tbuckley/cabot-search huggingface dataset:
Smoking and Radon-Reply
Authors: Ernest G. Létourneau
Journal: JAMA (1987)

<h3>In Reply.—</h3> We disagree strongly with Dr Ravenholt's hypotheses that polonium 210 contributes significantly to alpha particle activity in indoor air and thereby frustrates attempts to estimate household radon levels. Radon in air inside a dwelling is due to the migration of radon gas from soil underlying the dwelling. Many factors influence this process, including soil characteristics; the construction of the dwelling's foundations; prevailing atmospheric conditions, namely, humidity, barometric pressure, temperature, and wind speed and direction; and the activities of the occupants. It is therefore not surprising that there is a wide variation in radon levels in adjacent buildings. Average radon levels in dwellings are usually determined by the use of time-integrating passive radon detectors. One type of device is designed to exclude aerosol particles to which radon decay products and polonium 210 might be attached—the alpha track detector. In another common device, radon is absorbed on charcoal and its
Appropriateness of Percutaneous Coronary Intervention
Authors: Paul S. Chan, Manesh R. Patel, Lloyd W. Klein, Ronald J. Krone, Gregory J. Dehmer, Kevin Kennedy, Brahmajee K. Nallamothu, W. Douglas Weaver, Frederick A. Masoudi, John S. Rumsfeld, Ralph G. Brindis, John A. Spertus
Journal: JAMA (2011)

<h3>Context</h3>Despite the widespread use of percutaneous coronary intervention (PCI), the appropriateness of these procedures in contemporary practice is unknown.<h3>Objective</h3>To assess the appropriateness of PCI in the United States.<h3>Design, Setting, and Patients</h3>Multicenter, prospective study of patients within the National Cardiovascular Data Registry undergoing PCI between July 1, 2009, and September 30, 2010, at 1091 US hospitals. The appropriateness of PCI was adjudicated using the appropriate use criteria for coronary revascularization. Results were stratified by whether the procedure was performed for an acute (ST-segment elevation myocardial infarction, non–ST-segment elevation myocardial infarction, or unstable angina with high-risk features) or nonacute indication.<h3>Main Outcome Measures</h3>Proportion of acute and nonacute PCIs classified as appropriate, uncertain, or inappropriate; extent of hospital-level variation in inappropriate procedures.<h3>Results</h3>Of 500 154 PCIs, 355 417 (71.1%) were for acute indications (ST-segment elevation myocardial infarction, 103 245 [20.6%]; non–ST-segment elevation myocardial infarction, 105 708 [21.1%]; high-risk unstable angina, 146 464 [29.3%]), and 144 737 (28.9%) for nonacute indications. For acute indications, 350 469 PCIs (98.6%) were classified as appropriate, 1055 (0.3%) as uncertain, and 3893 (1.1%) as inappropriate. For nonacute indications, 72 911 PCIs (50.4%) were classified as appropriate, 54 988 (38.0%) as uncertain, and 16 838 (11.6%) as inappropriate. The majority of inappropriate PCIs for nonacute indications were performed in patients with no angina (53.8%), low-risk ischemia on noninvasive stress testing (71.6%), or suboptimal (≤1 medication) antianginal therapy (95.8%). Furthermore, although variation in the proportion of inappropriate PCI across hospitals was minimal for acute procedures, there was substantial hospital variation for nonacute procedures (median hospital rate for inappropriate PCI, 10.8%; interquartile range, 6.0%-16.7%).<h3>Conclusions</h3>In this large contemporary US cohort, nearly all acute PCIs were classified as appropriate. For nonacute indications, however, 12% were classified as inappropriate, with substantial variation across hospitals.
Renin-Angiotensin System Antagonists and Mortality in Patients With Heart Failure—Reply
Authors: Lars H. Lund, Lina Benson
Journal: JAMA (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 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
Wages to double for Romanian doctors
Authors: T. Toma
Journal: BMJ (1997)

The salaries of doctors in Romania are to at least double in the next two months, the department of health has announced.

This unprecedented move comes after months of serious criticism of the way doctors are paid and treated by the Romanian government. Currently a consultant earns around £80-90 ($128-144) a month but a junior doctor earns less than £50. In comparison a …
Rating of perceived exertion and heart rate relative to ventilatory threshold in women.
Authors: I L Swaine, J Emmett, D Murty, C Dickinson, M Dudfield
Journal: British Journal of Sports Medicine (1995)

Forty women took part in a study designed to investigate self-selected exercise intensity relative to ventilatory threshold during circuit weight training (CWT) and exercise-to-music (ETM) sessions. Subjects were assigned to one of two groups which were beginners (B) or habitual exercisers (HE) on the basis of their exercise habits. All subjects first underwent a laboratory cycle ergometer test involving a continuous incremental exercise protocol from which ventilatory threshold (VT) was determined using piecewise linear regression analysis. This point was expressed in terms of heart rate (VTHR) and rating of perceived exertion (VTRPE). These points were then compared with those determined during exercise training sessions (TRAHR and TRARPE respectively). The results showed that mean(s.d.) TRARPE (13.5(1.1) was not significantly different to mean(s.d.) VTRPE (12.8(0.5); P > 0.05) but that mean(s.d.) VTHR (134.8(13.5) beats min-1) and TRAHR (154.9(12.0) beats min-1) were different (P < 0.05). Beginners trained at a significantly higher percentage above VTHR than habitual exercisers (118(3.1) versus 111(2.8)% P < 0.05). During CWT the mean(s.d.) TRAHR for beginners (143.2(7.6) beats min-1) was significantly lower than that for habitual exercisers (152.5(10.1) beats min-1; P < 0.05), but not different during ETM (P < 0.05). When these TRAHR values were expressed relative to an estimated maximum heart rate (EMHR) they represented 86.5% in ETM and 80.5% in CWT which were different (P < 0.05). These results suggest that regardless of habitual exercise level and training mode, these women selected a common intensity of effort that was compatible with the described RPE.
Oxidative Stress-Induced Actin Reorganization Mediated by the p38 Mitogen-Activated Protein Kinase/Heat Shock Protein 27 Pathway in Vascular Endothelial Cells
Authors: Jacques Huot, Francois Houle, Francois Marceau, Jacques Landry
Journal: Circulation Research (1997)

Vascular endothelial cells are constantly in contact with oxyradicals and must be especially well equipped to resist their toxic effects and generate appropriate physiological responses. Despite the importance of oxyradicals in the physiopathology of the vascular endothelium, the mechanisms regulating the oxidative response of endothelial cells are poorly understood. In the present study, we observed that H sub 2 O 2 in concentrations that induced severe fragmentation of F-actin in fibroblasts rather induced a reorganization of F-actin in primary cultures of human umbilical vein endothelial cells (HUVECs) that was characterized by the accumulation of stress fibers, the recruitment of vinculin to focal adhesions, and the loss of membrane ruffles. H 2 O 2 also induced in these cells a strong (10- to 14-fold) activation of the p38 mitogen-activated protein (MAP) kinase, which resulted in activation of MAP kinase-activated protein kinase-2/3 and phosphorylation of the F-actin polymerization modulator, heat shock protein 27 (HSP27). The MAP kinases extracellular-regulated kinase, and c-Jun N-terminal kinase/stress-activated protein kinase were only slightly increased by these treatments. Inhibiting p38 activity with the highly specific inhibitor SB203580 blocked the H 2 O 2 -induced endothelial microfilament responses. Moreover, fibroblasts acquired an endothelium-like SB203580-sensitive actin response when HSP27 concentration was increased by gene transfection to the same high level as found in HUVECs. The results indicate that activation of p38 MAP kinase in cells such as endothelial cells, which naturally express high level of HSP27, plays a central role in modulating microfilament responses to oxidative stress. Consequently, the p38 MAP kinase pathway may participate in the several oxyradical-activated functions of the endothelium that are associated with reorganization of microfilament network.
Isolated HLA-B27 associated Achilles tendinitis.
Authors: I Olivieri, G Gemignani, S Gherardi, L Grassi, M L Ciompi
Journal: Annals of the Rheumatic Diseases (1987)

The case of a 37 year old man with a longstanding HLA-B27 associated bilateral Achilles tendinitis without seronegative spondyloarthropathy is reported. This case suggests that heel enthesopathy may for a long time be the only clinical manifestation of the HLA-B27 associated disease process.
Postendoscopic Sphincterotomy Stenosis
Authors: D. Galdermans, P. Michielsen, P. Pelckmans, M. Cremer, Y. van Maercke
Journal: Endoscopy (1989)

See also: Early Postendoscopic Sphincterotomy StenosisEndoscopy 1990; 22(02): 98-98DOI: 10.1055/s-2007-1012810
A CASE OF ORANGE DERMATITIS
Authors: J. AVIT-SCOTT
Journal: British Journal of Dermatology (1934)

Journal Article A CASE OF ORANGE DERMATITIS Get access J. AVIT‐SCOTT, M.D.B'ham. J. AVIT‐SCOTT, M.D.B'ham. Honorary Dermatologist, Midland Hospital, Easy Row, Birmingham Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 46, Issue 8-9, 1 August 1934, Pages 378–380, https://doi.org/10.1111/j.1365-2133.1934.tb09800.x Published: 01 August 1934
Inflammatory Mechanisms in Allergic Diseases
Authors: John J. Condemi
Journal: Annals of Internal Medicine (2002)

Medical Writings: Book Notes20 August 2002Inflammatory Mechanisms in Allergic DiseasesJohn J. Condemi, MDJohn J. Condemi, MDUniversity of Rochester, Rochester, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-4-200208200-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Zweiman B, Schwartz LB, eds. 581 pages. New York: Marcel Dekker; 2002. $195.00. ISBN 0824705408. Order phone 800-228-1160.Field of Medicine: Allergy and immunology.Format: Hardcover book.Audience: Trainees or physicians in the field of allergy and immunology and primary care physicians who want to update themselves in the field.Purpose: To review the complex inflammatory process, which includes cellular and humoral components involved in clinical disorders, and to point out deficiencies in our understanding of the pathogenesis of allergic diseases.Content: The book is divided into five parts. Part 1 defines the questions concerning our understanding of the pathogenesis ... Author, Article, and Disclosure InformationAffiliations: University of Rochester, Rochester, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 August 2002Volume 137, Issue 4Page: 300KeywordsAllergic diseasesAllergy and immunologyAsthmaInflammationPathogenesisQuality of lifeScientistsSoftware toolsUrticariaVasculitis ePublished: 20 August 2002 Issue Published: 20 August 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Regulation of T cell survival through coronin-1–mediated generation of inositol-1,4,5-trisphosphate and calcium mobilization after T cell receptor triggering
Authors: Philipp Mueller, Jan Massner, Rajesh Jayachandran, Benoit Combaluzier, Imke Albrecht, John Gatfield, Carmen Blum, Rod Ceredig, Hans-Reimer Rodewald, Antonius G Rolink, Jean Pieters
Journal: Nature Immunology (2008)
Right Ventricular Diastolic Impairment in Patients With Pulmonary Arterial Hypertension
Authors: Silvia Rain, M. Louis Handoko, Pia Trip, C. Tji-Joong Gan, Nico Westerhof, Ger J. Stienen, Walter J. Paulus, Coen A.C. Ottenheijm, J. Tim Marcus, Peter Dorfmüller, Christophe Guignabert, Marc Humbert, Peter MacDonald, Cris dos Remedios, Piet E. Postmus, Chandra Saripalli, Carlos G. Hidalgo, Henk L. Granzier, Anton Vonk-Noordegraaf, Jolanda van der Velden, Frances S. de Man
Journal: Circulation (2013)

Background— The role of right ventricular (RV) diastolic stiffness in pulmonary arterial hypertension (PAH) is not well established. Therefore, we investigated the presence and possible underlying mechanisms of RV diastolic stiffness in PAH patients. Methods and Results— Single-beat RV pressure-volume analyses were performed in 21 PAH patients and 7 control subjects to study RV diastolic stiffness. Data are presented as mean±SEM. RV diastolic stiffness (β) was significantly increased in PAH patients (PAH, 0.050±0.005 versus control, 0.029±0.003; P &lt;0.05) and was closely associated with disease severity. Subsequently, we searched for possible underlying mechanisms using RV tissue of PAH patients undergoing heart/lung transplantation and nonfailing donors. Histological analyses revealed increased cardiomyocyte cross-sectional areas (PAH, 453±31 μm 2 versus control, 218±21 μm 2 ; P &lt;0.001), indicating RV hypertrophy. In addition, the amount of RV fibrosis was enhanced in PAH tissue (PAH, 9.6±0.7% versus control, 7.2±0.6%; P &lt;0.01). To investigate the contribution of stiffening of the sarcomere (the contractile apparatus of RV cardiomyocytes) to RV diastolic stiffness, we isolated and membrane-permeabilized single RV cardiomyocytes. Passive tension at different sarcomere lengths was significantly higher in PAH patients compared with control subjects (&gt;200%; P interaction &lt;0.001), indicating stiffening of RV sarcomeres. An important regulator of sarcomeric stiffening is the sarcomeric protein titin. Therefore, we investigated titin isoform composition and phosphorylation. No alterations were observed in titin isoform composition (N2BA/N2B ratio: PAH, 0.78±0.07 versus control, 0.91±0.08), but titin phosphorylation in RV tissue of PAH patients was significantly reduced (PAH, 0.16±0.01 arbitrary units versus control, 0.20±0.01 arbitrary units; P &lt;0.05). Conclusions— RV diastolic stiffness is significantly increased in PAH patients, with important contributions from increased collagen and intrinsic stiffening of the RV cardiomyocyte sarcomeres.
Trusts must use, not just collect, clinical data
Authors: Z. Kmietowicz
Journal: BMJ (2000)

The first clinical governance reviews to come out of the Commission for Health Improvement (CHI) have shed valuable light on what to expect from an investigation by the government's clinical services watchdog.

Over the next four years every hospital, health authority, primary care trust, NHS trust, and local health group in England and Wales will be visited by a team of assessors to evaluate the clinical services being provided.

To help finalise the review process, three trusts—covering hospitals in Chesterfield, Southampton, and Sunderland—were assessed in a pilot scheme.

The reports on the trusts, published last week, highlight areas for which the hospitals are performing well and others for which …
Case 32-1967
Authors: William E. Strole, Wallace A. Jones
Journal: New England Journal of Medicine (1967)

Presentation of Case First admission. An eighty-six-year-old woman entered the hospital because of pain in the abdomen.She had been well until the onset of nausea and colicky pain in the right upper quadrant of the abdomen twelve hours previously. There was no history of jaundice.On examination the patient was obese. The lungs were clear; the left border of cardiac dullness was at the anterior axillary line. Diffuse tenderness was elicited in the right upper quadrant of the abdomen; no mass was palpable, and the liver and spleen were not enlarged.The temperature was 100.2°F., the pulse 90, and . . .
Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair
Authors: A H Sultan, M A Kamm, C N Hudson, C I Bartram
Journal: BMJ (1994)

<b>Objectives</b> To determine (i) risk factors in the development of third degree obstetric tears and (ii) the success of primary sphincter repair. <b>Design</b> (i) Retrospective analysis of obstetric variables in 50 women who had sustained a third degree tear, compared with the remaining 8553 vaginal deliveries during the same period. (ii) Women who had sustained a third degree tear and had primary sphincter repair and control subjects were interviewed and investigated with anal endosonography, anal manometry, and pudendal nerve terminal motor latency measurements <b>Setting</b>: Antenatal clinic in teaching hospital in inner London. <b>Subjects</b> (i) All women (n=8603) who delivered vaginally over a 31 month period. (ii) 34 women who sustained a third degree tear and 88 matched controls. <b>Main outcome measures</b> : Obstetric risk factors, defaecatory symptoms, sonographic sphincter defects, and pudendal nerve damage. Results - (i) Factors significantly associated with development of a third degree tear were: forceps delivery (50% v 7% in controls; P=0.00001), primiparous delivery (85% v 43%; P=0.00001), birth weight &gt;4 kg (P=0.00002), and occipitoposterior position at delivery (P=0.003). No third degree tear occurred during 351 vacuum extractions. Eleven of 25 (44%) women who were delivered without instruments and had a third degree tear did so despite a posterolateral episiotomy. (ii) Anal incontinence or faecal urgency was present in 16 women with tears and 11 controls (47% v 13%;20P=0.00001). Sonographic sphincter defects were identified in 29 with tears and 29 controls (85% v 33%; P=0.00001). Every symptomatic patient had persistent combined internal and external sphincter defects, and these were associated with significantly lower anal pressures. Pudendal nerve terminal motor latency measurements were not significantly different. <b>Conclusions</b> Vacuum, extraction is associated with fewer third degree tears than forceps delivery. An episiotomy does not always prevent a third degree tear. Primary repair is inadequate in most women who sustain third degree tears, most having residual sphincter defects and about half experiencing anal incontinence, which is caused by persistent mechanical sphincter disruption rather than pudendal nerve damage. Attention should be directed towards preventive obstetric practice and surgical techniques of repair.
MANIPULATIVE (CHIROPRACTIC) DISLOCATIONS OF THE ATLAS
Authors: EDWARD S. BLAINE
Journal: JAMA (1925)

Unintelligent manipulations of the structures of the region of the upper cervical spine may result in undesired sequelae, such as have occurred in the three cases here presented. A forward dislocation of the atlas on the axis has been a consequence in each of the cases, one with fracture of the odontoid process; all of the cases were apparently the result of chiropractic treatments. One of them resulted in death, the second in constant dull pain and limitation of motion, with a material loss in efficiency of the patient, while the third appears to be progressing satisfactorily in spite of the dislocation of the atlanto-axial joint, although there is a marked reduction in the movements of the head. <h3>ANATOMIC CONSIDERATIONS</h3> The articulation of the atlas with the axis is a joint of complicated nature, as it is made up of four distinct parts or joints. These are: (1) a pivot
Concealed conduction in accessory atrioventricular pathways: an important determinant of the expression of arrhythmias in patients with Wolff-Parkinson-White syndrome.
Authors: G J Klein, R Yee, A D Sharma
Journal: Circulation (1984)

Concealed conduction into accessory atrioventricular pathways has been postulated to explain variability of R-R intervals during atrial fibrillation in patients with Wolff-Parkinson-White syndrome. We examined the occurrence of concealed conduction into atrioventricular pathways using extrastimulus techniques in 26 consecutive patients undergoing electrophysiologic studies for the Wolff-Parkinson-White syndrome. Anterograde pathway concealment was demonstrated (10 patients) by introducing a second atrial extrastimulus (A3) after block in the accessory pathway occurred following the first extrastimulus (A2). The apparent effective refractory period (ERP) of the atrioventricular pathway with A3 (after A2 blocked in the pathway), or ERPB, was always greater than the ERP of the atrioventricular pathway (505 +/- 100 vs 323 +/- 105 msec, mean +/- SD; p less than .001), a finding explained by concealment into the pathway by the blocked A2. A measure of the apparent prolongation of refractoriness due to anterograde concealment (delta ERPB), defined as the difference between ERP and ERPB at a given cycle length, was derived. The average R-R interval in atrial fibrillation correlated better with delta ERPB (r = .8, p less than .01) than with the ERP (r = .6, p = NS), supporting the influence of anterograde atrioventricular pathway concealment in modulating the ventricular response during atrial fibrillation. By similar techniques, concealed retrograde conduction in the atrioventricular pathway could be demonstrated in 16 of 26 patients. In two of these patients "bystander" atrioventricular pathway conduction during orthodromic reciprocating tachycardia that did not involve the atrioventricular pathway did not occur, even though the ERP of the pathway should have permitted it, a finding readily explained by repetitive retrograde concealment into the atrioventricular pathway during tachycardia. Concealed conduction can be demonstrated in most patients with Wolff-Parkinson-White syndrome and is an important factor in the clinical expression of their arrhythmias.