tbuckley/cabot-search huggingface dataset:
Intramural esophageal hematoma: an unusual cause of acute chest pain
Authors: Benjamin Disney, Shay-Anne Preece, Sauid Ishaq
Journal: Endoscopy (2014)

A 79-year-old woman with a previous history of coronary artery bypass grafting presented with acute onset crushing central chest pain at rest. There were no preceding symptoms. On further questioning, the patient reported odynophagia at the time of symptom onset. She was hemodynamically stable with normal examination findings. Given her cardiac risk factors, she was initially treated as having acute coronary syndrome and received standard antiplatelet therapy. Serial electrocardiography and negative troponin test results excluded acute coronary syndrome.
Advantages of airport screening for Ebola
Authors: P. Cosford
Journal: BMJ (2014)

The Ebola virus outbreak in west Africa has been described by WHO as the “most severe acute health emergency in modern times.”

In the UK, Public Health England (PHE) has instituted enhanced entry screening for Ebola in passengers coming from Sierra Leone, Guinea, and Liberia. Screening is already in place at Heathrow and will shortly roll out to Gatwick and St Pancras (Eurostar). …
Protection from radiation injury by elemental diet: does added glutamine change the effect?
Authors: A H McArdle
Journal: Gut (1994)

The feeding of a protein hydrolysate based 'elemental' diet supplemented with added glutamine did not provide superior protection to the small intestine of dogs subjected to therapeutic pelvic irradiation. Comparison of diets with and without the added glutamine showed significant protection of the intestine from radiation injury. Both histological examination and electron microscopy showed lack of tissue injury with both diets. The activity of the free radical generating enzymes, scavengers, and antioxidants were similar in the intestinal mucosa of dogs fed either diet. After radiation, however, the activity of xanthine oxidase, superoxide dismutase, and glutathione peroxidase were significantly (p < 0.002) higher in the intestine of dogs fed elemental diet without the added glutamine. If the activities of these enzymes are important in the protection of the intestine from radiation injury, then the addition of extra glutamine may provide no benefit.
Antithrombotic Therapy for Patients With Atrial Fibrillation and Atherothrombotic Vascular Disease
Authors: Carlo Patrono, Felicita Andreotti
Journal: Circulation (2013)

A trial fibrillation (AF), the most prevalent cardiac arrhyth- mia, is estimated to affect 1.5% to 2.0% of the general population, that is, at least 100 million people worldwide. 1Left untreated, patients with nonvalvular AF (NVAF) are exposed to an annual risk of thromboembolic stroke of ≈5%, resulting in 5 million AF-related strokes each year. 1 Properly dosed anticoagulation (eg, warfarin adjusted to an international normalized ratio of 2.0-3.0) is extremely effective in preventing AF-related strokes, reducing risk by two thirds compared with no therapy and by one-half compared with aspirin. 1 In contrast, aspirin alone achieves a 21% relative reduction in risk of nonfatal stroke compared with no treatment, and aspirin plus clopidogrel yields an additional 11% reduction compared with aspirin alone. 1Thus, anticoagulation is the unchallenged current treatment of choice for patients with NVAF at moderate to high risk of thromboembolic complications.
Duodenogastric reflux after gastric surgery and in gastric ulcer disease: continuous measurement with a sodium ion selective electrode.
Authors: A Smythe, D O'Leary, A G Johnson
Journal: Gut (1993)

Duodenogastric reflux (DGR) was investigated with a sodium ion selective electrode in 10 normal controls, 10 patients with persistent pain after gastric surgery, and five patients with gastric ulcer. During an average study time of two and a half hours, normal controls had reflux for 12% of the study, whereas patients after gastric surgery had reflux for 91% of the study time (p &lt; 0.0002). Patients with a gastric ulcer had reflux on average for 67% of the study (p &lt; 0.001). The patients who had had gastric surgery had several symptoms, but there was no association between the number or nature of symptoms and the severity of DGR as determined by the sodium electrode. Patients with positive bile provocation tests did not show any significant difference in the duration of reflux compared with those with a negative provocation test (79% and 87%). There was also no relation between the results of the provocation test and the number and nature of symptoms. Continuous monitoring of intragastric sodium ions with a selective electrode is a practical means of assessing DGR. Results suggest that symptoms due to DGR may be related to the sensitivity of the gastric lining as well as the amounts of duodenal contents flowing back into the stomach.
Preferential Pulmonary Retention of (S)-Albuterol after Inhalation of Racemic Albuterol
Authors: RAJIV DHAND, MARK GOODE, RALSTON REID, JAMES B. FINK, PATRICK J. FAHEY, MARTIN J. TOBIN
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

The (R)-enantiomer of racemic albuterol produces bronchodilation, whereas the (S)-enantiomer may increase airway reactivity. After oral or intravenous administration of racemic albuterol, the (R)- enantiomer is metabolized several times faster than the (S)-enantiomer; however, enantiomer disposition after inhaling racemic albuterol with a metered-dose inhaler (MDI) is not known. Accordingly, 10 healthy subjects inhaled racemic albuterol with a MDI alone and with a MDI and holding chamber. We measured plasma levels of unchanged (R)- and (S)-albuterol before and up to 4 h after inhalation of racemic albuterol, and determined the unchanged R/S ratio in urine before and at 0.5, 4, 8, and 24 h later. The disposition of albuterol's enantiomers with a MDI and holding chamber was similar to that with a MDI alone. The area under the curve (AUC) of the plasma levels over time was significantly lower for the (S)- than for the (R)-enantiomer-395.5 +/- 141.0 (SE) versus 882.7 +/- 126.4 ng. ml(-)(1). min (p < 0.05)-indicating preferential retention of (S)-albuterol in the lung. The R/S ratio in urine at 0. 5 h after albuterol was > 1, reflecting the higher plasma level of the (R)-enantiomer. In conclusion, preferential retention of the (S)- compared with the (R)-enantiomer in the lung could lead to accumulation of the (S)-enantiomer after long-term use of racemic albuterol.
ACGME Duty-Hour Recommendations — A National Survey of Residency Program Directors
Authors: Ryan M. Antiel, Scott M. Thompson, Darcy A. Reed, Katherine M. James, Jon C. Tilburt, Michael P. Bannon, Philip R. Fischer, David R. Farley
Journal: New England Journal of Medicine (2010)

Taking into consideration the Institute of Medicine's 2008 recommendations regarding residents' duty hours,1 the 16-member Duty Hour Task Force of the Accreditation Council for GraduateMedical Education (ACGME) recently published proposed new recommendations,2 which, as eventually approved, would go into effect in July 2011. These recommendations represent a continuing commitment by the ACGME to both "foster a humanistic environment for graduate medical education" and ensure "excellent and safe patient care."2 The ACGME has solicited comments from the educational community and will modify its proposal as needed.The recommendations represent an attempt to address elements of the 2003 ACGME standards that generated . . .
A minimal role for selectins in the recruitment of leukocytes into the inflamed liver microvasculature.
Authors: J Wong, B Johnston, S S Lee, D C Bullard, C W Smith, A L Beaudet, P Kubes
Journal: Journal of Clinical Investigation (1997)

A two-step paradigm for leukocyte recruitment has been established in a number of tissues including the mesentery, skin, and muscle, and necessitates an initial rolling step via the selectins before firm leukocyte adhesion via the integrins. In view of the many inflammatory diseases that involve the liver, we investigated the importance of rolling and the selectins in the hepatic microvasculature and compared the responses to that of the commonly used mesentery or cremaster microvasculature. We visualized the liver microvasculature using intravital microscopy and we determined that within the liver the majority of leukocytes adhere within the sinusoids (80%) in response to a chemotactic stimulus such as FMLP (20% in postsinusoidal venules) whereas leukocytes adhere exclusively within postcapillary venules in tissue like the mouse cremaster. In the sinusoids, the adhesive response to FMLP is not dependent upon selectins inasmuch as adhesion was not reduced in the sinusoidal vessels of P-selectin-deficient mice or E-selectin/P-selectin- deficient animals in the presence or absence of L-selectin antibody. No rolling or adhesion was detected in response to FMLP in the selectin-deficient cremaster microvasculature. Immunoneutralization of selectins with fucoidan in wildtype mice eliminated rolling and adhesion in the cremaster but failed to affect adhesion in the liver sinusoids in response to FMLP. More long-term leukocyte recruitment with lipopolysaccharide (4 h) was also impaired in the cremaster but not the liver microvasculature in selectin-deficient animals. Leukocyte adhesion in the sinusoids was reduced in P-selectin-deficient mice also lacking intercellular adhesion molecule-1 (ICAM-1). This study for the first time demonstrates that selectins are not an essential step for leukocyte recruitment into the inflamed liver microvasculature.
The Respiratory-Distress Syndrome of Newborn Infants
Authors: Charles D. Cook, William D. Cochran
Journal: New England Journal of Medicine (1964)

THE respiratory-distress syndrome, or hyalinemembrane disease, is the commonest cause of death among newborn, especially premature, infants, and yet its pathogenesis remains a mystery and its treatment empirical and unsatisfactory. Any physician delivering or caring for newborn infants is confronted with the management of this syndrome, for which a variety of therapeutic regimens have been suggested, and it therefore seems useful to try to define the boundaries of ignorance and knowledge about its treatment.The syndrome can be defined as respiratory distress that develops at or shortly after birth and is not due to any presently known condition such as . . .
Kinematics of lumbar spine motion in rowing during a fatiguing protocol: a comparison of ergometer and boat rowing
Authors: F Wilson, C Simms, J Gormley, C Gissane
Journal: British Journal of Sports Medicine (2011)

Background The incidence of lumbar spine injury is high. Ergometer rowing and fatigue have been cited as risk factors for this injury. Objective Compare the kinematics of the lumbar spine in rowers on an ergometer and a sculling boat during a fatiguing protocol. Design Lumbar spine kinematics were assessed in the sagittal plane using a twin axis electrogoniometer. Setting A laboratory and field based study of elite level rowing. Participants 19 male rowers, mean age 24.2 (3.7) years, mean weight 82.5 (8.4) kg and height 1.88 (0.05) m. Assessment of risk factors Maximum range of lumbar flexion was measured before each test. Sagittal plane lumbar spine angular kinematics were measured during an ergometer rowing trial which comprised of an incremental ‘step test’ on a Concept 2 ergometer. The trial was repeated in a sculling boat on the water. Main outcome measurements Pre-test maximum flexion and maximum lumbar flexion during each test were compared. Mean sagittal flexion in the lumbar spine during the first and last stage of the step test was compared. The findings of ergometer and boat rowing were compared. Results Maximum sagittal flexion was 113% (15.2) of pre-test range during ergometer rowing and 104.1% (10.2) during boat rowing. Lumbar flexion increased over the course of testing. Increase in lumbar flexion was significantly greater on the ergometer (mean change+4.4°(0.85)) compared with the boat (mean change+1.3°(1.1)), (mean difference 3.1, 95% CI 0.3 to 5.9, t=2.28, p=0.035). Conclusion Rowers experience a very high level of lumbar spine flexion which increases over the course of a rowing trial. Ergometer rowing results in significantly greater increases in sagittal motion in the lumbar spine compared to boat rowing.
Thorax Annual Report October 2004-September 2005
Authors: J A Wedzicha
Journal: Thorax (2005)

IL-2 is critical for peripheral tolerance mediated by regulatory T (Treg) cells, which represent an obstacle for effective cancer immunotherapy. Although IL-2 is important for effector (E) T cell function, it has been hypothesized that therapies blocking IL-2 signals weaken Treg cell activity, promoting immune responses. This hypothesis has been partially tested using anti–IL-2 or anti–IL-2R Abs with antitumor effects that cannot be exclusively attributed to lack of IL-2 signaling in vivo. In this work, we pursued an alternative strategy to block IL-2 signaling in vivo, taking advantage of the trimeric structure of the IL-2R. We designed an IL-2 mutant that conserves the capacity to bind to the αβ-chains of the IL-2R but not to the γ<sub>c</sub>-chain, thus having a reduced signaling capacity. We show our IL-2 mutein inhibits IL-2 Treg cell–dependent differentiation and expansion. Moreover, treatment with IL-2 mutein reduces Treg cell numbers and impairs tumor growth in mice. A mathematical model was used to better understand the effect of the mutein on Treg and E T cells, suggesting suitable strategies to improve its design. Our results show that it is enough to transiently inhibit IL-2 signaling to bias E and Treg cell balance in vivo toward immunity.
Aspects of the toxicology of chloroprene: immediate and long-term effects.
Authors: I V Sanotskii
Journal: Environmental Health Perspectives (1976)

The maximum permissible concentration (MPC) of chloroprene was set at 2 mg/m3 in the USSR in the 1940's. The existing MPC is 4 mg/m3. The threshold of systemic effects as a result of chronic chloroprene exposure is l.69 mg/m3. However, the threshold for embryotoxic and mutagenic effects is 0.15 mg/m3. In consideration of this information, setting a new MPC for chloroprene at 0.05 mg/m3 is recommended.
Recurrent Herpes Labialis and Recurrent Aphthous Ulcerations: Psychological Components
Authors: M.P. Janicki
Journal: Psychotherapy and Psychosomatics (1971)

The relevant research literature is reviewed to determine the psychological components in 2 psychophysiological disorders, recurrent herpes labialis and recurrent aphthous ulcerations. Two major variables emerge: that emotional stress is usually associated with outbreaks of both, and appears to be the precipitating agent; and that counseling and psychotherapy appear to have an effect upon the nature of the recurrences and oftentimes upon their cessation. The need for further controlled experimentation is indicated.
Managed Care
Authors: Carolyn M. Clancy
Journal: JAMA (1995)

The topic most discussed by physicians today is the increasing percentage of US health care being taken over by managed care organizations.<sup>1</sup>While physicians in practice are struggling to interpret the requirements and implications of contracts with emerging or established health care systems,<sup>2</sup>many academic medical centers have also joined the "dance of vertical integration."<sup>3,4</sup>What has not emerged from the ofttimes emotional discussions is a cogent examination of the impact of the transformation of medical practice from a cottage industry to a corporate enterprise on how we deliver care, assess and improve the quality of care, and educate future physicians. It is an urgent matter, then, for the medical profession to address the ethical principles that will preserve a sound physician-patient relationship within this rapidly changing environment. See also pp 323 and 330. To address the ethics of the physician-patient relationship in managed care realistically and
Focus: Westminster New doctors in the house
Authors: J. Warden
Journal: BMJ (1997)

An unnoticed feature of the recent British general election has been a shift in the balance of power among doctor MPs. There are now six doctors in the House of Commons, one more than before, but three of them are Liberal Democrats. Out of 46 Liberal Democrat MPs that is a reasonable proportion and rewards political tenacity. Among the 30 or so doctors who stand at each general election, the Liberals consistently account for the largest group. But their efforts had a singular lack of success until last month. Their resurgence was at the expense of the Conservatives, whose reduced ranks now contain only one doctor against Labour's two.

It is a rebalancing which also calls for …
Relationship between HBV core-promoter sequences and selection of lamivudine resistant mutants in CHBe antigen-negative patients
Authors: Maria Maddalena Abate, Simona Paganin, Valeria Barbon, Marco Lagget, Grazia Niro, Antonella Olivero, Antonina Smedile, Mario Rizzetto
Journal: Journal of Hepatology (2002)
Lipolysosomes in Human Hepatocytes: Their Increase in Number Associated with Serum Level of Cholesterol in Chronic Liver Diseases
Authors: Hisao Hayashi, Yoichi Sameshima, Michio Lee, Yasuhiro Hotta, Toshihiko Kosaka
Journal: Hepatology (1983)

The clinical significance of hepatocellular lipolysosomes in patients with various liver diseases was investigated. Of the 102 cases studied, lipolysosomes were found in 78 cases or 76%. In patients with fatty change of the liver, hepatocellular lipolysosomes were found in 62 of 68 or 91%. In patients without fatty change, lipolysosomes were found in 16 of 34 or 47%. The lipolysosome:lipid ratio in the hepatocytes ranged from 0 to 10%. No differences were found in the lipolysosome:lipid ratios of patients with acute hepatitis, cholestasis, fatty liver, chronic hepatitis, or cirrhosis. In chronic hepatitis and cirrhosis with associated fatty change, the ratio was correlated with the serum level of cholesterol, whereas in fatty liver the ratio was not correlated with any parameters of patient's age, etiologic factors, or serum level of cholesterol. The findings suggest that lysosomal function is less significant as a pathogenesis of fat infiltration but lipolysosomes increase in number as a sequence of cholesterol overload to the liver.
Hepatitis B Virus and Cryoglobulinemia
Authors: MASSIMO GALLI
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 October 1981Hepatitis B Virus and CryoglobulinemiaMASSIMO GALLI, M.D., FULVIO INVERNIZZI, M.D.MASSIMO GALLI, M.D.Search for more papers by this author, FULVIO INVERNIZZI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-4-522_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dr. Levo (1) refers in his comment on the paper by Popp and colleagues (2) to our data (3) in support of the hypothesis of a significant correlation between hepatitis B virus (HBV) infection and essential mixed cryoglobulinemia. Our data, now drawn from 40 cases of essential mixed cryoglobulinemia (27 females and 13 males, mean age 52, 37 ± 12.07) indicate an exposure to HBV in 60% of these cases. We could not, however, find a statistically significant difference between these patients and the control group composed of patients, age and sex matched, hospitalized for noninfectious, neoplastic,...References1. LEVO Y. Hepatitis B virus and essential mixed cryoglobulinemia. Ann Intern Med. 1981;94:282. Letter. LinkGoogle Scholar2. POPPDIENSTAGWANDSBLOCH JJJK. Essential mixed cryoglobulinemia without evidence for hepatitis B virus infection. Ann Intern Med. 1980;92:379-83. LinkGoogle Scholar3. GALLICAREDDUD'ARMINOMONTIMESSINAINVERNIZZI MFAGKF. Hepatitis B virus and essential mixed cryoglobulinemia. Lancet. 1980;1:1093. Letter. CrossrefMedlineGoogle Scholar4. GIUSTIGALANTIGAETA GBG. Epidemiology of viral hepatitis in Italy. Boll 1st Sieroter Milan. 1980;59:572-80. Google Scholar5. GOREVICKASSABLEVO PHY. Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients. Am J Med. 1980;69:287-308. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MASSIMO GALLI, M.D.; FULVIO INVERNIZZI, M.D.Affiliations: University of Milan Milan Italy PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1981Volume 95, Issue 4Page: 522-522 ePublished: 12 March 2020 Issue Published: 1 October 1981 PDF downloadLoading ...
Effect of Dietary Ascorbic Acid Restriction and Supplementation on Urine pH in Elderly Males
Authors: J. M. Trang, J. Blanchard, K. A. Conrad, G. G. Harrison
Journal: JAMA (1984)

<h3>To the Editor.—</h3> The efficacy of ascorbic acid (AA) in lowering urine pH in humans has been studied with equivocal results.<sup>1-3</sup>The primary clinical application of urinary acidification with AA is as an adjunct to methenamine mandelate therapy in the treatment of urinary tract infections. Doses of AA ranging from 1.5 to 6 g daily have been recommended for this purpose,<sup>1</sup>but recent investigationshave indicated that AA (1 g four times daily) is ineffective in lowering urine pH.<sup>2,3</sup>The influence of dietary AA<i>restriction</i>on urine pH in the elderly has not been studied. Since many persons now routinely ingest large (eg, 1 to 10 g daily) doses of AA and since urine pH can influence the renal excretion of weak acids and weak bases, we felt that it would be of interest to report the changes in urine pH that we observed during an investigation of
Ensuring Ethical Internet Information
Authors: Charles Marwick
Journal: JAMA (2000)

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