tbuckley/cabot-search huggingface dataset:
Glucocorticoids induce transcription and expression of the alpha 1B adrenergic receptor gene in DTT1 MF-2 smooth muscle cells.
Authors: M Sakaue, B B Hoffman
Journal: Journal of Clinical Investigation (1991)

Steroid hormones modulate physiological processes by a number of mechanisms including regulation of gene expression. We wondered if glucocorticoids might induce expression of alpha 1 adrenergic receptors, which could contribute to the increased sensitivity of vascular smooth muscle to catecholamines that may occur with glucocorticoid excess. We examined the effects of dexamethasone on the expression of the alpha 1B adrenergic receptor gene in DDT1 MF-2 smooth muscle cells. Dexamethasone (10(-6) M) produced a 1.8 +/- 0.2-fold increase in expression of alpha 1B receptors determined with [3H]prazosin. Steady-state values of alpha 1B adrenergic receptor mRNA, analyzed by Northern blotting, increased 2.8 +/- 0.7-fold after 48 h exposure to dexamethasone. This effect of dexamethasone occurred in the presence of the protein synthesis inhibitor cycloheximide. alpha 1B receptor mRNA abundance was also increased by testosterone and aldosterone, whereas beta estradiol and progesterone had no effect. The alpha 1B receptor gene transcription rate, determined in nuclear run-off assays, increased 2.6 +/- 0.6-fold in cells treated with dexamethasone for 24 h. The half-life of the alpha 1B receptor mRNA was unchanged by dexamethasone. These data indicate that glucocorticoids regulate expression of alpha 1B receptors by increasing the rate of transcription of this gene.
Allergy to Fluoride
Authors: George E. Shambaugh
Journal: JAMA (1972)

<h3>To the Editor.—</h3> Commenting on the question of allergy to fluoride, I have utilized fairly large doses, from 40 to 120 mg daily, for patients with active spongification of the cochlear capsule to promote recalcification. A total of 1,500 patients have been treated to date for periods of six months and up to four years. Any untoward reactions or symptoms are reported and recorded. In only three cases to date has there occurred a typical drug rash which cleared when the medication was stopped, and recurred when it was resumed. Since allergic reactions can occur with minute amounts of allergen, it is, of course, possible that similar reactions<i>could</i>occur with very small amounts of fluoride. If so, we should expect patients in high-fluoride areas to develop sensitivity, and as far as I know, this does not occur. Even though allergy to fluoride<i>can</i>occur, it is rare, and as
Interventions to Reduce 30-Day Rehospitalization: A Systematic Review
Authors: Luke O. Hansen, Robert S. Young, Keiki Hinami, Alicia Leung, Mark V. Williams
Journal: Annals of Internal Medicine (2011)

Background: About 1 in 5 Medicare fee-for-service patients discharged from the hospital is rehospitalized within 30 days. Beginning in 2013, hospitals with high risk-standardized readmission rates will be subject to a Medicare reimbursement penalty. Purpose: To describe interventions evaluated in studies aimed at reducing rehospitalization within 30 days of discharge. Data Sources: MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched for reports published between January 1975 and January 2011. Study Selection: English-language randomized, controlled trials; cohort studies; or noncontrolled before–after studies of interventions to reduce rehospitalization that reported rehospitalization rates within 30 days. Data Extraction: 2 reviewers independently identified candidate articles from the results of the initial search on the basis of title and abstract. Two 2-physician reviewer teams reviewed the full text of candidate articles to identify interventions and assess study quality. Data Synthesis: 43 articles were identified, and a taxonomy was developed to categorize interventions into 3 domains that encompassed 12 distinct activities. Predischarge interventions included patient education, medication reconciliation, discharge planning, and scheduling of a follow-up appointment before discharge. Postdischarge interventions included follow-up telephone calls, patient-activated hotlines, timely communication with ambulatory providers, timely ambulatory provider follow-up, and postdischarge home visits. Bridging interventions included transition coaches, physician continuity across the inpatient and outpatient setting, and patient-centered discharge instruction. Limitations: Inadequate description of individual studies' interventions precluded meta-analysis of effects. Many studies identified in the review were single-institution assessments of quality improvement activities rather than those with experimental designs. Several common interventions have not been studied outside of multicomponent "discharge bundles." Conclusion: No single intervention implemented alone was regularly associated with reduced risk for 30-day rehospitalization. Primary Funding Source: None.
505 The influence of cumulative exposure to combination peginterferon alfa-2A (40 KD) (Pegasys) and ribavirin on sustained virological response (SVR) rates in patients with genotype 1 chronic hepatitis C
Authors: K.R. Reddy, M.W. Fried, M.L. Shiffman, S.J. Hadziyannis, H. Sette, T.R. Morgan, S. Schaefer, M. Popescu
Journal: Journal of Hepatology (2004)
Is Anti-TNF Therapy Safer Than Previously Thought?
Authors: Will Dixon, David T. Felson
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
Semiquantitative Analysis of Brain Metabolism in Patients With Paraneoplastic Neurologic Syndromes
Authors: Allison J. Clapp, Christopher H. Hunt, Geoffrey B. Johnson, Patrick J. Peller
Journal: Clinical Nuclear Medicine (2013)

The objective of this study was to evaluate brain metabolism with F-FDG-PET in patients with definite or possible paraneoplastic neurologic syndromes (PNS) using qualitative assessment and semiquantitative measurements with subsequent correlation with MRI.The institutional review board approved this Health Insurance Portability and Accountability Act-compliant study. A prospective PET database of patients referred for PNS between 2001 and 2010 was queried retrospectively and identified 102 patients who met the diagnostic criteria for PNS, had PET brain imaging, and lacked clinical or MRI evidence of an alternative diagnosis.Qualitative and semiquantitative evaluation of brain metabolism was obtained by 3-dimensional stereotactic surface projection and region-based analysis. Qualitative and semiquantitative assessment was performed blinded to clinical data.PET/CT demonstrated that 67 patients had abnormal brain glucose metabolism. Six categories of brain hypometabolism were identified: diffuse (36/67), cerebellar (10/67), basal ganglia (10/67), frontal (9/67), temporal (1/67), and occipital (1/67). The mean Z score of the cerebral cortex in diffuse hypometabolism was 1.65 (range, 0.25-3.46). For cerebellar hypometabolism, the mean Z score of the cerebellum was 2.31 (range, 0.52-4.54). In basal ganglia hypometabolism, the mean Z score was 2.53 (range, 1.78-3.89), and in frontal lobe hypometabolism, the mean Z score was 2.11 (range, 1.39-4.45). The majority (39/67, 62.9%) with abnormal glucose metabolism on PET had a normal MR.Patients with PNS frequently have abnormal brain metabolism on semiquantitative PET/CT. With semiquantitative analysis, we defined 6 common patterns of abnormalities, which often correlated with clinical symptoms. Both qualitative and semiquantitative analyses of brain glucose metabolism may be helpful in evaluating PNS, especially in patients with a normal MRI.
Elevated CK-MB Levels in Marathon Runners
Authors: Majid Ali
Journal: JAMA (1982)

To the Editor.—  Siegel et al have demonstrated marked elevations of serum levels of creatine kinase MB (CK-MB) isoenzyme (up to 21 times the upper limit of normal) in marathon runners during the postrace period (1981;246:2049). They believed that the source of this isoenzyme in their subjects was skeletal muscle injury. Largely on the basis of negative technetium Tc 99m pyprophosphate scintigrams, they concluded that serum CK-MB in these runners does not arise from a myocardial source.  While skeletal rhabdomyolysis does appear to be the principal source of CK-MB, another lesion that should be considered in this setting is ischemic injury to individual myocardial fibers; such injury may cause substantial leakage of CK-MB isoenzyme and may be reversible or irreversible (cardiac myocytolysis). Cardiac myocytolysis may be defined as disintegration of individual myocardial fibers unaccompanied by an inflammatory response. Ischemia resulting in myocytolysis may involve randomly distributed myocardial fibers during a
Points: Telling patients about their medicines
Authors: C W Koenigsberger
Journal: BMJ (1987)

sensitivity to halothane in children with a, anti- trypsin deficiency,3 but they refer to an article in the New England 3rournal of Medicine.4Again, there is no mention of this sensitivity.This is an example ofan error compounded through misread- ing and referencing.The authors present seven cases of suspected halothane hepatitis.In case 7, however, they found no halothane antibody, but they still classified this child as having halothane hepatitis, explaining that it is possible that the antibody was produced but was undetectable.In the case report they state that a 3½/2 year old boy weighed 1800 g.This is an extremely small child.Though halothane hepatitis may occur in children, it is extremely rare, and Dr Kenna and coworkers cannot give the incidence that might be expected in children.In a review article on halothane hepatitis Stock et al concluded that there is no diagnostic test that is specific for halothane induced liver damage and that therefore the diagnosis can be made only by excluding all other causes of postoperative liver dysfunction.5Walton states that non-A, non-B hepatitis may be responsible for halothane hepatitis after a single exposure.6Thus we still cannot define specifically the diagnostic criteria for halothane hepatitis.If it exists it remains extremely rare in children and has an incidence less than that of non-A, non-B hepatitis in the general population.An extensive clinical study of preoperative liver function in asymptomatic children who received halothane and were then followed up for a long period would be needed to provide clearer conclusions.
Chronic myeloid leukemia: mechanisms of blastic transformation
Authors: Danilo Perrotti, Catriona Jamieson, John Goldman, Tomasz Skorski
Journal: Journal of Clinical Investigation (2010)

The BCR-ABL1 oncoprotein transforms pluripotent HSCs and initiates chronic myeloid leukemia (CML). Patients with early phase (also known as chronic phase [CP]) disease usually respond to treatment with ABL tyrosine kinase inhibitors (TKIs), although some patients who respond initially later become resistant. In most patients, TKIs reduce the leukemia cell load substantially, but the cells from which the leukemia cells are derived during CP (so-called leukemia stem cells [LSCs]) are intrinsically insensitive to TKIs and survive long term. LSCs or their progeny can acquire additional genetic and/or epigenetic changes that cause the leukemia to transform from CP to a more advanced phase, which has been subclassified as either accelerated phase or blastic phase disease. The latter responds poorly to treatment and is usually fatal. Here, we discuss what is known about the molecular mechanisms leading to blastic transformation of CML and propose some novel therapeutic approaches.
Effect of sex and gender on psychosocial aspects of prostate and breast cancer
Authors: A. Kiss, S. Meryn
Journal: BMJ (2001)

<h3>Background</h3> The ‘fit note’, with the opportunity for the GP to advise that a patient ‘may be fit’ to do some work, was introduced in April 2010. <h3>Aim</h3> To estimate numbers of fit notes with ‘may be fit’ advice, the types of advice, and factors associated with any inclusion of such advice in the fit note. <h3>Design and setting</h3> Cross-sectional analysis of fit note data from 68 general practices in eight regions of England, Wales and Scotland. <h3>Method</h3> Collection of practice fit note data via GP use of carbonised pads of fit notes for a period of 12 months. <h3>Results</h3> The ‘may be fit’ box was ticked on 5080 fit notes (6.4% of all fit notes in study). But there was a wide variation in completion rates across the 68 practices (from 1% to 15%). The most prevalent individual item of advice was to ‘amend duties’ of patient as a prerequisite for return to work (included in 42% of all notes containing any ‘may be fit’ advice). Advice was often incomplete or irrelevant, with some GPs failing to comply with official guidance. Inclusion of any ‘may be fit’ advice was independently associated with the patient being female, less socially deprived and having a physical health reason for receiving a fit note. <h3>Conclusion</h3> Unlike other studies that have relied upon eliciting opinion, this study investigates how the fit note is being used in practice. Findings provide some evidence that the fit note is not yet being used to the optimum benefit of patients (and their employers).
Outcomes of pediatric bone marrow transplantation for leukemia and myelodysplasia using matched sibling, mismatched related, or matched unrelated donors
Authors: Peter J. Shaw, Fangyu Kan, Kwang Woo Ahn, Stephen R. Spellman, Mahmoud Aljurf, Mouhab Ayas, Michael Burke, Mitchell S. Cairo, Allen R. Chen, Stella M. Davies, Haydar Frangoul, James Gajewski, Robert Peter Gale, Kamar Godder, Gregory A. Hale, Martin B.A. Heemskerk, John Horan, Naynesh Kamani, Kimberly A. Kasow, Ka Wah Chan, Stephanie J. Lee, Wing H. Leung, Victor A. Lewis, David Miklos, Machteld Oudshoorn, Effie W. Petersdorf, Olle Ringdén, Jean Sanders, Kirk R. Schultz, Adriana Seber, Michelle Setterholm, Donna A. Wall, Lolie Yu, Michael A. Pulsipher
Journal: Blood (2010)
Progression of liver fibrosis among injection drug users with chronic hepatitis C
Authors: Lucy E. Wilson, Michael Torbenson, Jacquie Astemborski, Hawazin Faruki, Charles Spoler, Rudra Rai, Shruti Mehta, Gregory D. Kirk, Kenrad Nelson, Nezam Afdhal, David L. Thomas
Journal: Hepatology (2006)

Although most hepatitis C virus (HCV) infections are acquired by injection drug use, prospective data on the progression of liver fibrosis are sparse. Baseline liver biopsies were obtained (1996-1998) on a random sample of 210 out of 1667 HCV-positive injection drug users (IDUs). Subjects were followed biannually, with a second biopsy offered to those eligible. Paired biopsies were scored 0 to 6 (modified Ishak score), significant fibrosis was defined as score 3 or greater, and progression of fibrosis was defined as an increase 2 or more units or clinical evidence of end-stage liver disease. Predictive values of blood markers [FibroSURE, aspartate aminotransferase-to-platelet-ratio index (APRI) and alanine aminotransferase (ALT)] were assessed for detection of contemporaneous and future liver fibrosis. Among 119 prospectively followed IDUs, 96% were African American; 97% HCV genotype 1a/b; 27% HIV-infected, and median age was 42 years. Most (90.7%) did not have significant liver fibrosis at first biopsy. Although predictive value for detecting insignificant fibrosis at first biopsy was greater than 95% for FibroSURE, APRI, and ALT, specificities were 88.9%, 72.7%, and 72.7%, respectively. After 4.2 years median follow-up, 21% had progression of fibrosis, which was significantly associated with serum level of HCV RNA and ALT. No serological test had predictive value greater than 40% for contemporaneous or future significant fibrosis. Even initial biopsy result had only a 30.4% value for predicting future significant fibrosis. In conclusion, significant liver fibrosis and progression were detected in some, but not most, IDUs in this cohort. In this setting with low fibrosis prevalence, FibroSURE, ALT, and APRI tests predict insignificant fibrosis; however, further work is needed to find noninvasive markers of significant liver fibrosis.
Queuing in Canada
Authors: Thomas J. Berger
Journal: JAMA (1992)

<h3>To the Editor.</h3> —A recent Special Communication<sup>1</sup>discussed the referral of coronary bypass patients to Seattle, Wash, due to treatment delays of up to 10 months, and more than a dozen deaths among Canadians waiting for surgery. Rather than recognize this as a symptom of the failure of socialized medicine, the authors chose to obfuscate the issue with soothing sophistries. Perhaps it is significant that none of these authors are cardiac surgeons. Our own federal bureaucracy is now on the verge of destroying our current health care provision system in favor of a similar socialized medicine model. The American people will be doomed to suffer this catastrophe if we lack the courage to recognize the failures of such a system even when they become patently obvious. Where will we send our backlog of dying patients suffering from angina as they wait for some bureaucrat to direct them to the
Identification of an autologous insulin B chain peptide as a target antigen for H-2Kb-restricted cytotoxic T lymphocytes.
Authors: J M Sheil, S E Shepherd, G F Klimo, Y Paterson
Journal: The Journal of Experimental Medicine (1992)

We have examined the CD8+ peripheral T cell repertoire of C57BL/6 (H-2b) mice for cytotoxic T lymphocyte (CTL) reactivities to insulin, using in vitro immunization with a chymotryptic digest of reduced bovine insulin. The results presented in this study demonstrate that potentially autoreactive H-2Kb-restricted cytotoxic T cells specific for an autologous insulin B chain peptide are present in the preimmune splenic T cell repertoire. The immunogenic peptide comprises residues 7-15 from the insulin B chain and has features in common with naturally processed Kb-restricted peptides identified by others. The minimal peptide sequence recognized by these cytotoxic T cells is 10-15, which is highly conserved in mammalian species and constitutes a self-peptide in mice. The presence of class I major histocompatibility complex-restricted CTLs with potentially autoreactive specificities in preimmune animals raises the possibility of a role for such cells in autoimmune disease states. Possible mechanisms for the in vivo expansion of insulin peptide-specific CTLs are discussed.
Non-randomised studies cannot be ignored
Authors: J G Thornton, R J Lilford
Journal: BMJ (1994)

EDITOR, - T H Bloomfield's and John F Stratton's analogy to cars, while colourful, is poor. Try ours. Imagine a successful motor racing team that claims to improve its cars' performance with a package of special fuel, oil, and tyres but also has expert drivers. Let us pretend that trials of all three components combined are impossible. Nevertheless, when other teams perform trials of the special fuel and oil separately and of both fuel and oil combined they show no clear benefits, …
Spontaneous acceptance of rat liver allografts is associated with an early downregulation of intragraft interleukin-4 messenger RNA expression
Authors: Oliver Farges, Peter J. Morris, Margaret J. Dallman
Journal: Hepatology (1995)

Liver allografts are not rejected in the fully incompatible Lewis-RT11 (LEW) to blood group D Agouti-RT1a (DA) rat strain combination despite an early infiltration by recipient mononucleated cells that initially display a phenotype, an ability to respond to interleukin-2 (IL-2) and donor-specific cytotoxicity indistinguishable from that observed in the rejected, DA to LEW combination. To further analyze the mechanism of this tolerance, we have compared in these two combinations, as well as in syngeneic grafts and in normal livers, the presence of intrahepatic cytokine transcripts (IL-1α, IL-2, IL-4, IL-6, IL-10, tumor necrosis factor [TNF]-α, TNF-β, and transforming growth factor [TGF]-β) by a semiquantitative polymerase chain reaction (PCR) or by northern-blotting. In normal livers or syngeneic grafts, IL-1α, TNF-β, and TGF-β were the only cytokines detected by these methods. The levels of all cytokine transcripts were increased in allogeneic grafts. Expression of cytokine transcripts was very similar in the two allogeneic strain combinations except IL-4, which was expressed at a much lower level in the nonrejected strain than in the rejected strain from day 2 onward. We conclude that selective downregulation of IL-4 gene expression is associated with, and a potential mediator of, the induction of tolernce in this model.
Diagnosis of Diffuse Myocardial Fibrosis
Authors: C. SIDNEY BURWELL, EUGENE D. ROBIN
Journal: Circulation (1959)

Diffuse myocardial fibrosis is a disease of diverse etiology; the commonest cause is coronary artery disease. Physiologically, it produces a restriction of diastolic filling and thus resembles constrictive pericarditis and endocardial fibroelastosis. Clinically, it resembles constrictive pericarditis so closely that in many patients the differential diagnosis between these 2 disorders can be resolved only by thoracotomy and direct observation of the pericardium.
Kidney-lung Relationship
Authors: J. Sophian
Journal: BMJ (1970)

Peritoneal Dialysis in Pulmonary Oedema SIR,-The paper by Dr. M. P. Chopra and colleagues (11 July, p. 77) suggests the use of peritoneal dialysis for the treatment of pulmonary oedema after acute myocardial infarction.I would like to make the follow- ing comments.The authors do not mention whether their patients were given salt-free diets.Myocardial infarction may be followed by intense sodium retention which results in rapid gain of body weight unless sodium intake is restricted.(Dr.Chopra and colleagues do not mention what happened to body weight.)If the patients were allowed to go into positive sodium balance it is hardly surprising that diuretics were ineffec- tive.The maximum doses of frusemide given (80 mg. in one case, 120 mg. in another, and 200 mg. in the other two) were quite small.Why were not higher doses of frusemide given?The authors do not mention whether the patients were kept in the sitting position in a cardiac bed.It would be unfortunate to subject patients with pulmonary oedema after myocardial infarction to peritoneal dialysis when the simpler methods of gravity, salt restriction, and high dose frusemide have not been used first.-Iam, etc.,