tbuckley/cabot-search huggingface dataset:
T-cell involvement in drug-induced acute generalized exanthematous pustulosis
Authors: Markus Britschgi, Urs C. Steiner, Simone Schmid, Jan P.H. Depta, Gabriela Senti, Andreas Bircher, Christoph Burkhart, Nikhil Yawalkar, Werner J. Pichler
Journal: Journal of Clinical Investigation (2001)

Acute generalized exanthematous pustulosis (AGEP) is an uncommon eruption most often provoked by drugs, by acute infections with enteroviruses, or by mercury. It is characterized by acute, extensive formation of nonfollicular sterile pustules on erythematous background, fever, and peripheral blood leukocytosis. We present clinical and immunological data on four patients with this disease, which is caused by different drugs. An involvement of T cells could be implied by positive skin patch tests and lymphocyte transformation tests. Immunohistochemistry revealed a massive cell infiltrate consisting of neutrophils in pustules and T cells in the dermis and epidermis. Expression of the potent neutrophil-attracting chemokine IL-8 was elevated in keratinocytes and infiltrating mononuclear cells. Drug-specific T cells were generated from the blood and skin of three patients, and phenotypic characterization showed a heterogeneous distribution of CD4/CD8 phenotype and of T-cell receptor Vβ-expression. Analysis of cytokine/chemokine profiles revealed that IL-8 is produced significantly more by drug-specific T cells from patients with AGEP compared with drug-specific T cells from patients that had non-AGEP exanthemas. In conclusion, our data demonstrate the involvement of drug-specific T cells in the pathomechanism of this rather rare and peculiar form of drug allergy. In addition, they indicate that even in some neutrophil-rich inflammatory responses specific T cells are engaged and might orchestrate the immune reaction.
Translating Lifestyle Intervention to Practice in Obese Patients With Type 2 Diabetes
Authors: Anne M. Wolf, Mark R. Conaway, Jayne Q. Crowther, Kristen Y. Hazen, Jerry L.Nadler, Beverly Oneida, Viktor E. Bovbjerg
Journal: Diabetes Care (2004)

OBJECTIVE—To assess the efficacy of a lifestyle intervention program that can be readily translated into clinical practice for obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—The study consisted of a 12-month randomized controlled trial of 147 health plan members with type 2 diabetes and obesity (BMI ≥27 kg/m2). Participants were randomized to lifestyle case management or usual care. Case management entailed individual and group education, support, and referral by registered dietitians; intervention cost was $350 per person. Individuals treated with usual care received educational material. Both groups received ongoing primary care. Outcomes were difference between groups for change in weight (kilograms), waist circumference (centimeters), HbA1c, fasting lipid levels, use of prescription medications, and health-related quality of life. RESULTS—Case management resulted in greater weight loss (P &amp;lt; 0.001), reduced waist circumference (P &amp;lt; 0.001), reduced HbA1c level (P = 0.02), less use of prescription medications (P = 0.03), and improved health-related quality of life (P &amp;lt; 0.001) compared with usual care. The 12-month group difference in weight loss and waist circumference was 3.0 kg (95% CI −5.4 to −0.6) and −4.2 cm (−6.8 to −1.6). HbA1c differences were greatest at 4 months (−0.59%, P = 0.006) but not significant by 12 months (−0.19%, P = 0.45). Participants in the case management group lowered their use of medications, primarily diabetes medications, by 0.8 medications per day more than participants treated with usual care (P = 0.03). In seven of nine quality-of-life domains, the case management group improved compared with usual care (P &amp;lt; 0.05). CONCLUSIONS—Moderate-cost dietitian-led lifestyle case management may improve diverse health indicators among obese patients with type 2 diabetes.
LEECHES: EXOTIC LEECHES
Authors: A. E. Shipley
Journal: BMJ (1914)

Age Irwidence.The comparative rarity of severe appendicular trouble in children during the first few years of life may possibly be explained by the relatively wide and frequently funnel- shaped aperture of the appendix at this period, allowing of the ready entrance and exit of faecal matter.The corresponding, though less marked, rarity of such trouble in old people is accounted for by the pronounced fibrotic changes so commonly seen in senile appendices, changes which, according to Aschoff,9 represent previous mild attacks of inflammation, and whiclh, as a rule, -'altogether preclude the entrance of faecal matter.In the inter- vening age period, particularly that earlier part of it which might be termed the period of physical activity and dietary indiscretion, the anatomical condition of the appendix predisposes it to acute morbid changes of botU inflammatory and obstructive types. CONCLUSIONS.1. Two acute pathological processes are met with in tlle vermiform appendix-acute appendicitis and acute appendicular obstruction.2. Clinically acute appendicitis is distinguished by the signs of inflammation, there being from the onset a rise in puilse and temperature.Acute appendicular obstruction gives rise to vomiting, colicky pain, and abdominal tenderness, but at the outset to no appreciable rise in pulse or temperature.3. The changes occurring in an appendix the lumen of which is completely obstructed depend on the presence or absence of faecal matter witlhin its lumen.4. In experimental obstruction in an artificial appendix the changes vary greatly according to the nature of the diet of the animal previous to the experiment, ricll protein diet being associated with muclh more rapidly destructive clhanges than carbohydrate.5. Undigested protein, putrefactive bacteria, and an alkaline reaction together produce rapid gangrene in the walls of the obstructed organ.6.The prevalence of the severer forms of acute appen- dlicular disease in Western as contrasted with Eastern peoples is probably to be explained by the animal diet indulged in by the former.7. On the same lines may be explained the increasing frequency of such disease in large industrial areas anid its relative frequency in tlle male sex.
Coinheritance of Gilbert syndrome–associatedUGT1A1 mutation increases gallstone risk in cystic fibrosis
Authors: Hermann E. Wasmuth, Hildegard Keppeler, Ulrike Herrmann, Ramin Schirin‐Sokhan, Michael Barker, Frank Lammert
Journal: Hepatology (2006)

The prevalence of "black" pigment gallstones is increased in patients with cystic fibrosis (CF). Bile acid malabsorption with augmented bilirubin uptake from the intestine and the development of "hyperbilirubinbilia" have been proposed as key factors in gallstone formation in CF patients. We have now tested the hypothesis that the coinheritance of the common UGT1A1 promoter mutation associated with Gilbert syndrome is an additional lithogenic risk factor for gallstone formation in CF. Our results show that patients with CF and gallstones are significantly more likely to carry at least one Gilbert UGT1A1 allele compared with stone-free patients (OR 7.3; P = .042) and that these carriers display significantly higher serum levels of unconjugated bilirubin (P = .002). In conclusion, the Gilbert UGT1A1 allele increases the risk of gallstone formation in CF. This genetic association supports the current concept for gallstone formation in CF and suggests that genetic and exogenous sources contributing to hyperbilirubinbilia might be lithogenic in CF patients.
If it doesn't work, stop it
Authors: Tom P Marshall
Journal: BMJ (2004)

Editor—Why do doctors use treatments that do not work?1 A simple question with many answers.



Doctors are paid to do this.


Doctors are taught to “practise medicine” not to “help the patient.” When these do not overlap doctors are guided by adherence to professionally accepted theories as much as by evidence of benefit.


Diffusion and uptake of knowledge have limits. Doctors are overloaded with irrelevant information but have little access to information on things that they have been doing for years but do not work.


There is a tension between short term relief and long term attempts to “help the patient.” Some things provide instant relief but little long term benefit (or even harm).


Effort must be justified. If people take a lot of effort to achieve something they tend to justify their efforts by attaching value to what they have achieved. Doctors spend years learning to offer some treatments that don't work, making it harder to accept that they may have no value.


The myth of the pathophysiological model is strong. Students are taught medicine as if people first learnt how the body works, then learnt how it went wrong, and finally deduced how to fix it. This makes doctors resistant to evidence from clinical trials contradicting a cherished pathophysiological model. In reality, medical knowledge is often discovered in reverse. We first identify an illness, accidentally finding that something works to cure it. We then infer how the treatment works and elucidate the underlying disease mechanism.
<i>JAMA</i>Cardiovascular Disease Theme Issue
Authors: Philip Greenland, Eric D. Peterson, J. Michael Gaziano
Journal: JAMA (2015)

a theme issue on cardiovascular disease, and this will mark the fifth year the theme issue will coincide with the American Heart Association Scientific Sessions.This issue will include articles about cardiovascular disease that are relevant to the broad readership of JAMA.We will consider any manuscript that addresses cardiovascular disease in humans.This runs the gamut from firstin-human investigations to multicenter randomized clinical trials to population-based clinical, genetic, or biomarker epidemiological investigations.Given that JAMA also is interested in translating science into practice, we also encourage submission of studies that examine health care quality, safety, and efficiency; implementation evaluations; and other relevant health policy issues.With the timing of this theme issue, we are especially interested in late-breaking research, particularly late-breaking randomized clinical trials that will be presented at the American Heart Association meeting.We encourage authors who are involved with such studies to con-
Hemofiltration and Peritoneal Dialysis in Infection-Associated Acute Renal Failure in Vietnam
Authors: Nguyen Hoan Phu, Tran Tinh Hien, Nguyen Thi Hoang Mai, Tran Thi Hong Chau, Ly Van Chuong, Pham Phu Loc, Christopher Winearls, Jeremy Farrar, Nicholas White, Nicholas Day
Journal: New England Journal of Medicine (2002)

In some parts of the world, peritoneal dialysis is widely used for renal replacement in acute renal failure. In resource-rich countries, it has been supplanted in recent years by hemodialysis and, most recently, by hemofiltration and associated techniques. The relative efficacy of peritoneal dialysis and hemofiltration is not known.
Accountable Care Organizations in Surgery: Location, Location, Location
Authors: David F. Penson
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
619 INTRAHEPATIC ANGIOPOIETIN-2 PROTEIN EXPRESSION MODULATION BY HEPATITIS C VIRUS: MAPK, PI3K AND REACTIVE OXYGEN SPECIES (ROS) IMPLICATION
Authors: P. Sanz-Cameno, S. Martin-Vilchez, Y. Rodriguez-Munoz, M.J. Borque, P.L. Majano, F. Molina-Jimenez, M. Lopez-Cabrera, R. Moreno-Otero
Journal: Journal of Hepatology (2008)
Diagnosis of Placenta Praevia by Photoscanning With Albumin Labeled With Technetium Tc 99m
Authors: Wil B. Nelp
Journal: JAMA (1967)

The occurrence of vaginal bleeding during the third trimester of pregnancy presents a challenging problem in obstetrical diagnosis and management. If placenta praevia is the cause of bleeding, close medical observation is necessary and the majority of patients will be delivered by cesarean section prior to term. If placenta praevia is present, vaginal examination may cause sufficient hemorrhage that immediate delivery of the infant is necessary. A method for the accurate diagnosis of placenta praevia, without vaginal examination, when vaginal bleeding first occurs, therefore would be of great importance. Procedures to estimate the size and position of the placenta such as soft-tissue radiography, injection of radiopaque dye into the vascular bed of the placenta, or surface counting of the trace amounts of radioisotopes (usually iodinated I 131 serum albumin or sodium chromate Cr 51-tagged red blood cells) in the placental blood pool are clinically useful. Too often, however, these procedures
Intrapericardial aneurysm of the left atrial appendage.
Authors: T Tanabe, M Ishizaka, S Ohta, S Sugie
Journal: Thorax (1980)

A 24-year-old housewife with congenital aneurysm of the left atrial appendage underwent a successful operation for its removal. Operation, using cardiopulmonary bypass, is indicated in all patients with atrial aneurysm. The procedure has proved uniformly safe and successful.
1263 ADENOSINE A2a RECEPTOR STIMULATION REDUCES INFLAMMATORY Th CELLS SUBSETS IN STEATOTIC MICE LIVER AND PREVENTS PROGRESSION TO NASH
Authors: S. Rolla, C. Imarisio, E. Alchera, A. Follenzi, E. Albano, F. Novelli, R. Carini
Journal: Journal of Hepatology (2013)
The Detection of Vesicoureteral Reflux in a Nonfunctioning Kidney on a Tc-99m DTPA Renal Function Study
Authors: MUSTAFA KİBAR, ZEYNEP DOĞRUCA, GÜLGÜN BÜYÜKDERELİ, AYTÜL NOYAN, ÇETİN ÖNSEL
Journal: Clinical Nuclear Medicine (1998)

A 7-year-old child who had previously undergone a left pyeloplasty because of vesicoureteral reflux (VUR) underwent dynamic Tc-99m-DTPA imaging for an evaluation of renal function. Dynamic images showed a nonfunctioning left kidney and a normally functioning right kidney with pelvicaliceal stasis. Following furosemide injection, the right pelvicaliceal stasis disappeared in a few minutes, while the left ureteral and subsequently left pelvicaliceal system was filling with the activity that came from the right kidney that had passed through the bladder. This drainage demonstrated a high degree VUR(Grade III) on the side of the nonfunctioning kidney. Extensive parenchymal damage was thought to be due to a high degree VUR in the left kidney. A static Tc-99m DMSA study and ultrasonography revealed the presence of left VUR nephropathy.
The plaque lipid lysophosphatidic acid stimulates platelet activation and platelet-monocyte aggregate formation in whole blood: involvement of P2Y1 and P2Y12 receptors
Authors: Nadine Haserück, Wolfgang Erl, Dharmendra Pandey, Gabor Tigyi, Philippe Ohlmann, Catherine Ravanat, Christian Gachet, Wolfgang Siess
Journal: Blood (2003)
Keratinocyte growth factor increases transalveolar sodium reabsorption in normal and injured rat lungs.
Authors: B P Guery, C M Mason, E P Dobard, G Beaucaire, W R Summer, S Nelson
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Keratinocyte growth factor (KGF) prevents alpha-naphthylthiourea (ANTU)-induced permeability edema ex vivo. To explore the mechanisms in this involved effect, we administered KGF (5 mg/kg, intratracheally) 48 h prior to ANTU (50 mg/kg, intraperitoneally). Several groups were studied: phosphate-buffered saline/dimethylsulfoxide (PBS/DMSO) (vehicles), PBS/ANTU, and KGF/ANTU. At 90 min after ANTU injection the lungs were removed, ventilated, and perfused ex vivo for 180 min. Quantification of fluorescein isothiocyanate (FITC)-labeled dextran in bronchoalveolar lavage fluid (BALF) was used to assess alveolar capillary barrier permeability. KGF attenuated ANTU-induced edema and blockade of sodium transport, with ouabain (10(-3) M) or amiloride (10(-4) M) added ex vivo reversed this effect. FITC-dextran was increased in the PBS/ANTU group as compared with the PBS/DMSO group, indicating permeability edema. In the KGF/ANTU group, there was concentration of BALF FITC-dextran, consistent with permeability edema and increased alveolar fluid export. Albumin space measurements showed similar increases in permeability in the PBS/ANTU and KGF/ANTU groups. Extravascular lung water (measured with radiolabeled erythrocytes) was decreased in the KGF/ANTU group. Following KGF pretreatment, uninjured lungs exported more intratracheal PBS than normal lungs following terbutaline stimulation ex vivo. In conclusion, KGF, through type II alveolar pneumocyte hyperplasia with increased sodium-potassium-adenosine triphosphatase (Na,K-ATPase) activity, attenuated ANTU-induced edema formation by potentiating alveolar fluid clearance.
Acute tear of the fascia cruris at the attachment to the Achilles tendon: a new diagnosis
Authors: Nick Webborn, Dylan Morrissey, Kasthuri Sarvananthan, Otto Chan
Journal: British Journal of Sports Medicine (2014)

The fascia cruris encloses the posterior structures of the calf and connects to the paratenon and the Achilles tendon. We describe the clinical presentation, ultrasound imaging characteristics and the time to the recovery of tears of the fascia cruris at the attachment to the Achilles tendon.Retrospective review of 11 tears of the fascia cruris in the different legs as separate events in 9 patients (6 male and 3 female, mean age 35.52 years, range 11-48) identified using diagnostic ultrasound, after presenting with Achillodynia.11 participants presented at a mean of 4.5 weeks (range 0.5-12) after onset of symptoms. The left Achilles was more commonly injured than the right (7 : 4) and the lateral side more than the medial (6 : 4) with one case with medial and lateral presentation. Clinically, there was swelling and tenderness over the medial or lateral border in the mid to upper portion of the Achilles. 7 of the 11 (63.6%) had functional overpronation. Ultrasound appearances of a tear were identified as hypoechoic area extending from the medial or lateral border of the Achilles extending along the anatomical plane of the fascia cruris. Average return to activity was 5.2 weeks (range 1-22). Participants presenting later had longer recovery but all participants returned to full activity (r=0.4).This is the first description of the clinical details and sonographic findings of a tear to the fascia cruris at its attachment to the Achilles tendon. This needs to be considered as a cause of Achillodynia in athletes as recognition will affect the management.
Coagulation, Hemorrhage and Thrombosis
Authors: Benjamin Alexander
Journal: New England Journal of Medicine (1955)

“DAS Blut ist ein besonderer Saft” (Goethe).During the past decade research in coagulation, one of the vital homeostatic functions, has been in a state of intense ferment. As a consequence, notable advances have been made, and substantial clarification has been achieved in this field, long known for its confusion and bitter controversy. Knowledge has come from many disciplines — human and comparative physiology, biochemistry, physical chemistry, animal husbandry, pathology, genetics and, not least, clinical investigation — reflecting the multifaceted background required of the student of this subject.As has been aptly pointed out,1 the ordinary physician is no longer . . .
Activation of protein breakdown and prostaglandin E2 production in rat skeletal muscle in fever is signaled by a macrophage product distinct from interleukin 1 or other known monokines.
Authors: A L Goldberg, I C Kettelhut, K Furuno, J M Fagan, V Baracos
Journal: Journal of Clinical Investigation (1988)

During sepsis or after injection of endotoxin into rats, there is a large increase in muscle protein breakdown and prostaglandin E2 (PEG2) production. Prior studies showed that partially purified interleukin 1 (IL-1) from human monocytes can stimulate these processes when added to isolated rat muscles. The availability of pure recombinant IL-1 and other monokines has allowed us to investigate the identity of the active agent in this process. Incubation of muscles with recombinant human or murine IL-1 alpha or IL-1 beta or with IL-1 plus a phorbol ester did not stimulate muscle proteolysis or PGE2 production. Homogeneous natural porcine IL-1 ("catabolin") and mouse or human IL-1 beta were also not effective in vitro. In addition, a variety of other human cytokines, including tumor necrosis factor ("cachectin"), epidermal thymocyte-activating factor, eosinophil cytotoxicity-enhancing factor, interferon-alpha, beta, and gamma, platelet-derived growth factor, and transforming growth factor (TGF) beta, which are all released by activated macrophages, TGF-alpha, or mixtures of these polypeptides, also failed to activate proteolysis or PGE2 production. By contrast, a large increase in net protein breakdown could be induced in the rat soleus by polypeptides released from porcine monocytes or by the serum from febrile cattle which had been injected with Pasteurella haemolytica or bovine rhinotracheitis virus. Therefore, a still-unidentified product of activated monocytes appears to be responsible for the negative nitrogen balance that accompanies infectious illness.