tbuckley/cabot-search huggingface dataset:
Beneficial Effects of Vagal Stimulation and Bradycardia During Experimental Acute Myocardial Ischemia
Authors: RICHARD W. MYERS, ALAN S. PEARLMAN, RICHARD M. HYMAN, RICHARD A. GOLDSTEIN, KENNETH M. KENT, ROBERT E. GOLDSTEIN, STEPHEN E. EPSTEIN
Journal: Circulation (1974)

It is commonly believed that vagally-mediated bradycardia predisposes to ventricular fibrillation (VF) during acute myocardial ischemia. Recent experimental studies, however, have shown that bradycardia and vagal stimulation independently raise the threshold for electrically induced VF in the ischemic canine heart. To determine the influence of vagal stimulation on the spontaneous development of VF occurring during acute myocardial ischemia, open-chest dogs with acute coronary occlusion were observed with and without electrical vagal stimulation. When heart rate was allowed to fall, mean time to VF was 14.7 ± 2.1 min ( se ) in the control dogs (heart rate about 180/min), 23.4 ± 1.9 ( P &lt; 0.01) in the dogs with low intensity vagal stimulation (heart rate about 100/min), and 28.6 ± 0.9 ( P &lt; 0.001) in dogs with high intensity vagal stimulation (heart rate about 60/min). Only 10% of the control animals survived after 30 min of occlusion compared with 40% (NS) of the dogs with low intensity vagal stimulation and 71% ( P &lt; 0.05) of the dogs with high intensity vagal stimulation. Thus, vagal stimulation and bradycardia were associated with a postponement or prevention of VF. In a second series of animals with heart rate maintained constant by right ventricular pacing, vagal stimulation continued to exert a protective effect against the development of VF. Time to VF was increased from 11.0 ± 2.0 min in control animals to 22.6 ± 2.5 in dogs with vagal stimulation ( P &lt; 0.005), and percent survival was enhanced (12% in control animals versus 57% in the vagally stimulated group, P &lt; 0.02). Similar results were observed in a third series of dogs in which electrical stimulation was applied to the peripheral ends of the cut cervical vagi. We conclude that vagal stimulation, with or without accompanying bradycardia, reduces the incidence of spontaneous VF in experimental coronary occlusion. Thus, enhanced vagal tone might act to reduce, rather than increase, the risk of arrhythmic death occurring during acute myocardial ischemia in man.
Cryoglobulinemia and Hepatitis C Virus
Authors: Kurt J. Bloch
Journal: New England Journal of Medicine (1992)

Lerner and Watson suggested the term "cryoglobulin" to describe a group of proteins with the common property of precipitating from cooled serum.1 On the basis of immunochemical studies of cryoprecipitable proteins from 86 patients, Brouet et al.2 identified three types of cryoglobulins in 1974: Type I consisted of a homogeneous immunoglobulin or free light chains; Type II consisted of a mixture of a homogeneous immunoglobulin (most commonly an IgM-κ M component) with anti-IgG activity (rheumatoid factor) and heterogeneous IgG; and Type III consisted of a mixture of heterogeneous IgM and heterogeneous IgG molecules. The heterogeneous IgM in Type III also . . .
Bipolar Disorder in Later Life
Authors: Mark H. Fleisher
Journal: JAMA (2007)

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
Transvaginal access for NOTES: a cohort study of microbiological colonization and contamination
Authors: G. Linke, I. Tarantino, T. Bruderer, J. Celeiro, R. Warschkow, P. Tarr, B. Müller-Stich, A. Zerz
Journal: Endoscopy (2012)

<b>Background and study aims:</b> Animal data and limited clinical evidence suggest a low incidence of infection following transvaginal natural orifice transluminal endoscopic surgery (NOTES). However, a systematic microbiological evaluation has not yet been carried out. The aim of this prospective cohort study was to evaluate the extent of microbiological contamination of the peritoneal cavity caused by the transvaginal access for NOTES and the impact of preoperative vaginal disinfection on vaginal colonization. <b>Patients and methods:</b> Consecutive female patients with symptomatic cholecystolithiasis were offered either transvaginal rigid-hybrid cholecystectomy (tvCCE) or conventional laparoscopic cholecystectomy. Patients who opted for tvCCE were prospectively evaluated between February and June 2010. Disinfection in patients undergoing tvCCE included hexetidine tablets and octenidine applied vaginally. All patients received a single dose of perioperative cefuroxime. Swabs were obtained from the posterior fornix and the peritoneal cavity at different intervals. <b>Results:</b> Of 32 patients, 27 (84 %) opted to undergo tvCCE. One patient (4 %; 95 % confidence interval [CI] 0.7 % – 18.3 %) had a positive bacterial culture in the Douglas pouch prior to transvaginal access compared with two patients (7 %; 95 %CI 2.1 % – 23.4 %) following colpotomy closure (<i>P</i> = 1.000). Vaginal disinfection significantly decreased vaginal bacterial load (<i>P</i> = 0.001) and bacterial growth in routine cultures (<i>P</i> < 0.001); in 16 patients (59 %; 95 %CI 40.7 % – 75.5 %) vaginal swabs were sterile after disinfection. No postoperative surgical site infections occurred (95 %CI 0 % – 12.5 %). <b>Conclusions:</b> In selected patients and following vaginal antisepsis, transvaginal access for NOTES is associated with microbiological contamination of the peritoneal cavity in a minority of patients, indicating a low risk of peritoneal contamination caused by the transvaginal access.
Arteriosclerotic Heart Disease: An Often Abused and Incorrect Diagnosis
Authors: Nathan Frank
Journal: JAMA (1973)

To the Editor.—  As every physician is aware, arteriosclerotic heart disease is the most frequently diagnosed form of heart disease. However, the diagnosis in many instances is based on the discovery of heart disease in an individual over 50 years of age. It seems that a great many physicians use age as the sole criterion to make the diagnosis and to sign death certificates and insurance forms. Obviously, this great lack of proper diagnostic investigation makes this a waste paper diagnosis. As a result, our vital statistics become grossly inaccurate.  Several forms of heart disease occur in middle aged- and elderly people that are not arteriosclerotic heart disease, and we must not forget them. We know (1) that people with rheumatic heart disease can and do live beyond the proverbial fourscore and ten, and (2) that others with congenital heart anomalies may attain ripe old age. These two entities should
Upper Gastrointestinal Fiberoptic Panendoscopy: A 4-year study in a district general hospital
Authors: P. Tauris
Journal: Endoscopy (1978)

Four years' experience of an upper gastrointestinal endoscopy service in a district general hospital is reviewed. The study comprises 500 prospective peroral endoscopic and radiographic investigations of 432 consecutive patients. The endoscopic diagnoses are compared with the results of conventional barium studies and the incidences of correct diagnoses with the two methods of investigation are estimated on the basis of the histological diagnoses on directed biopsy specimens. Endoscopy is more accurate than radiology in the examination of the stomach, especially in cases of radiologically distorted antrum and pyloric canal. We found fewer duodenal ulcers by means of combined panendoscopy than demonstrated by X-ray; the reason is discussed and the results of endoscopic biopsy and cytology in the diagnosis of gastric cancer are reported.
Reducing Dietary Intake of Fat and Cholesterol in Children
Authors: Thomas B. Newman
Journal: JAMA (1995)

<h3>To the Editor.</h3> —We do not share the conclusion of the authors of the DISC study<sup>1</sup>that the "results indicate that children who<i>require</i>dietary change to lower their LDL-C levels may<i>safely</i>and<i>successfully</i>do so under supervision" (emphasis added). First, although the DISC found no adverse effects on growth, blood chemistry, or psychosocial health, it is not possible, with a 3-year study of only about 300 children per group, to say that the intervention is "safe." Although the diet clearly is not grossly hazardous, the real issue is whether there are uncommon, delayed, or subtle harmful effects that exceed the benefits. Given the small magnitude of the benefits, this question remains unanswered. Harms could be far greater than benefits and could still not be found in this study. Second, we disagree that the change of 0.08 mmol/L (3.23 mg/dL) in LDL-C achieved with intensive diet treatment (compared
Hepatic retransplantation in cholestatic liver disease: Impact of the interval to retransplantation on survival and resource utilization
Authors: Ray W. Kim, Russell H. Wiesner, John J. Poterucha, Terry M. Therneau, Michael Malinchoc, Joanne T. Benson, Jeffrey S. Crippin, Goran B. Klintmalm, Jorge Rakela, Thomas E. Starzl, Ruud A. Krom, Roger W. Evans, Rolland E. Dickson
Journal: Hepatology (1999)

The aim of our study was to quantitatively assess the impact of hepatic retransplantation on patient and graft survival and resource utilization. We studied patients undergoing hepatic retransplantation among 447 transplant recipients with primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) at 3 transplantation centers. Cox proportional hazards regression analysis was used for survival analysis. Measures of resource utilization included the duration of hospitalization, length of stay in the intensive care unit, and the duration of transplantation surgery. Forty-six (10.3%) patients received 2 or more grafts during the follow-up period (median, 2.8 years). Patients who underwent retransplantation had a 3.8-fold increase in the risk of death compared with those without retransplantation ( P &lt; .01). Retransplantation after an interval of greater than 30 days from the primary graft was associated with a 6.7-fold increase in the risk of death ( P &lt; .01). The survival following retransplantations performed 30 days or earlier was similar to primary transplantations. Resource utilization was higher in patients who underwent multiple consecutive transplantations, even after adjustment for the number of grafts during the hospitalization. Among cholestatic liver disease patients, poor survival following hepatic retransplantation is attributed to late retransplantations, namely those performed more than 30 days after the initial transplantation. While efforts must be made to improve the outcome following retransplantation, a more critical evaluation may be warranted for late retransplantation candidates.
Electronic monitoring of vaccine cold chain in a metropolitan area
Authors: A. Wawryk, C. Mavromatis, M. Gold
Journal: BMJ (1997)

Successful immunisation strategies depend on the provision of immunogenic vaccines and the correct manufacture and storage of those vaccines. Studies in developed and developing countries have shown that vaccines are stored inadequately and that the vaccine cold chain can be disrupted.1 2 We measured the temperature of vaccines stored long term in a metropolitan area of a developed country using electronic data loggers to determine how long vaccines had been exposed to temperatures <0°C.

In Adelaide childhood vaccines are distributed from a single centre to local council sites and general practices (providers). We randomly selected 20 of the 21 local councils and 20 of the 650 general practices.

Electronic temperature loggers (Hobo-Temp, Onset Computer, Pocasset, MA, USA) for recording …
Hepatic Venous Obstruction by a Membranous Web
Authors: K Kakizaki, H Yamauchi
Journal: New England Journal of Medicine (1996)

Figure 1. Abdominal ultrasonography in a 25-year-old man who reported pain in the right upper quadrant on exertion (Panel A) revealed communicating vessels between the right (RHV) and middle (MHV) hepatic veins and a membranous septum (arrow) at the confluence of the middle and left (LHV) hepatic veins and the inferior vena cava (IVC). Color Doppler imaging confirmed the presence of reversed blood flow in the middle hepatic vein (red segment in Panel B), suggesting the Budd–Chiari syndrome. The diagnosis was confirmed by inferior venacavography (Panel C), which revealed a membranous septum (arrow), about 1 mm thick, above the level . . .
Autoantibodies to tyrosinase‐related protein‐1 detected in the sera of vitiligo patients using a quantitative radiobinding assay
Authors: None Kemp, None Waterman, None Gawkrodger, None Watson, None Weetman
Journal: British Journal of Dermatology (1998)

In the present study, we describe the in vitro transcription–translation of human tyrosinase‐related protein‐1 (TRP‐1) cDNA and subsequent use of the resulting 35S‐labelled TRP‐1 in a radioimmunoassay to analyse vitiligo sera for the presence of TRP‐1 antibodies. Of 53 vitiligo sera examined in the assay, three (5.7%) were found to be positive for TRP‐1 antibodies. In contrast, sera from 20 controls, 10 patients with Hashimoto's thyroiditis and 10 patients with Graves' disease were all negative for TRP‐1 antibodies. Although glycosylation of the labelled protein was necessary for its immunoprecipitation by TRP‐1‐specific monoclonal antibody TA99, this post‐translational processing did not affect the binding of any of the sera tested. All three patients positive for TRP‐1 antibodies (aged 50–63 years) had had vitiligo of the symmetrical type for more than 1 year, and all of them also had an associated autoimmune disorder: Graves' disease in one and autoimmune hypothyroidism in two. In addition, antibodies to the melanogenic enzymes tyrosinase and tyrosinase‐related protein‐2 (TRP‐2) were present in their serum. Absorption studies indicated that preincubation with COS‐7 cell extract containing either expressed TRP‐1, tyrosinase or TRP‐2 absorbed out the immunoreactivity of the three sera positive in the radioimmunoassay (RIA) with [35S]TRP‐1. The results indicate that autoantibodies to TRP‐1 cross‐react with tyrosinase and TRP‐2, suggesting one or more common epitopes between the three proteins.
Adenine nucleotide changes in kidney, liver, and small intestine during different forms of ischemic injury.
Authors: R A Zager
Journal: Circulation Research (1991)

The purpose of this study was to better characterize renal adenine nucleotide pool responses to different forms of shock, contrast the changes to those found in other intra-abdominal organs (the liver and small intestine), and assess whether these changes are closely mimicked by those produced by renal arterial occlusion, the usual method used to study ischemic acute renal failure. Rats were subjected to hemorrhagic shock, septic shock, or cardiopulmonary shock of varying severities and durations. The liver consistently had the greatest energy depletion, followed by the kidney, and then the small intestine. However, only the kidney developed clear morphological damage (S3 brush border sloughing). Kidney adenylate pools were better preserved during septic shock and cardiopulmonary shock than during hemorrhagic shock despite comparable blood pressures. Only profound hemorrhagic shock (35-40 mm Hg for 25 minutes) decreased total adenylate pools (ATP + ADP + AMP). However, the degree of renal catabolite (nucleosides plus purine base) accumulation did not correlate with the amount of renal total adenine nucleotide depletion, partially because circulating catabolites contributed to intrarenal catabolite pools. Purine base/uric acid ratios differed among shocked organs, consistent with different degrees of xanthine oxidase activity (small intestine greater than liver greater than kidney). Renal morphological damage decreased during the immediate (0-30 minutes) postshock period, and the extent of this improvement was not altered by xanthine oxidase inhibition (oxypurinol), suggesting that the immediate postshock period is not one of serious oxidative injury. Shock, in comparison with renal arterial occlusion, caused only modest ATP loss/catabolite accumulation, very low purine base/uric acid ratios, and no immediate-reperfusion (0-30 minutes) resynthesis of the total adenylate pool. Thus, ischemia-induced renal adenylate changes may differ considerably, depending on the nature of the ischemic event.
Inducible Nitric Oxide Synthase Expression in Smooth Muscle Cells and Macrophages of Human Transplant Coronary Artery Disease
Authors: Stefano Ravalli, Arline Albala, Ming Ming, Matthias Szabolcs, Alessandro Barbone, Robert E. Michler, Paul J. Cannon
Journal: Circulation (1998)

Background —The inducible isoform of the nitric oxide synthase (iNOS) produces large amounts of nitric oxide in response to cytokine stimulation. Previous investigations have demonstrated iNOS expression in the setting of acute and chronic rejection in experimental cardiac transplant models. The goal of this study was to investigate whether iNOS is upregulated in human transplant coronary artery disease (TCAD), a major cause of late mortality after cardiac transplantation. Methods and Results —We studied 15 patients with TCAD and 10 with normal coronary arteries. In situ hybridization and immunohistochemistry were used in tissue sections to localize iNOS mRNA and protein, respectively. The presence of peroxynitrite was indirectly assessed by immunostaining with an anti-nitrotyrosine antibody. Normal coronary arteries had no evidence of iNOS expression. In contrast, 30 of 36 coronary artery segments with TCAD (83%) were immunostained by the iNOS antibody. The presence of iNOS mRNA was demonstrated in these vessels by in situ hybridization. Specific cell markers identified iNOS-positive cells as neointimal macrophages and smooth muscle cells. Nitrotyrosine immunoreactivity colocalized with iNOS expression in arteries with TCAD, distributed in macrophages and smooth muscle cells. Conclusions —iNOS mRNA and protein are expressed in human arteries with TCAD, where they are associated with extensive nitration of protein tyrosines. These findings indicate that the high-output nitric oxide pathway and possibly the oxidant peroxynitrite might be involved in the process leading to the development of TCAD.
Army doctor who tried to resuscitate Iraqi man after soldier's beating faces GMC hearing
Authors: C. Dyer
Journal: BMJ (2012)

The army doctor serving with 1st Battalion the Queen’s Lancashire Regiment (1QLR) in Basra in 2003, when civilian detainee Baha Mousa was beaten to death, faces charges of lying in witness statements and in evidence to the court martial and public inquiry at a six week General Medical Council hearing starting on 11 June.

Derek Keilloh, who now works as a GP, told the public inquiry into the events in September 2003 that he saw no injuries on Baha Mousa’s body except a small trace of blood under his nose, when he was called by soldiers to try to resuscitate him. A post mortem later …
USE OF CLOPIDOGREL, PRASUGREL AND TICAGRELOR IN PATIENTS WITH NSTE-ACS UNDERGOING PCI IN CLINICAL PRACTICE: RESULTS OF THE ALKK-PCI REGISTRY
Authors: Uwe Zeymer, Matthias Hochadel, Albrecht Elsaesser, Dietrich Andresen, Ralf Zahn
Journal: Journal of the American College of Cardiology (2015)
BEACOPP: A new regimen for advanced Hodgkin’s disease
Authors: V. Diehl, J. Franklin, D. Hasenclever, H. Tesch, M. Pfreundschuh, B. Lathan, U. Paulus, M. Sieber, J.-U. Rüffer, M. Sextro, A. Engert, J. Wolf, R. Hermann, L. Holmer, U. Stappert-Jahn, E. Winnerlein-Trump, G. Wulf, S. Krause, A. Glunz, K. von Kalle, H. Bischoff, C. Haedicke, E. Dühmke, A. Georgii, M. Loeffler
Journal: Annals of Oncology (1998)
Differential roles of migratory and resident DCs in T cell priming after mucosal or skin HSV-1 infection
Authors: Heung Kyu Lee, Melodie Zamora, Melissa M. Linehan, Norifumi Iijima, David Gonzalez, Ann Haberman, Akiko Iwasaki
Journal: The Journal of Experimental Medicine (2009)

Although mucosal surfaces represent the main portal of entry for pathogens, the mechanism of antigen presentation by dendritic cells (DCs) that patrol various mucosal tissues remains unclear. Instead, much effort has focused on the understanding of initiation of immune responses generated against antigens delivered by injection. We examined the contributions of migratory versus lymph node–resident DC populations in antigen presentation to CD4 and CD8 T cells after needle injection, epicutaneous infection, or vaginal mucosal herpes simplex virus (HSV) 1 infection. We show that upon needle injection, HSV-1 became lymph-borne and was rapidly presented by lymph node–resident DCs to CD4 and CD8 T cells. In contrast, after vaginal HSV-1 infection, antigens were largely presented by tissue-derived migrant DCs with delayed kinetics. In addition, migrant DCs made more frequent contact with HSV-specific T cells after vaginal infection compared with epicutaneous infection. Thus, both migrant and resident DCs play an important role in priming CD8 and CD4 T cell responses, and their relative importance depends on the mode of infection in vivo.