staging systems in anti-HCV patients with liver cirrhosis
Authors: E GIANNINI, F BOTTA, P ROMAGNOLI, F MALFATTI, A FUMAGALLI, E TESTA, E PODESTA, B CHIARBONELLO, S POLEGATO, R TESTA
Journal: Hepatology (2003)

Background: The advances in immunotherapy, along with a liberalization of eligibility criteria have contributed significantly to the ever increasing demand for donor organs. In an attempt to expand the donor pool, transplant programs are now accepting older donors as well as donors from more remote areas. The purpose of this study is to determine the effect of donor age and organ ischemic time on survival following orthotopic heart transplantation (OHT).From April 1981 to December 1996 372 adult patients underwent OHT at the University of Western Ontario. Cox proportional hazards models were used to identify predictors of outcome. Variables affecting survival were then entered into a stepwise logistic regression model to develop probability models for 30-day- and 1-year-mortality.The mean age of the recipient population was 45.6 ± 12.3 years (range 18–64 years: 54 ≤ 30; 237 were 31–55; 91 > 56 years). The majority (329 patients, 86.1%) were male and the most common indications for OHT were ischemic (n = 180) and idiopathic (n = 171) cardiomyopathy. Total ischemic time (TIT) was 202.4 ± 84.5 minutes (range 47–457 minutes). In 86 donors TIT was under 2 hours while it was between 2 and 4 hours in 168, and more than 4 hours in 128 donors. Actuarial survival was 80%, 73%, and 55% at 1, 5, and 10 years respectively. By Cox proportional hazards models, recipient status (Status I–II vs III–IV; risk ratio 1.75; p = 0.003) and donor age, examined as either a continuous or categorical variable ([age < 35 vs ≥ 35; risk ratio 1.98; p < 0.001], [age < 50 vs ≥ 50; risk ratio 2.20; p < 0.001], [age < 35 vs 35–49 versus ≥ 50; risk ratio 1.83; p < 0.001]), were the only predictors of operative mortality. In this analysis, total graft ischemic time had no effect on survival. However, using the Kaplan-Meier method followed by Mantel-Cox logrank analysis, ischemic time did have a significant effect on survival if donor age was >50 years (p = 0.009). By stepwise logistic regression analysis, a probability model for survival was then developed based on donor age, the interaction between donor age and ischemic time, and patient status.Improvements in myocardial preservation and peri-operative management may allow for the safe utilization of donor organs with prolonged ischemic times. Older donors are associated with decreased peri-operative and long-term survival following OHT, particularly if graft ischemic time exceeds 240 minutes and if these donor hearts are transplanted into urgent (Status III–IV) recipients.
Coeliac disease among children in Kuwait: difficulties in diagnosis and management.
Authors: F A Khuffash, M H Barakat, A A Shaltout, S S Farwana, M S Adnani, M F Tungekar
Journal: Gut (1987)

Twenty children with coeliac disease were diagnosed over a five year period in an area with 10,000-12,000 births per year. The average annual incidence was 1:3000 births. All children presented with severe symptoms and rickets was not uncommon (25%). Mean age at onset of symptoms was 38 months (range 6-120) and 72 months at the time of diagnosis (range 13-192), with a mean delay of 34 months. No cases were diagnosed during infancy. The difficulties in the differentiation of coeliac disease from the more common causes of chronic diarrhoea, and problems with diagnosis and management are discussed.
PREDICTORS OF CONTRAST-INDUCED NEPHROPATHY AFTER PERCUTANEOUS CORONARY INTERVENTION FOR CTO LESIONS.
Authors: Masashi Kimura, Soichiro Ebisawa, Yoshihiro Ko, Nobuyoshi Tanaka, Kenya Nasu, Tatsuya Ito, Yoshihisa Kinoshita, Mariko Ehara, Etsuo Tsuchikae, Mitsuyasu Terashima, Yasushi Asaskura, Osamu Katoh, Takahiko Suzuki
Journal: Journal of the American College of Cardiology (2010)
PURE CULTURES OF CELLS
Authors: Alexis Carrel
Journal: The Journal of Experimental Medicine (1912)

In experiment I a group of ameboid cells was isolated from a culture of cardiac muscle sixty-three days old, and cultivated in plasma. After several passages, they formed a dense tissue from which ameboid cells radiated. The culture was divided into two parts. The part cultivated in plasma alone kept its morphological characters and continued to produce ameboid cells. The part cultivated upon silk in plasma became modified; the cells lost their ameboid characters, and were transformed into large elongated cells which were united in chains, or interlaced to form a network. In experiment II the round cells taken from a culture of connective tissue seventy-four days old multiplied rapidly. They transformed themselves into elongated cells and produced, after a few passages, a mass of dense connective tissue. From the tissue a large number of elongated cells were constantly growing. In both experiments the tissues originated from the ameboid or round cells extirpated from cultures that were sixty-three and seventy-four days old respectively. These cultures were still growing actively thirty and forty days later; that is, more than one hundred days after the extirpation of the original fragments from the organism. These experiments show that from old cultures it is possible to isolate and propagate cells that belong to a definite type. A tissue, formed by a pure strain of cells, can be obtained in this way, and this new method may be of value in cytological investigations.
α<sub>2</sub>‐Agonists as analgesic agents
Authors: Maria Paola Giovannoni, Carla Ghelardini, Claudia Vergelli, Vittorio Dal Piaz
Journal: Medicinal Research Reviews (2008)

Abstract It is well known that norepinephrine is involved in the control of pain by modulating pain‐related responses through various pathways. α 2 ‐Adrenergic agonists have a well‐established analgesic profile and, in the recent years, have found a wider application, in particular as adjunct to anesthetics and analgesics in perioperative settings. This review analyzes the α 2 ‐agonists currently in clinical use, starting from the prototype Clonidine, as well as the most promising and studied molecules. In addition, an overview of the imidazoles, imidazolines, and hydroxyethyl‐thioureas derivatives published in both the open and patented literature is presented, providing chemical description and pharmacological data. Finally, the most commonly α 2 ‐agonists used in veterinary medicine are described. © 2008 Wiley Periodicals, Inc. Med Res Rev, 29, No. 2, 339–368, 2009
The Imaginary Safety Net
Authors: David B Kilgore
Journal: JAMA (2006)

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
Electric Fields of the Brain: The Neurophysics of EEG
Authors: Joseph Fermaglich
Journal: JAMA (1982)

Computer technology is widely used to process biomedical information. Indeed, electrodiagnostic studies of heart, nervous system, and blood flow as well as radiographic procedures are dependent on computer assistance. Clinical electroencephalography, by contrast, remains largely a test, the interpretation of which must be done the old-fashioned way—by people. In their book the authors present mathematical, physical, physiological, engineering, and medical facts in an effort to diminish a communication gap amongst electroencephalographers, engineers, and physicists. In fact, their book is directed to practitioners of each of those disciplines. The book focuses on the various aspects of electrophysiology of the brain. The first three chapters concern the relationship of physics and electrophysiology, while subsequent chapters are related to potentials in different biologic media and the generation and recording of cerebral electrical activity. Computer methodology applicable to electroencephalography is mentioned. This book has considerable value in its presentation of clinical, theoretical, and speculative
A REPORT OF TWO CASES OF MYXEDEMA.
Authors: GORDON W. RICE
Journal: JAMA (1907)

In view of the fact that the diagnosis of this disease in these patients had been overlooked for some time, and they thus deprived of early treatment, it might be of interest if the following were reported: <h3>Case 1.—History.</h3> —Mrs. E. O., aged 40, a resident of Galena, Ill., occupation housewife, height 5 feet 3 inches. There was nothing of importance in the family history; as a child and young woman she enjoyed good health, average weight 115 pounds. Married at age of 20; had no children and no abortions. She was healthy until the beginning of her present condition, which she noticed about the age of 33, when she began to increase in weight and to have severe headaches. She also suffered at times from indigestion and constipation. Continued to increase in weight for about two years, when she reached 187 pounds, and, to use her own expression,
Alterations in the Ubiquitin Proteasome System in Persistent but Not Reversible Proteinuric Diseases
Authors: Maire Beeken, Maja T. Lindenmeyer, Simone M. Blattner, Victoria Radón, Jun Oh, Tobias N. Meyer, Diana Hildebrand, Hartmut Schlüter, Anna T. Reinicke, Jan-Hendrik Knop, Anuradha Vivekanandan-Giri, Silvia Münster, Marlies Sachs, Thorsten Wiech, Subramaniam Pennathur, Clemens D. Cohen, Matthias Kretzler, Rolf A.K. Stahl, Catherine Meyer-Schwesinger
Journal: Journal of the American Society of Nephrology (2014)

Podocytes are the key cells affected in nephrotic glomerular kidney diseases, and they respond uniformly to injury with cytoskeletal rearrangement. In nephrotic diseases, such as membranous nephropathy and FSGS, persistent injury often leads to irreversible structural damage, whereas in minimal change disease, structural alterations are mostly transient. The factors leading to persistent podocyte injury are currently unknown. Proteolysis is an irreversible process and could trigger persistent podocyte injury through degradation of podocyte-specific proteins. We, therefore, analyzed the expression and functional consequence of the two most prominent proteolytic systems, the ubiquitin proteasome system (UPS) and the autophagosomal/lysosomal system, in persistent and transient podocyte injuries. We show that differential upregulation of both proteolytic systems occurs in persistent human and rodent podocyte injury. The expression of specific UPS proteins in podocytes differentiated children with minimal change disease from children with FSGS and correlated with poor clinical outcome. Degradation of the podocyte-specific protein α-actinin-4 by the UPS depended on oxidative modification in membranous nephropathy. Notably, the UPS was overwhelmed in podocytes during experimental glomerular disease, resulting in abnormal protein accumulation and compensatory upregulation of the autophagosomal/lysosomal system. Accordingly, inhibition of both proteolytic systems enhanced proteinuria in persistent nephrotic disease. This study identifies altered proteolysis as a feature of persistent podocyte injury. In the future, specific UPS proteins may serve as new biomarkers or therapeutic targets in persistent nephrotic syndrome.
Peers clash over physician assisted suicide
Authors: C. Dyer
Journal: BMJ (2010)

Doctors who oppose the right of terminally ill patients to physician assisted suicide are putting their own moral principles above those of the patient, declared the eminent philosopher Mary Warnock as she opened a debate on assisted suicide.

“We would never countenance that in the earlier stages of life,” insisted the peer and former mistress of Girton College, Cambridge.

“When people say that the trust between doctor and patient would be eroded if assisted suicide were permitted, I think that the opposite is the case.”

But her fellow peer Ilora Finlay, professor of palliative medicine at Cardiff University, said that legalising assisted suicide would be asking doctors, who try to prevent patients committing suicide, …
Metabolic aspects of programmed cell survival and cell death in the heart
Authors: C Depre
Journal: Cardiovascular Research (2000)

Normal cardiac function requires a tight interaction between metabolism, contractile function and gene expression. The main perturbation challenging this equilibrium in vivo is ischemia, which alters energy flux through the control of key enzymes. The review highlights metabolic imprints and energetic aspects of programmed cell survival, programmed cell death, and of necrosis. When sustained and severe, ischemia leads to a total collapse of energy transfer, to the accumulation of metabolic endproducts, and to the development of myocardial necrosis. When moderate, ischemia results in a coordinated cellular response including enhanced anaerobic glucose metabolism, a modification of cardiac gene expression, and the development of specific mechanisms for programmed cell survival (preconditioning, stunning, hibernation). Repetitive stress results in a decrease of contractile function, a downregulation of gene expression and an impairment of energy transfer, which eventually cause the heart to fail. When the failing heart becomes energy-depleted, the programs of cell survival are no longer operational and programmed cell death ensues. To define the point of departure from programmed cell survival to cell death remains a major challenge.
Impaired Left Ventricular Function in Alcoholic Cirrhosis With Ascites
Authors: CONSTANTINOS J. LIMAS, NABIL H. GUIHA, OSOTH LEKAGUL, JAY N. COHN
Journal: Circulation (1974)

Left ventricular function was assessed in 10 patients with alcoholic cirrhosis and ascites without clinical evidence of heart disease. In the resting state pulmonary wedge pressure (PWP) was normal (average 9.7 mm Hg), cardiac output (CO) was elevated (average 9.7 L/min) and systemic vascular resistance (SVR) was low (average 825 dynes-sec-cm –5 ). During infusion of angiotensin in a dose sufficient to raise diastolic arterial pressure 20 mm Hg, SVR increased to 1140 dynes-sec-cm -5 ( P &lt; 0.01) and PWP rose to 19.2 mm Hg ( P &lt; 0.001) with no change in CO. Resting hemodynamics were essentially unchanged in seven patients restudied 45-60 min after intravenous administration of 0.5 mg ouabain. Repeat infusion of angiotensin after ouabain again resulted in a rise in PWP to an average of 17.0 mm Hg ( P &lt; 0.001) with no significant change in CO. In seven additional cirrhotic patients with ascites, systolic time intervals were unchanged by 0.5 mg ouabain whereas in four normal volunteers the same dose resulted in significant shortening of total electromechanical systole, pre-ejection period and left ventricular ejection time. These data indicate that depression of the left ventricular response to an increase in afterload is a uniform finding in alcoholic patients with cirrhosis and ascites. The absence of clinical symptoms of heart disease, therefore, could be attributed to the low systemic vascular resistance characteristic of cirrhosis. Since acute administration of ouabain neither improved left ventricular function nor altered systolic time intervals, digitalis may have a limited place in the therapy of this form of cardiac impairment.
Influence of intravenous and intracerebroventricular vasopressin on baroreflex control of renal nerve traffic.
Authors: T Imaizumi, M D Thames
Journal: Circulation Research (1986)

We performed experiments in alpha-chloralose-anesthetized rabbits with vagi sectioned, to determine the influence of intravenous and intracerebroventricular vasopressin on arterial baroreflex control of renal nerve activity. Arterial baroreflex control of renal nerve activity was assessed during phenylephrine-induced increases and nitroglycerin-induced decreases in arterial pressure. Intravenous vasopressin (4 and 40 mU over 1 minute) reduced basal renal nerve activity (from 149 +/- 14 to 101 +/- 13 and 28 +/- 13 impulses/sec) without changing arterial pressure and reduced the sensitivity of the arterial baroreflex control of renal nerve activity. This effect was reversed by vasopressin antagonist (d(CH2)5[Tyr(Me)2]AVP) which blocks vasoconstrictor effects of vasopressin. Intracerebroventricular vasopressin (4, 40, or 400 mU) did not alter basal renal nerve activity or arterial pressure but increased the sensitivity of baroreflex control of renal nerve activity. This effect was not blocked by the vasopressin antagonist. The influence of intravenous vasopressin on basal renal nerve activity was not altered by sinoaortic baroreceptor denervation. In contrast, the inhibitory influence of intravenous vasopressin on lumbar sympathetic nerve activity was abolished by sinoaortic denervation. Finally, intravenous vasopressin inhibited renal nerve activity (by 43 +/- 5%) in six rabbits with spinal cord transection. This effect was abolished by the vasopressin antagonist. We draw the following conclusions from these data: (1) intravenous and intracerebroventricular vasopressin have different effects on basal and baroreflex control of renal nerve activity; (2) these effects are mediated by different vasopressin receptors; (3) the effects of intravenous vasopressin on basal renal nerve activity are not baroreflex dependent, and appear to be mediated by spinal or, possibly, ganglionic mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)
A prospective randomized trial comparing repeated endoscopic sclerotherapy and propranolol in decompensated (child class B and C) cirrhotic patients
Authors: S. Dasarathy, Manisha Dwivedi, Dinesh K. Bhargava, K. R. Sundaram, K. Ramachandran
Journal: Hepatology (1992)

A prospective randomized study was conducted to compare the efficacy of long–term endoscopic sclerotherapy vs. propranolol in Child class B and C patients with variceal bleeds within the 30 days before the study. Forty–five and 46 patients were randomized to receive sclerotherapy and propranolol, respectively, after preentry stratification for Child scores. Sclerotherapy was administered with 1% polidocanol at 10–day intervals until obliteration of varices was achieved. Propranolol was administered to achieve a reduction in resting pulse rate of 25%. Rebleeding occurred in 19 patients undergoing sclerotherapy and in 31 receiving propranolol (p &lt; 0.05). The number of episodes of rebleeding was higher (p &lt; 0.05) in the propranolol group (n = 64) than in the sclerotherapy group (n = 35). The mean bleeding risk factor, number of hospitalizations for rebleeding and blood transfusion requirement were also significantly higher in the propranolol–treated patients. The median bleed–free period was more than 36 mo in the sclerotherapy group and 2.5 mo in the propranolol group (p &lt; 0.01). The median survival time was significantly longer in the sclerotherapy group (&gt;36 mo) than in the propranolol group (&gt;24 mo). We conclude that in decompensated cirrhotic patients, long–term endoscopic sclerotherapy is superior to propranolol in preventing rebleeding and improving survival. (Hepatology 1992;16:89-94.)