tbuckley/cabot-search huggingface dataset:
End-of-Life Conversations
Authors: Dale G. Larson, Daniel R. Tobin
Journal: JAMA (2000)

This article examines the evolution of and need for "end-of-life conversations." Barriers to end-of-life discussions that have been identified in patients and families, health care professionals, and health care systems can seriously interfere with the quality of remaining life for terminally ill patients. Strategies for enhancing end-of-life discussions are most productively linked to (1) physicians' interpersonal communication skills, (2) a patient-centered model of care, (3) a focus on quality of remaining life, and (4) innovative clinical models for implementing these discussions earlier in the care process. We conclude that end-of-life conversations must become a routine, structured intervention in health care and that advance care planning is best viewed as one component in a series of ongoing end-of-life discussions. Randomized trials are needed to examine new approaches and models for enhancing end-of-life conversations.
Researchers discover adult cell that acts like stem cell from embryos
Authors: S. Gottlieb
Journal: BMJ (2002)

Researchers have found a previously unknown type of cell in adult bone marrow that acts much like the highly versatile stem cells from human embryos and is ca-pable of turning into a wide assortment of the body's various tissues. The finding raises hopes that the new cells can be fashioned into transplantable material for patients whose own cells and tissues have become faulty.

Previously, scientists had documented other cells of the adult body that give rise to various tissues, but nothing nearly as versatile as these bone …
Duodenal Duplication Cyst
Authors: T. Gyökeres, R. Schwab, M. Burai, K. Bor, Á. Pap
Journal: Endoscopy (2002)

We read with interest the article by Wada et al. [1], reporting a case of duodenal duplication cyst (DDC) treated with endoscopic partial resection using the O-ring ligation kit. The method described is an ingenious solution, but we would like to ask Dr. Wada whether it might not be dangerous to aspirate and ligate the soft wall of a DDC?
Abstract 4027: The lectin concanavalin-A induces cyclooxygenase-2 expression through an IKKgamma/NFkB-dependent pathway in U87 glioblastoma cells
Authors: Asmaa Sina, Sébastien Proulx-Bonneau, Borhane Annabi
Journal: Cancer Research (2010)

Abstract The lectin from Canavalia ensiformis (Concanavalin-A, ConA), one of the most abundant lectins known, enables one to mimic biological lectin/carbohydrate interactions that regulate extracellular matrix protein recognition. As such, ConA is known to induce membrane type-1 matrix metalloproteinase (MT1-MMP) and is, therefore, routinely used to assess MT1-MMP-mediated functions. Given that gliomas with increasing histological grade demonstrated MT1-MMP expression that correlated with high expression of cyclooxygenase (COX)-2, we specifically assessed the early proinflammatory cellular signaling processes triggered by ConA, a lectin known to induce MT1-MMP expression, in the regulation of COX-2. We found that treatment with ConA or direct overexpression of a recombinant MT1-MMP resulted in the induction of COX-2 expression. This increase in COX-2 was correlated with a concomitant decrease in phosphorylated AKT suggestive of cell death induction, and was independent of MT1-MMP's catalytic function. ConA and MT1-MMP-mediated intracellular signaling and induction of COX-2 was also validated in both wild-type and Nuclear Factor-kappaB (NF-κB) p65−/− mutant mouse embryonic fibroblasts (MEF), but was abrogated in NF-κB1 (p50)−/− and in I kappaB kinase (IKK) γ−/− mutant MEF cells. Collectively, our results highlight an IKK/NF-κB-dependent pathway linking MT1-MMP-mediated intracellular signaling to the induction of COX-2 by ConA. That signaling pathway could account for the inflammatory balance responsible for the therapy resistance phenotype of glioblastoma cells, and prompts for the design of new therapeutic strategies that target cell surface carbohydrate structures and MT1-MMP-mediated signaling. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4027.
The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors: A Population Study of Elderly Adults
Authors: Linda E. Lévesque, James M. Brophy, Bin Zhang
Journal: Annals of Internal Medicine (2005)

Background: Cyclooxygenase-2 (COX-2) selective inhibitors have been marketed since 1999 as safer alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs). Debate about their cardiac safety has culminated in the recent withdrawal of rofecoxib. Additional studies are needed to better understand this risk and to determine whether this safety concern represents a class effect. Objective: To assess the influence of various NSAIDs on the risk for a first myocardial infarction (MI). Design: Population-based, retrospective cohort study analyzed using a time-matched, nested case–control approach. Setting: Québec, Canada. Participants: 113 927 elderly persons without previous MI and newly treated with an NSAID between 1 January 1999 and 30 June 2002. Measurements: NSAID exposure and occurrence of MI assessed by using Québec's administrative health databases. Results: Compared with no use of NSAIDs in the year preceding the event, current use of rofecoxib was associated with an increased risk for an acute MI (rate ratio [RR], 1.24 [95% CI, 1.05 to 1.46]) that was more pronounced at higher doses (RR, 1.73 [CI, 1.09 to 2.76]). The concomitant use of aspirin appears to decrease the risk associated with low-dose rofecoxib (RR, 1.00 [CI, 0.77 to 1.28]) but not with high-dose rofecoxib (RR, 2.36 [CI, 1.27 to 4.39]). No increased risks were observed with celecoxib (RR, 0.99 [CI, 0.85 to 1.16]) or the other NSAIDs. Limitations: The study could not completely account for all potential confounders, including over-the-counter use of aspirin and ibuprofen. Conclusions: These results provide evidence of an increased risk for acute MI in current users of rofecoxib among elderly persons with no history of MI. This risk appears greater at higher doses. Aspirin use mitigates the risk associated with low-dose but not high-dose rofecoxib. There was no evidence of an increased risk with the other NSAIDs.
Soluble Fc gamma receptor III in human plasma originates from release by neutrophils.
Authors: T W Huizinga, M de Haas, M Kleijer, J H Nuijens, D Roos, A E von dem Borne
Journal: Journal of Clinical Investigation (1990)

FcRIII (the CD16-antigen), a low affinity receptor for IgG, is expressed by neutrophils, natural killer lymphocytes, and macrophages. We have developed a sensitive radioimmunoassay to quantify FcRIII. A soluble form of FcRIII was identified in human plasma. Immunoprecipitation of FcRIII from plasma showed that the plasma form of FcRIII has an identical electrophoretic mobility as the FcRIII expressed by neutrophils. Moreover, the plasma form of FcRIII exhibited the same polymorphism as does the neutrophil FcRIII. The neutrophil expresses the phosphatidylinositol-linked form of FcRIII, encoded by the gene FcRIII-1. Because it is not known whether this gene is also active in nonhematopoietic cells, we analyzed patients with an acquired clonal disorder of their hematopoietic cells, paroxysmal nocturnal hemoglobinuria (PNH). PNH patients appeared to have a strongly reduced expression of FcRIII on their neutrophils. The concentration of FcRIII in the plasma of these patients was also reduced, indicating that plasma FcRIII originates from neutrophils. A patient deficient in FcRIII-1 but with a normal expression of FcRIII-2 had no soluble FcRIII in her plasma, also indicating that plasma FcRIII originates from neutrophils. The electrophoretic mobility of the protein backbone of plasma FcRIII and FcRIII released by activated neutrophils was identical, whereas deglycosylated FcRIII obtained from a lysate of neutrophils migrated slower. This indicates that plasma FcRIII originates from activation-induced release by neutrophils. Stimulation of neutrophils or neutrophil cytoplasts (closed membrane vesicles filled with cytoplasm) with low concentrations of FMLP (10(-9)-10(-8) M) or phorbol myristate acetate (1-10 ng/ml) induced a dose-dependent release of FcRIII. The plasma concentration of FcRIII was relatively constant (range 40-280% of the mean). Soluble FcRIII was also detected in inflamed joint fluids of arthritis patients, suggesting that FcRIII is also released by activated neutrophils in vivo.
The Use of Packed Red Blood Cells
Authors: Allan Kliman
Journal: JAMA (1976)

<h3>To the Editor.—</h3> I believe that many transfusion experts and public health planners will strongly disagree with Dr Grindon's article. Proper use of known community blood resources requires that all units of blood collected be centrifuged promptly to harvest the labile blood components. This, in turn, requires that surgeons must be educated in the safe use of PRBC intraoperatively, since in most communities, 60% of the blood use is intraoperative. Surgeons can and must use PRBC for the average surgical patient when less than 2,000 ml of the blood volume is going to be lost. Failure to implement a full PRBC program has resulted in a continuing nationwide shortage of blood components as well as prohibitively high blood-fraction costs. Unless better use is made of the nation's blood supply, we are inviting restrictive government intervention—and it seems certain that such intervention will prove far more uncomfortable to surgeons than the
Prolactin enhances the in vitro production of IgG in peripheral blood mononuclear cells from patients with systemic lupus erythematosus but not from healthy controls
Authors: Jacobi Am, Rohde W, Volk Hd, Dörner T, Burmester Gr, Hiepe F
Journal: Annals of the Rheumatic Diseases (2001)

<h3>OBJECTIVES</h3> Recent evidence suggests that prolactin (PRL) plays a part in the pathogenesis of systemic lupus erythematosus (SLE). Because B cell hyperreactivity and autoantibodies are characteristic hallmarks of SLE, this study aimed at assessing the impact of this pituitary hormone on IgG production by stimulating peripheral blood mononuclear cells (PBMC) with PRL. <h3>METHODS</h3> PBMC from 11 patients with SLE assessed by the ECLAM score and eight healthy controls were incubated with PRL and cultured for seven days. IgG production was measured by enzyme linked immunosorbent assay (ELISA). <h3>RESULTS</h3> Spontaneous IgG production of SLE PBMC was significantly enhanced compared with that found in healthy controls. After PRL stimulation, the IgG concentrations of supernatants from SLE PBMC were significantly higher than those of unstimulated PBMC (median 394 ng/ml). Of note, the physiological concentration of PRL (20 ng/ml) induced IgG production more effectively (median 1139 ng/ml) than PRL at 100 ng/ml (median 1029 ng/ml). In contrast, preincubation with PRL did not stimulate IgG production in normal PBMC. A significant correlation between PRL induced IgG production and the disease activity (ECLAM) of the patients with SLE was seen. Moreover, the maximum amount of PRL induced IgG depended on the serum PRL concentrations of the patients with SLE. <h3>CONCLUSIONS</h3> The results suggest that PBMC from patients with SLE have an extraordinarily high susceptibility to PRL, showing the most striking effect at a concentration usually found in vivo. This indicates a potential role for mild hyperprolactinaemia in the pathogenesis of SLE, influencing both IgG production and disease activity.
Reactivation of Cytomegalovirus Infection in Critically Ill Immunocompetent Patients
Authors: Amanda Peppercorn, Jonathan Serody, Bruce Cairns
Journal: JAMA (2008)

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
Choroidal Tubercles
Authors: Francisco Olazábal
Journal: JAMA (1967)

The finding of choroidal tubercles allowed the successful early institution of antituberculotic therapy in three cases of acute miliary tuberculosis. In one case the lesions disappeared completely with therapy. The presence of choroidal tubercles is valuable, easily obtained, objective evidence of hematogenous tuberculosis. Their discovery should lead to a specific therapeutic trial of adequate length. Healing of the lesions, as well as a systemic response to treatment, is also of diagnostic significance.
The role of mitochondria and sarcoplasmic reticulum calcium handling upon reoxygenation of hypoxic myocardium.
Authors: J A Pesaturo, J K Gwathmey
Journal: Circulation Research (1990)

The mechanism of twitch prolongation of hypoxic myocardium after reoxygenation was studied before and after interventions that affect cellular cyclic nucleotide levels, subcellular calcium handling, or oxygen-derived free radical production/survival. Right ventricular ferret papillary muscles were subjected to two 20-minute periods of hypoxia, each followed by 1 hour of reoxygenation. The first sequence of hypoxia/reoxygenation was done without intervention. Before the second sequence, the pharmacological agent under study was added to the superfusate or the superfusate calcium concentration was increased from 2.5 to 8 mM. Time from peak to 80% decline in twitch tension was measured in the presence and absence of each intervention immediately before each period of hypoxia and after reoxygenation at maximal twitch prolongation. Interventions that affect Ca2+ flux across the sarcolemma (verapamil and 8 mM [Ca2+]o) or agents that affect oxygen free radical production/survival (dimethyl sulfoxide and allopurinol) did not affect twitch prolongation. Pharmacological agents that increase cyclic AMP levels (forskolin and milrinone) or those that inhibit mitochondrial activity (oligomycin B and ruthenium red) attenuated twitch prolongation. Pharmacological agents that decrease cyclic AMP levels (carbachol) or inhibit function of the sarcoplasmic reticulum (ryanodine) augmented twitch prolongation. The effect of mitochondrial inhibitors on intracellular calcium handling during hypoxia and reoxygenation was examined using muscles loaded with the bioluminescent calcium indicator aequorin. Mitochondrial inhibitors abbreviated the calcium transient and maximal twitch prolongation after hypoxia. We conclude that alterations in sarcoplasmic reticulum and mitochondria calcium handling contribute to the prolonged relaxation seen upon reoxygenation of hypoxic myocardium.
Access to Bariatric Surgery and Patients With Diabetes
Authors: Francesco Rubino
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
Assisted Reproductive Technology in the United States
Authors: Robert W. Rebar, Alan H. DeCherney
Journal: New England Journal of Medicine (2004)

Of the 60.2 million women in the United States who were of reproductive age in 1995, about 1.2 million, or 2 percent, had had an infertility-related medical appointment within the previous year, and about 15 percent had received infertility services at some time in their lives.1 Major causes of infertility in women include obstruction of the fallopian tubes, pelvic adhesions, endometriosis, and anovulation; the primary cause in men is poor semen quality.Two important developments in the past 50 years now provide hope for infertile couples. First, drugs have been developed that can induce ovulation in almost all anovulatory women . . .
Prognostic implications of diagnostic Q waves after myocardial infarction.
Authors: A G Wasserman, G B Bren, A M Ross, D W Richardson, R G Hutchinson, J C Rios
Journal: Circulation (1982)

The long-term prognostic implications of the electrocardiographic location of a myocardial infarction and the subsequent retention or disappearance of diagnostic Q waves were examined in patients enrolled in the Aspirin Myocardial Infarction Study (AMIS). The 4524 participants, ages 30-69 years, had sustained a myocardial infarction 8 weeks to 60 months before randomization to aspirin and placebo groups. Subjects were followed for at least 3 years (average 38.2 months). Using the Minnesota Code, myocardial infarctions were classified according to three electrocardiographic locations: lateral, inferior and anterior, with further subdivision into major, moderate and minor criteria based on Q-wave duration and Q/R rations. Total mortality was not significantly different among patients with single infarct sites: lateral 11.8%, inferior 8.0% and anterior 9.4%. Patients with multiple electrocardiographic infarct locations had a significantly higher mortality (14.6%, p less than 0.0002). Participants with Minnesota Code major criteria of infarction also had a significantly higher mortality (10.6%) than those with moderate (7.2%) or minor (7.4%) criteria (p less than 0.01). Loss of a previously documented diagnostic Q wave occurred in 14.2% of participants. Mortality among patients who lost Q waves (6.5%) was not significantly different from that among those with persistent Q waves in a single infarct location (8.7%). No long-term prognostic significance can be attributed to the site of infarction or loss of Q wave on the resting ECG. However, major Q-wave criteria and extent of infarction based on multiple coded sites are associated with a higher 3-year mortality.
Correlation of Myocardial and Renal Necrosis With Tissue Electrolyte Changes
Authors: David Lehr
Journal: JAMA (1966)

It is known that degeneration and necrosis of tissue is associated with substantial changes in the electrolyte content of affected areas. It is not certain, however, whether such alterations are solely one of the consequences of tissue injury, or whether certain electrolyte shifts contribute to the elicitation of organic damage. In favor of a causative influence of electrolyte shifts, one may cite the fact that severe myocardial injury can be produced by dietary deficiency of potassium or magnesium, the two most important intracellular cations, and that the severity of cardiac lesions induced by dietary and other means can be enhanced by sodium-loading or by mineralocorticoids, and inhibited by the administration of potassium and magnesium salts. <h3>Primary Goals</h3> The primary goals of the present investigation were the following: (1) to search for possible similarities in the derangement of the electrolyte pattern occurring in myocardial necrosis produced by different means, (2) to
THE APPLICATION OF ICE IN LOBAR PNEUMONIA.
Authors: P. A. AURNESS
Journal: JAMA (1905)

It may be of interest to report a line of treatment of lobar pneumonia that I have carried out for a number of years with no deaths. The treatment may be outlined as follows: As soon as a diagnosis of lobar pneumonia is made, the patient is given a full warm bath, for cleansing purposes, put to bed and given a laxative dose of calomel and soda. A systematic, routine examination and recording of the general condition of the patient is followed by a careful examination to outline the chest area of the lung tissue involved. This being noted, one or more, as the case may demand, specially constructed ice bags are moderately, but evenly filled with crushed ice and applied so as to accurately cover the chest surface of the parts inflamed. Each bag is wrapped in a thin layer of gauze, and is kept in place by a
Reminders to Physicians from an Introspective Computer Medical Record
Authors: Clement J. McDONALD, Siu L. Hui, David M. Smith, William M. Tierney, Stuart J. Cohen, Morris Weinberger, George P. McCABE
Journal: Annals of Internal Medicine (1984)

We developed a computer-stored medical record system containing a limited set of the total clinical data base—primarily diagnostic studies and treatments. This system responds to its own content according to physician-authored reminder rules. To determine the effect of the reminder messages generated by 1490 rules on physician behavior, we randomly assigned practitioners in a general medicine clinic to study or control groups. The computer found indications for six different actions per patient in 12 467 patients during a 2-year study: 61 study group residents who received computer reminders responded to 49% of these indications; 54 control group residents, to only 29% (p < 0.0001). Preventive care (occult blood testing, mammographic screening, weight reduction diets, influenza and pneumococcal vaccines) was affected. The intentions of the study group to use a given action for an indication predicted their response to the indications (p < 0.03, r 2 = 0.33). The intentions of the control residents did not.
ALBUMINURIA IN DISEASE OF THE KIDNEY IN INFANCY AND CHILDHOOD.
Authors: JOHN R. RATHMELL
Journal: JAMA (1901)

Diseases of the kidney in infancy and childhood are not so varied as in adults. They are chiefly active hyperemia and nephritis following the contagious diseases, especially scarlet fever. The acquired diseases of the kidney in childhood show considerable difference from adults, because acute affections, common to childhood, causing diseases of this organ, are seldom met with in after life. Under 15 years of age there is less likelihood to disorders of circulation than in later periods, and consequently under this age they are less likely to have chronic lesions of the kidneys. Again, a child's kidney rapidly recovers from an injury. It is very rare to find a case of pyelonephritis, or hydronephrosis in children. But cachectic conditions lead to amyloid infiltration and this, in turn, to chronic albuminuria in children as well as in adults. Physiological albuminuria may occur at any period of infancy or childhood, but it