tbuckley/cabot-search huggingface dataset:
Early Infant Feeding and Risk of Developing Type 1 Diabetes–Associated Autoantibodies
Authors: Anette-G. Ziegler
Journal: JAMA (2003)

Dietary factors modifying type 1 diabetes mellitus (DM) risk have been proposed, but little is known if they trigger the islet autoimmunity that precedes clinical disease.To determine whether breastfeeding duration, food supplementation, or age at introduction of gluten-containing foods influences the risk of developing islet autoantibodies.Prospective natural history cohort study conducted from 1989 to 2003 in inpatient/outpatient clinics in Germany.The BABYDIAB study follows newborn children of parents with type 1 DM. Eligibility requirements were met in 1610 children. Blood samples were obtained at birth, age 9 months, 2, 5, and 8 years. Dropout rate was 14.4% by age 5 years. Breastfeeding data were obtained by prospective questionnaires (91% complete), and food supplementation data were obtained by family interview (72% for food supplementation and 80% for age of gluten introduction).Development of islet autoantibodies (insulin, glutamic acid decarboxylase, or IA-2 antibodies) in 2 consecutive blood samples.Life-table islet autoantibody frequency was 5.8% (SE, 0.6%) by age 5 years. Reduced total or exclusive breastfeeding duration did not significantly increase the risk of developing islet autoantibodies. Food supplementation with gluten-containing foods before age 3 months, however, was associated with significantly increased islet autoantibody risk (adjusted hazard ratio, 4.0; 95% confidence interval, 1.4-11.5; P =.01 vs children who received only breast milk until age 3 months). Four of 17 children who received gluten foods before age 3 months developed islet autoantibodies (life-table 5-year risk, 24%; SE, 10%). All 4 children had the high-risk DRB1*03/04,DQB1*0302 genotype. Early exposure to gluten did not significantly increase the risk of developing celiac disease-associated autoantibodies. Children who first received gluten foods after age 6 months did not have increased risks for islet or celiac disease autoantibodies.Ensuring compliance to infant feeding guidelines is a possible way to reduce the risk of development of type 1 DM autoantibodies.
PTU-076 Factors at first ERCP which influence the decision to proceed to subsequent surgery or repeat ERCP for complex biliary problems
Authors: E Watts, H Nair, S Bow, A MacGilchrist, A Bathgate, J Plevris, J Casey, J Powell, J Garden, R Parks, M Duxbury, N Church, D Mole, R Ravindran
Journal: Gut (2012)

<h3>Introduction</h3> ERCP is a safe and highly effective solution to many pancreaticobiliary problems. However, surgical options also exist. After a challenging first ERCP, it can be unclear whether surgery or repeat ERCP is preferred. The aim of this study was to identify predictive factors at first ERCP which inform this decision. <h3>Methods</h3> All ERCPs performed at one hospital (April 2008–March 2011) were analysed. Patients having more than one ERCP were evaluated in detail. Demographics, disease-specific and procedure-specific variables relating to ERCPs and any subsequent surgery were extracted. The primary outcome measure was a requirement for surgery after two or more ERCPs. Descriptive statistics and logistic regression were performed. <h3>Results</h3> 1729 ERCPs were done in 1270 patients, of which 317 patients had more than one ERCP. Of these, 140 patients were randomly sampled and analysed in detail. These form the denominator for this analysis. The primary diagnosis was gallstones in 62.8%, malignancy in 16.9% and stricture in 10.2%. Combinations of these or other diagnoses occurred in 17.6%. 74.5% of first ERCPs were urgent or emergent. Cannulation was attempted in 96.3% and successful in 81.5% of patients. The operator deemed the first ERCP to be successful in 40.6%. Multiple stones requiring a stent and planned revisit occurred in 15.2% and a large stone requiring lithotripsy in 9.8%. Repeat ERCP was deemed successful by the operator in 65.2% of cases. 40.2% went on to subsequent ERCP attempts. 31.1% of patients having a second or subsequent ERCP ended up having surgery (open biliary exploration, biliary bypass and other operations). On logistic regression, a primary diagnosis of gallstones was associated with likelihood of endoscopic success (OR (95% CI): 3.8 (1.2 to 12.3, p=0.027). In those patients with a primary diagnosis of gallstones, younger patients (OR 1.07 (1.01 to 1.12, p=0.012)) and those with sepsis at presentation (OR 5.3 (1.1 to 25.2, p=0.038)) were significantly more likely to require surgery. No other pattern was predictive of subsequent ERCP success after a first attempt. <h3>Conclusion</h3> From this analysis, there are no unequivocal clinical or technical factors which make either ERCP or surgery preferable following an incomplete first ERCP. Repeat ERCP should be considered in gallstone disease. In gallstone disease, younger or septic patients should be considered for early surgery if a first ERCP is not successful. This decision is not straightforward; multidisciplinary teamwork and communication between surgeon and endoscopist are essential. <h3>Competing interests</h3> None declared.
Dermal Mast Cells Determine Susceptibility to Ultraviolet B–induced Systemic Suppression of Contact Hypersensitivity Responses in Mice
Authors: Prue H. Hart, Michele A. Grimbaldeston, Georgina J. Swift, Aleksandra Jaksic, Frances P. Noonan, John J. Finlay-Jones
Journal: The Journal of Experimental Medicine (1998)

Different strains of mice have varying susceptibilities to ultraviolet radiation (UV) of wavelength 280–320 nm (UVB) for 50% suppression of systemic contact hypersensitivity (CHS) responses. Prevalence of histamine-staining dermal mast cells in different strains of mice (C57BL/ 6J, DBA/2, BALB/c) correlated directly with their susceptibility to UVB-induced systemic immunosuppression. BALB/c mice carrying Uvs1, a major locus for susceptibility to UV-induced immunosuppression, contained greater numbers of dermal mast cells than BALB/c mice of the same parental origin. Strains of mice that were differentiated on their susceptibility to UVB-induced downregulation of systemic CHS responses were similar in their susceptibility to histamine-induced immunomodulation. Histamine, but not UVB irradiation, decreased systemic CHS responses in mast cell–depleted mice (W f/W f). Reconstitution of the dorsal skin of W f/W f mice with bone marrow–derived mast cell precursors from nonmutant mice rendered the mice susceptible to UVB irradiation for systemic suppression of CHS responses. UVB irradiation did not suppress delayed type hypersensitivity responses to allogeneic spleen cells in W f/W f mice. In contrast, UV irradiation suppressed CHS responses in W f/W f mice when hapten was applied to the irradiated site. This study demonstrates that dermal mast cells are necessary for the induction of systemic suppression of CHS responses by UVB radiation, and suggests that mast cell– derived histamine is one component of this UVB-induced systemic immunosuppression.
Paroxysmal anal hyperkinesis: a characteristic feature of proctalgia fugax.
Authors: S S Rao, R A Hatfield
Journal: Gut (1996)

Proctalgia fugax is a common problem, yet its pathophysiology is poorly understood. The objective was to characterise colorectal disturbances in a paraplegic patient with a 10 year history of proctalgia fugax that began two years after an attack of transverse myelitis.Standard anorectal manometry and prolonged 33 hour ambulatory colonic manometry at six sites in the colon were performed together with myoelectrical recording of the anus. Provocative tests designed to simulate psychological and physical stress and two types of meals were included.Anorectal manometry showed normal internal sphincter tone and normal rectoanal inhibitory reflex but an inability to squeeze or to bear down or to expel a simulated stool. Rectal sensation (up to 360 ml inflation) was absent. Pudendal nerve latency was prolonged (4.5 ms (normal < 2.2 ms). During colonic manometry, the patient reported 27 episodes of pain, of which 23 (85%) were associated with bursts (1-60 min) of a high amplitude (0.5 to > 3.2 mv), high frequency (5-50/min) anal myoelectrical activity, particularly after stress tests, meals, and at night. The myoelectrical disturbance only occurred with proctalgia. Intermittently, 16 bursts of 3 cycles/ min phasic rectal contractions were seen, but only six were associated with proctalgia. Colonic motility was reduced compared with normal subjects.The temporal association between a high amplitude, high frequency myoelectrical activity of the anal sphincter, and the occurrence of proctalgia suggests that paroxysmal hyperkinesis of the anus may cause proctalgia fugax.
Hospital Care for Patients With Strokes in the Acute Stage
Authors: Charles M. Wylie
Journal: JAMA (1965)

The annual incidence of acute cerebrovascular accidents (CVA) in which the patients require hospital care probably ranges between 1.5 and 2.5 per 1,000 population in most parts of North America. The length of stay also rises with advancing age, and is likely to average 15 to 30 days in most areas. Between 20% and 40% of patients are dead on discharge; this proportion has fallen in recent years. The hospital charge per CVA-patient-day, a charge which falls with age, may average 85% to 95% of the daily charge for all hospital patients. However, the charge per hospital stay of CVA patients is considerably greater than average, and is particularly high for those aged 65 and older. For CVAs in future years, hospital admission rates and patient-day costs may rise more than average, and more patients will survive into the long-term phase.
Diagnostic dilemma in an elderly woman
Authors: F. Khan, M. Curtice
Journal: BMJ (2011)

A woman in her 70s with basic school education first presented to the mental health centre with an obsession with her pillows—she used to compulsively straighten creases in pillow covers. A diagnosis of obsessive-compulsive disorder was made. 

Within a few months her obsessive symptoms had changed to psychotic symptoms with delusional intensity. Amisulpride was prescribed for a few months with some benefit. Less than a year after her original presentation her husband reported that she was displaying some odd behaviour: she often stood or sat in a place and stared at the walls or anything in the surrounding area in a “trance like state” for minutes at a time, which professionals suspected were absence seizures.

Electroencephalography showed abnormal focal paroxysmal beta rhythmic activity, from the left temporal region initially but later also independently from the right side. Her score on the mini-mental state examination was 22/30, and computed tomography of her head revealed cerebral atrophy more prominent than would be expected for a patient of her age. Magnetic resonance imaging of her head showed fronto-parietal vascular changes and focal bi-temporal atrophy. 

The patient’s condition deteriorated, and her cognitive decline became obvious. She had problems with recent memory, difficulty finding words, made up new words, and was disorientated in time, place, and person. She also exhibited a gross decline in comparison with her premorbid personality. She was admitted to hospital on the basis of these symptoms.



### 1 What is the most likely diagnosis and the differential diagnoses?

#### Short answer

The main diagnosis is mixed vascular and Alzheimer’s dementia. Differential diagnoses should include subcortical vascular dementia, complex partial seizures, dementia …
CASE OF TYPHOID IN AN INFANT.
Authors: MINNIE C. T. LOVE
Journal: JAMA (1900)

The only notable thing in this case is the age of the patient. She was born March 8, 1900, so that she was 8 months old at the time of contracting the fever. When I began taking her temperature, regularly, I found it ranging between 102.5 and 103 in the mornings, and 103.5 and 104 in the afternoons. I was attending an older brother who had scarlet fever, and the mother called my attention to the baby, saying that she had had considerable fever of nights for over a week. On examination, I found rose spots on the trunk, and a dry, brown tongue. Although the clinical picture was so plain, I was skeptical, and asked Dr. J. N. Hall to see the patient with me. He was of the opinion that it was an undoubted typhoid, and the examination of the blood by Dr. Wilder, for the Widal test,
Failure to Diagnose Acute Myocardial Infarction
Authors: David H. Spodick
Journal: JAMA (1984)

<h3>To the Editor.—</h3> In "Failure to Diagnose Acute Myocardial Infarction," Zarling and colleagues presented an instructive experience. While I have little doubt about the facts and the objectivity of the individual numbers reported, I am mildly disturbed about the design of the report. In the introduction they state, "In the usual environment of clinical practice... the diagnosis of acute myocardial infarction... often is not made promptly or indeed before death." This implies that they already had access to the autopsy findings, although this conclusion is first ascribed to "casual observation." More importantly, the percentages given are quite unrealistic when comparing their groups. One hundred percent diagnostic accuracy in class I for noncardiological medical subspecialists actually represents only two of two cases, and a figure of 33% represents one of three cases. To express these as percents is unrealistic. Indeed, only nine cases each were seen by the subspecialists and by
Compulsiveness in Physicians
Authors: A. C. Worden
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Dr Gabbard<sup>1</sup>has written about the role of compulsiveness in the normal physician. Is it not hypocritical (not to mention supercilious) to spell out so disagreeable a picture of the trait of "compulsiveness," yet admit that "we would all probably choose a compulsive physician if we were seriously ill"? You can bet your bottom dollar that when I need my common duct explored I am going to hunt up the most exquisitely "compulsive" surgeon I can possibly find! Could it not be that because almost 100% of physicians have this trait, the author's views of its desirability should be reexamined?
Case of Scirrhus of the Optic Thalamus and Corpus Striatum
Authors: J. Waters
Journal: BMJ (1841)

ance which it offers, compared to the sharp-pointed in- strument, gives a better indication of its having entered tlhe cavity of the bladder, and is less liable to injure its coats.I may also maake a few remarks upon the difficuilties -vhich present themselves in the seizing anid removing the stone, whiclh may arise from the size, form, position, and consistence of the caleulus, and the condition of the bladder itself-circumstances, lhowever, of suich practical import- azice, that I shall occupy another lecture uipoii the subject of lithotomy, especially with regard to the various difficul- ties wlhlich may embarrass the operator.CASE OF SCIRRHUS OF TIHE OPTIC THALAMUS AND CORPUS STRIATUM.
Reducing Opioid Abuse and Diversion—Reply
Authors: Nora D. Volkow, Thomas A. McLellan
Journal: JAMA (2011)

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
Hepatobiliary Imaging for Demonstration of Bile Leaks
Authors: RICHARD S. ROZRAN, DAVID F. PRESTON, JOHN H. McMILLAN
Journal: Clinical Nuclear Medicine (1984)

Three cases are presented in which hepatobiliary scans demonstrated extent and course of active bile extravasation. Correlation with computed tomography is demonstrated. The results of the examinations significantly influenced the direction of clinical care of all three patients. Hepatobiliary scanning is suggested for early evaluation of postoperative and post-traumatic complications involving the biliary system.
Transcription factor EBF1 is essential for the maintenance of B cell identity and prevention of alternative fates in committed cells
Authors: Robert Nechanitzky, Duygu Akbas, Stefanie Scherer, Ildiko Györy, Thomas Hoyler, Senthilkumar Ramamoorthy, Andreas Diefenbach, Rudolf Grosschedl
Journal: Nature Immunology (2013)
Voices of the ICU
Authors: Phillip J. Cozzi
Journal: Annals of Internal Medicine (1997)

Ad Libitum1 February 1997Voices of the ICUPhillip J. Cozzi, MDPhillip J. Cozzi, MDElmhurst, IL 60126Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-3-199702010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail You were bruised and I ... Author, Article, and Disclosure InformationAffiliations: Elmhurst, IL 60126Corresponding Author: Phillip J. Cozzi, MD, 447 Cottage Hill, Elmhurst, IL 60126. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1997Volume 126, Issue 3Page: 248-249KeywordsForecastingHeartIntensive care units ePublished: 15 August 2000 Issue Published: 1 February 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A Tick-Borne Epidemic of Tularemia
Authors: Willard B. Warring, J. Sterling Ruffin
Journal: New England Journal of Medicine (1946)

BECAUSE tularemia has been generally regarded as a relatively infrequent disease, and because emphasis has been placed on its transmission by contact with animals, especially rabbits, an epidemic of 50 cases most of which were caused by tick bites is reported. These cases occurred among soldiers in the Tennessee maneuver area from March to December, 1943. Grouped according to the Hughes1 classification of tularemia, these cases were divided as follows: ulceroglandular type, 35 cases; pulmonic type, 11 cases; glandular type, 3 cases; mixed ulceroglandular and pulmonic type, 1 case. All patients but 1 recovered.Tularemia has been reported in every . . .
Patient-Centered Operating Room Briefings to Improve Surgical Quality
Authors: Kevin Koo
Journal: JAMA Surgery (2014)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
The Toxicity and Dose of Desipramine Hydrochloride-Reply
Authors: J. John Mann
Journal: JAMA (1994)

In Reply.  —Drs Amitai and Frischer agree with our report that desipramine is more lethal on overdose than other tricyclics. Amitai et al1found that the in vitro RBC/plasma ratio of desipramine (1.60) was no different from nortriptyline (1.57) or nordoxepin (1.62); parent compounds had lower ratios (eg, 0.73 for imipramine and 0.45 for amitriptyline). In vivo, their results1in cases of drug overdose are consistent and suggest that the parent compound washes out of RBCs and plasma faster than the desmethyl metabolite, and that the parent compound, more so than the metabolite, is found in higher concentrations in the plasma than the RBCs. However, the presence of coma was unrelated to plasma or RBC concentrations of parent drug or metabolite. The duration of the QRS interval correlated with RBC and plasma levels of metabolite, but not parent compound. Therefore, these results do not demonstrate that the RBC/plasma
Medical Students in the Philippines
Authors: Jose Cuyegkeng
Journal: JAMA (1965)

<h3>To the Editor:—</h3> Dr. Bowers' communication is indeed very timely and informative. We in the Philippines are indeed grateful for the time and effort that Dr. Bowers spent in collecting and putting together quite accurately the various facets which mold the Filipino medical student. I would like, however, to take this opportunity to update your readers, in the briefest possible manner, on recent developments in medical education in the Philippines. There are presently seven medical schools, five of which are in and around Manila and two in the city of Cebu in one of the islands south of Luzon. Of these seven medical schools, only one is tax-supported; one is administered by a religious corporation; one is private and organized on a nonstock and not-for-profit basis; and four are private and organized on a stock corporation basis. Under the joint efforts of the Council of Deans of Philippine Medical Schools