tbuckley/cabot-search huggingface dataset:
Nifedipine-lnduced Hypotension and Myocardial Ischemia in Refractory Angina Pectoris
Authors: William E. Boden
Journal: JAMA (1985)

Combined nitrate/β-blocker/nifedipine therapy is commonly used to treat refractory angina pectoris. We have observed "paradoxical" myocardial ischemia in ten patients with refractory angina (seven receiving combined β-blocker and nitrate therapy, and three receiving nitrate treatment alone) in whom nifedipine (mean dosage, 92 mg/day; range, 60 to 120 mg/day) induced a decrease in blood pressure, angina pectoris (10/10 patients), and ischemic ECG changes (7/10 patients). These ten patients, all of whom regularly reported angina within 20 to 30 minutes of nifedipine ingestion, were prospectively studied before and after usual nifedipine dose administration, while blood pressures, heart rate, and ECGs were recorded. Mean systolic BP fell from 109 to 94 mm Hg after nifedipine (<i>P</i>&lt;.001, paired<i>t</i>test); mean heart rate increased from 64 to 68 beats per minute (<i>P</i>&lt;.05); seven patients developed transient ECG changes (five with ST-T wave depression and two with ST-T wave elevation) during the hypotensive period. Nifedipine may provoke angina and myocardial ischemia in certain patients with refractory angina pectoris receiving concomitant β-blocker and nitrate therapy. (<i>JAMA</i>1985;253:1131-1135)
Variations in cancer mortality among local authority areas in England and Wales: relations with environmental factors and search for causes.
Authors: M J Gardner, P D Winter, E D Acheson
Journal: BMJ (1982)

Geographical variations in specific causes of mortality among the 1366 local authority areas of England and Wales as defined at 1971 were studied by examining extracts from death certificates held on computer tape. Five items of information on each death--year of death, age at death, sex, local authority area of residence, and the underlying cause of death, during the 11 years 1968-78--permitted a more detailed investigation than had been possible before. Analysis of some early results of the study--including maps of mortality for pleural mesothelioma, nasal cancer and bladder cancer--suggested that, despite the known limitations of death certification, systematic study of the mortality of small areas may give clues to aetiological factors in the environment. Analyses relating mortality to the distribution of environmental factors and examining disease profiles of each area may also provide clues. These will be followed up by other methods of study, such as case-control techniques.
Closure of GP maternity units.
Authors: A R Dewsbury
Journal: BMJ (1977)

biopsies are necessary if such a claim is to be made.The changes in subepidermal IgA deposition reported in the paper would thus provide a useful additional basis for the assessment of a patient's progress.However, one would need to know that the pattem of IgA deposition did not show spontaneous variation before changes occurring over a period of six months could be confidently accepted as evidence of improvement.In consequence we are not yet convinced that the changes represent "a more objective and sensitive index of improvement in the skin than the ability to reduce dapsone," though the need for such an index is undisputed.
A Conversation With My Mother-Reply
Authors: David M. Eddy
Journal: JAMA (1995)

<h3>In Reply.</h3> —Drs Cheong, Heilman, and Doty describe both a general concern that underlying depression should not be overlooked in a patient who talks of suicide, and a specific concern that my mother might have had a treatable depression that could have been managed better. To address the second point first, in my article I omitted the details of her medications for the obvious reason that the management of depression was not the point of the article. The facts are that because we all knew that my mother had a history of depression, we were very alert to the importance of proper treatment. When she was depressed, we would not discuss suicide with her. We were also convinced that she was not depressed when she made and reaffirmed her final decisions. I am not certain what a "formal" evaluation is, but I doubt it could be much better than the
Return to The House of God: Medical Resident Education 1978-2008
Authors: Tony Miksanek
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
Abstract 1302: Genetic analysis in a patient with nine primary malignant neoplasms: A rare case of Li-Fraumeni syndrome
Authors: Xiaoyuan Li, Juan Kang, Qi Pan, Wenwei Yin, Shiwen Tong, Dachun Zhao, Changting Meng, Chunmei Bai, Hong Ren, Keyue Ding
Journal: Cancer Research (2014)

Abstract The identification of patients with hereditary cancer predisposition syndromes has important clinical implications for early diagnosis, prevention, and treatment. We applied whole exome sequencing to identify mutations underlying a patient diagnosed with Li-Fraumeni syndrome, who had a first-degree family antecedent of breast cancer at age 42 years. Nine primary metachronous malignant neoplasms were developed in this patient within a period of 38 years, including upper lip neuroblastoma (7 years) and rhabdomyosarcoma (7 years), breast cystosarcoma phyllodes carcinoma (28 years), bronchioalveolar cell carcinoma (29 years), breast infiltrating ductal carcinoma (39 years), and thyroid papillary carcinoma (39 years), gastric adenocarcinoma (41 years), maxillary (41 years) and sternal osteosarcoma (43 years), as well as acute myeloid leukemia (45 years). Peripheral blood lymphocyte DNA from the patient was obtained. Exome capture was performed using the SureSelect Human All Exon 51Mb System, and paired-end sequencing was performed using Illumina HiSeq90 platform. A bioinformatics pipeline was used to analyze sequencing reads and call single nucleotide variants (SNVs). We used a candidate strategy to analyze mutations in the case of only a single dominantly affected individual available. Whole-exome sequencing of peripheral blood lymphocyte DNA resulted in an output of 30 GB of raw sequence. After quality control, we obtained clean reads with an average depth of coverage of 105× and 99.4% exome regions were covered at least four times. Analysis of 451,409 SNVs revealed increased genetic risk for some cancers, including genes related to hereditary cancer disposition syndromes [e.g., TP53 (p.P72R and p.R273H), BRCA1, and BRCA2], and genes associated with sporadic cancers. Pathway analysis found that, of 68 genes in p53-signaling pathway, the number of mutated genes (n=14) was significantly higher than expected (P=0.02). Of novel mutations, five nonsense mutations in four genes and 242 missense mutations in 233 genes were discovered. Whole-exome sequencing can identify known and/or novel mutations in cancer susceptibility genes and establish mutation profile in a rare case of Li-Fraumeni syndrome. Citation Format: Xiaoyuan Li, Juan Kang, Qi Pan, Wenwei Yin, Shiwen Tong, Dachun Zhao, Changting Meng, Chunmei Bai, Hong Ren, Keyue Ding. Genetic analysis in a patient with nine primary malignant neoplasms: A rare case of Li-Fraumeni syndrome. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1302. doi:10.1158/1538-7445.AM2014-1302
Accumulation of Bone-Seeking Radionuclides in Liver Metastasis from Colon Carcinoma
Authors: ANTONIO C. GARCIA, S D J YEH, R S BENUA
Journal: Clinical Nuclear Medicine (1977)

Fifteen colon cancer patients with metastasis to the liver were examined by both liver and bone scans. Seven of these showed accumulation of bone seeking radionuclides in the liver at the site of a defect in the scan. Such accumulation was found in two diphosphonate, in one pyrophosphate and in six 18F scans. To our knowledge, this is the first series to report localization of 18F in intrahepatic metastasis from colon cancer. The precise mechanism for this non-skeletal accumulation is unknown.
Gastric polyp in pernicious anemia: an argument to remove even when biopsy shows hyperplasia
Authors: R. Saravanan, P. Kamalaporn, C. Streutker, G. May, G. Kandel, N. Marcon, P. Kortan
Journal: Endoscopy (2008)

Hyperplastic polyps constitute the majority of nonfundic gland gastric polyps found incidentally at endoscopy [1]. Malignant transformation has been reported in hyperplastic polyps but invasive carcinoma is rare [2].
Modulation of Na-K-ATPase activity in the mouse medullary thick ascending limb of Henle. Effects of mineralocorticoids and sodium.
Authors: E B Grossman, S C Hebert
Journal: Journal of Clinical Investigation (1988)

This study investigates the effect of variations in mineralocorticoid as well as cell sodium delivery and uptake on Na-K-ATPase activity in the mouse medullary thick ascending limb of Henle (mTALH). Pharmacologic doses of the mineralocorticoid deoxycorticosterone acetate (DOCA) resulted in a 28% increase of Na-K-ATPase activity. Furosemide-induced inhibition of sodium uptake by the mTALH cell also resulted in Na-K-ATPase activity reduction (45%). Sodium deprivation did not cause a clear change in enzyme activity, either at 3 d or 2 wk, likely reflecting the result of the opposing influences of decreased sodium delivery and increased endogenous aldosterone. Finally, the behavior of Na-K-ATPase activity at 3 d of sodium deprivation in the mTALH contrasted with a 60% increase in activity observed in the cortical collecting tubule, a nephron segment known to be responsive to mineralocorticoid, and this heterogeneity of response may suggest an important role for the mTALH in maintaining salt homeostasis.
Improved Detection of Early Iron Deficiency in Nonanemic Subjects
Authors: Suzanne McClure
Journal: JAMA (1985)

We measured the complete blood cell count, including the index of RBC size heterogeneity (RBC distribution width [RDW]), in 181 subjects without anemia to determine whether RDW became abnormal earlier in the development of iron deficiency than did other variables. In 163 subjects selected only for otherwise normal blood cell counts, an increased RDW was 66% specific (48/73) and 100% sensitive (48/48) for decreased serum iron saturation. Stool guaiac testing was equally specific but less sensitive. In 13 subjects with polycythemia, as iron deficiency developed, RDW increased a minimum of four weeks before mean cell volume changed. In one apparently normal young woman, an abrupt isolated rise in RDW revealed a newly developed low serum transferrin saturation; all values remained normal during serial testing of four other normal subjects. We conclude that RDW is the part of the routine blood cell count that first becomes abnormal during the development of iron deficiency.
Effects of Hemodialysis and of Glucose-Insulin Administration on Plasma Potassium and on the Electrocardiogram
Authors: BORYS SURAWICZ, ARTHUR S. KUNIN, ETHAN A. H. SIMS
Journal: Circulation Research (1963)

Hypopotassemia was produced in dogs by hemodialysis or by intravenous administration of glucose with insulin. Both methods resulted in a similar decrease in plasma K concentration and similar ECG changes although K was withdrawn from the cells during dialysis while it entered the cells during glucose-insulin infusion. The maximal plasma K decrease occurred after two hours of dialysis or glucose-insulin infusion; administration of glucose-insulin after dialysis resulted in no further plasma potassium decrease. However, dialysis after glucose-insulin infusion caused further lowering of plasma potassium. The ECG changes were evaluated in relation to changes in plasma K concentration. The most consistent effects of hypopotassemia were in decreasing order: increased duration of the QRS complex, increased duration of the QT c interval and increase in amplitude of the P wave. Correlation coefficients (R) between these ECG changes and the plasma K decreases were of the order -0.48 to -0.54. The ECG changes failed to show even a weak correlation with absolute plasma K concentrations or with calculated changes in intracellular K.
Long-Term Effects of Caffeine Therapy for Apnea of Prematurity on Sleep at School Age
Authors: Carole L. Marcus, Lisa J. Meltzer, Robin S. Roberts, Joel Traylor, Joanne Dix, Judy D’ilario, Elizabeth Asztalos, Gillian Opie, Lex W. Doyle, Sarah N. Biggs, Gillian M. Nixon, Indra Narang, Rakesh Bhattacharjee, Margot Davey, Rosemary S. C. Horne, Maureen Cheshire, Jeremy Gibbons, Lorrie Costantini, Ruth Bradford, Barbara Schmidt
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Apnea of prematurity is a common condition that is usually treated with caffeine, an adenosine receptor blocker that has powerful influences on the central nervous system. However, little is known about the long-term effects of caffeine on sleep in the developing brain.We hypothesized that neonatal caffeine use resulted in long-term abnormalities in sleep architecture and breathing during sleep.A total of 201 ex-preterm children aged 5-12 years who participated as neonates in a double-blind, randomized, controlled clinical trial of caffeine versus placebo underwent actigraphy, polysomnography, and parental sleep questionnaires. Coprimary outcomes were total sleep time on actigraphy and apnea-hypopnea index on polysomnography.There were no significant differences in primary outcomes between the caffeine group and the placebo (adjusted mean difference of -6.7 [95% confidence interval (CI) = -15.3 to 2.0 min]; P = 0.13 for actigraphic total sleep time; and adjusted rate ratio [caffeine/placebo] for apnea-hypopnea index of 0.89 [95% CI = 0.55-1.43]; P = 0.63). Polysomnographic total recording time and total sleep time were longer in the caffeine group, but there was no difference in sleep efficiency between groups. The percentage of children with obstructive sleep apnea (8.2% of caffeine group versus 11.0% of placebo; P = 0.22) or elevated periodic limb movements of sleep (17.5% in caffeine group versus 11% in placebo group) was high, but did not differ significantly between groups.Therapeutic neonatal caffeine administration has no long-term effects on sleep duration or sleep apnea during childhood. Ex-preterm infants, regardless of caffeine status, are at risk for obstructive sleep apnea and periodic limb movements in later childhood.
Chest pain in women: clinical, investigative, and prognostic features
Authors: A K Sullivan, D R Holdright, C A Wright, J L Sparrow, D Cunningham, K M Fox
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To characterise clinical, investigative, and prognostic features of women referred with chest pain who subsequently underwent coronary angiography. <b>Design</b>: Analysis of all women with angina referred to one consultant during 1987-91 who subsequently underwent coronary angiography, with follow up to present day. <b>Setting</b>: Cardiothoracic centre <b>Subjects</b>: Women with normal coronary arteries; women with coronary artery disease shown on angiography; men with coronary artery disease matched for age; men referred with chest pain during the same period subsequently found to have normal coronary arteries. <b>Main outcome measures</b>: Risk factor analysis; results of exercise testing and coronary angiography; intervention; morbidity and mortality. <b>Results</b>: Women comprised 23% (202/886) of patients referred with chest pain who subsequently underwent angiography. 83/202 women had normal coronary angiograms compared with 55/684 men (41% v 8%, P&lt;0.001). Diabetes mellitus was the only risk factor more frequently encountered in women with coronary artery disease (P=0.001). The specificity and positive predictive value of exercise testing before angiography were significantly lower in women than men (71% v 93%, P&lt;0.001 and 76% v 95%, P&lt;0.001, respectively). Revascularisation procedures were as common in women with coronary artery disease as in men (81 (68%) v 70 (59%)), and there was no difference in event rate during follow up. Many patients with normal coronary arteries, irrespective of sex, had symptoms during follow up (61 (73%) women, 36 (65%) men) and continued to take antianginal drugs (27 (33%) women, 14 (28%) men); 14 (17%) women and six (11%) men required hospital readmission for severe symptoms. <b>Conclusions</b>: In this series, although women comprised the minority of patients referred with chest pain, a diagnosis of normal coronary arteries was five times more common in women than men. Risk factor analysis and exercise testing were of limited value in predicting coronary artery disease in women. There was no sex bias regarding revascularisation procedures, and outcome was similar. A diagnosis of non-cardiac chest pain in patients with normal coronary arteries was of little benefit to the patient with regard to morbidity.
AP-1, NF-kappa-B, and ERK activation thresholds for promotion of neoplastic transformation in the mouse epidermal JB6 model.
Authors: Kazumi Suzukawa, Thomas J Weber, Nancy H Colburn
Journal: Environmental Health Perspectives (2002)

The promotion-sensitive mouse epidermal JB6 cells (clone 41) have been used to identify the tumor-promoting activity of various compounds. Because treatment by tumor promoters [12-O-tetradecanoylphorbol-13-acetate (TPA), epidermal growth factor (EGF), or tumor necrosis factor alpha (TNF-alpha)] transforms clone 41 cells to anchorage-independent and tumorigenic phenotypes, they are considered to be undergoing late-stage tumor promotion. Here we address the question of how much activation of transformation-relevant transcription factors [activator protein-1 (AP-1), ternary complex factors (TCFs), or nuclear factor kappa-B (NF-kappa-B)] is required for transformation response and how much tumor promoter produces significant risk of transformation. Stable transfectants harboring a reporter construct with an AP-1 response element, serum-response element (SRE), or NF-kappa-B response element were established. We examined the relationship between concentration of tumor promoters, key signaling events, and activation of the transcription factors. A concentration of > 0.2 nM TPA or 0.12 ng/mL (0.02 nM) EGF produced a significant increase in transformation response as well as in extracellular signal-regulated protein kinase (ERK), SRE, or AP-1 activation. Treatment with > 0.4 U/mL (2.35 pM) TNF-alpha increased NF-kappa-B activity and transformation response in a dose-dependent manner. However, transformation response decreased at > 33 U/mL TNF-alpha due to a cytotoxic response. These findings suggest that the signaling pathway leading to the activation of ERK, TCF, and AP-1 proteins constitutes a major factor determining the risk of tumor promotion by TPA or EGF. Cell toxicity in addition to NF-kappa-B activation should be considered in predicting TNF-alpha-induced transformation response.
Changing Incidence of Out-of-Hospital Ventricular Fibrillation, 1980-2000
Authors: Leonard A. Cobb, Carol E. Fahrenbruch, Michele Olsufka, Michael K. Copass
Journal: JAMA (2002)

ContextRecent reports from 2 European cities and an earlier observation from Seattle, Wash, suggest that the number of patients treated for out-of-hospital ventricular fibrillation (VF) has declined.ObjectiveTo analyze the incidence of cardiac arrest and to examine relationships among incidence, sex, race, age, and first identified cardiac rhythm in Seattle.Design, Setting, and PatientsPopulation-based study of all cardiac arrest cases with presumed cardiac etiology who received advanced life support from Seattle Fire Department emergency medical services during specified periods between 1979 and 2000. United States Census data for Seattle in 1980, 1990, and 2000 were used to determine incidence rates for treated cardiac arrest with adjustments for age and sex.Main Outcome MeasuresChanges in incidence of cardiac arrest and initial recorded cardiac rhythm.ResultsThe adjusted annual incidence of cardiac arrest with VF as the first identified rhythm decreased by about 56% from 1980 to 2000 (from 0.85 to 0.38 per 1000; relative risk [RR], 0.44; 95% confidence interval [CI], 0.37-0.53). Similar reductions occurred in blacks (54%; RR, 0.45; 95% CI, 0.26-0.79) and whites (53%; RR, 0.47; 95% CI, 0.38-0.58) and was most evident in men (57%; RR, 0.43; 95% CI, 0.35-0.53), in whom the baseline incidence was relatively high. When all treated arrests with presumed cardiac etiology were considered, that incidence decreased by 43% (RR, 0.58; 95% CI, 0.49-0.67) in men but negligibly in women, for whom a relatively low incidence of VF also declined but was offset by more cases with asystole or pulseless electrical activity.ConclusionWe observed a major decline in the incidence of out-of-hospital VF and in all cases of treated cardiac arrest presumably due to heart disease in Seattle. These changes likely reflect the national decline in coronary heart disease mortality.
Yao and Artusio’s Anesthesiology: Problem-Oriented Patient Management
Authors: Joseph H. McIsaac
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 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