tbuckley/cabot-search huggingface dataset:
Climate Change and Infectious Disease: Is the Future Here?
Authors: Catherine M. Cooney
Journal: Environmental Health Perspectives (2011)

A fter kayaking on Vancouver Island's eastern shore, a 45-year-old woman's headaches and night sweats were little indication that she had been exposed to a rare and dangerous fungus while on the water.Her doctors, mystified as to the cause of the symptoms, didn't recognize that the infection was Cryptococcus gattii-a species of pathogenic yeast-until shortly before her death in 2002. 1 Most cases of C. gattii have been reported in the warmer climates of Australia, Asia, Africa, and Southern California.But at least two strains of the fungus are now affecting humans, pets, and wild animals in the U.S. Pacific Northwest. 2 From January 2004 through July 2010, a total of 15 people died from C. gattii infection, according to the Centers for Disease Control and Prevention (CDC), and 60 human cases of the illness were reported in Oregon, Washington, California, and Idaho. 3Despite the alarming sound of the disease, public health officials in Oregon have urged residents not to consider the spread of C. gattii as a health emergency-although the fungus is present in the wild, few people have become seriously ill with this infection, and even fewer have died, says Oregon state epidemiologist Katrina Hedberg.Nevertheless, the mere presence of this foreign species so far from its home raises questions.Reports suggest the fungus may have been exported from its native habitat on commercially valuable trees such as eucalyptus and ornamental Ficus species. 4"We don't know exactly why the [Pacific Northwest] outbreak emerged," says Edmond Byrnes, a postdoctoral fellow at the Johns Hopkins University School of Medicine who has studied the fungus. 5"One of the more current hypotheses is that climate change is one of the factors that should be considered."Byrnes explains that C. gattii may be able to establish itself in the Pacific Northwest region because of milder winters with daily average temperatures above freezing.C. gattii is one of several pathogens whose spread is hypothesized to be linked to climate change.Like many aspects of climate change, the connection with infectious disease involves controversy.Some
Protective effect of drugs on bronchoconstriction induced by sulphur dioxide.
Authors: W C Tan, E Cripps, N Douglas, M F Sudlow
Journal: Thorax (1982)

The response to inhaled sulphur dioxide in eight normal, seven atopic, and 22 asthmatic subjects was studied by measuring thoracic gas volume and airway resistance in a whole-body plethysmograph. The fall in specific airway conductance in relation to the concentration of sulphur dioxide inhaled (0-20 ppm) was determined in all three groups. The specific airway conductance fell significantly in the atopic and asthmatic subjects but not in the normal group. In a double-blind study prior inhalation of disodium cromoglycate caused a significant reduction in the response to sulphur dioxide inhalation in atopic and asthmatic subjects. Prior treatment with inhaled ipratropium bromide blocked the response in the atopic subjects, but the effect was variable in the patients with asthma. Previous treatment with inhaled clemastine also reduced the response in patients with asthma, without causing a change in baseline specific conductance. We conclude that non-allergic bronchial hyperreactivity was increased in the atopic and the asthmatic subjects and that mediator release, in addition to a vagal reflex, has a role in such bronchoconstriction.
Quantitation and typing of serum hepatitis C virus RNA in patients with chronic hepatitis C treated with interferon-β
Authors: Yoshinao Kobayashi, Shozo Watanabe, Masayoshi Konishi, Masato Yokoi, Ryuichi Kakehashi, Masahiko Kaito, Masahiro Kondo, Yuji Hayashi, Takahito Jomori, Shiro Suzuki
Journal: Hepatology (1993)

We quantified serum hepatitis C virus RNA titers and determined hepatitis C virus subtypes in chronic hepatitis C patients treated with interferon-beta to investigate relationships among serum ALT response, serum hepatitis C virus titer and hepatitis C virus subtype. Of 146 chronic hepatitis C patients who received interferon-beta therapy, 24 patients with sustained serum ALT normalization (complete responders) and 26 patients without serum ALT normalization (nonresponders) were randomly selected. Detection, typing and quantitation of hepatitis C virus were performed by means of the "single-tube" polymerase chain reaction method. Of the 24 complete responders, 21 (87.5%) became negative for hepatitis C virus RNA, whereas 21 (80.8%) of the 26 nonresponders remained positive. Hepatitis C virus infections with types I, II, III, IV, II + III and III + IV occurred in 0 (0%), 22 (51.2%), 10 (23.3%), 1 (2.3%), 7 (16.5%) and 3 (7.9%) patients, respectively. The mean pretreatment hepatitis C virus RNA titer of complete responders (0.4 +/- 2.0 x 10(4) CID50/ml) was significantly lower than that of nonresponders (3.8 +/- 4.5 x 10(4) CID50/ml) (p < 0.01). Regardless of HCV subtype, patients with more than 10(4) CID50/ml of HCV did not show serum ALT normalization, whereas complete serum ALT response was seen in most cases with less than 10(2) CID50/ml HCV. These results show that mixed infections with different hepatitis C virus subtypes appear to be more common than previously reported and that the pretreatment serum level of hepatitis C virus RNA is a more important predictor of outcome of interferon therapy than is virus genotype.
Coarctation of the Aorta
Authors: Robert E. Gross, Charles A. Hufnagel
Journal: New England Journal of Medicine (1945)

COARCTATION of the aorta is an unusual abnormality, but is found with sufficient frequency and is accompanied by severe enough complications to warrant a search for technical methods leading to its surgical correction in selected cases. Many persons with this disease have a reasonably long life and suffer relatively little incapacitation. A high degree of obstruction — or a complete block — in this arterial pathway carries a distinct hazard, however, because of the possibility of certain complications. In the first place, aneurysmal dilatation of the aorta may arise above or below the constricted zone. Secondly, a dissecting aneurysm may . . .
Weakness, Fatigue, and an Abnormal White Blood Cell Count
Authors: Ramzi Abboud, Ronald Sham
Journal: JAMA (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 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
ADDENBROOKE'S HOSPITAL, CAMBRIDGE. EXCISION OF THE CONDYLE OF THE LOWER JAW
Authors: G. M. Humphry
Journal: BMJ (1856)

CASE.A healthy young woman, aged 21 years, with dark hair and florid complexion, was admitted as an out-patient in January 1854, on account of a peculiar distortion of the face.The chinwas thrust to the left side frther than would, under natural circumstances, be practicable.This was caused by displacement of the lower jaw, the left median incisor tooth being opposite to, or a little beyoad, the lateral incisor of the upper jaw, and the whole lower alveolar arch, with its teeth, being, in a proportionate degree, lateralised.Moreover, the jaw was placed obliquely; the right ramus and angle being on a plane lower than the left.When she endeavoured to rectify the position, the chin and left ramus were advanced forward, so that the cor-
When is it futile for ambulance personnel to initiate cardiopulmonary resuscitation?
Authors: A. K Marsden, G A. Ng, K. Dalziel, S. M Cobbe
Journal: BMJ (1995)

Abstract <b>Objective</b>: To determine whether patients with unexpected prehospital cardiac arrest could be identified in whom ambulance resuscitation attempts would be futile. <b>Design</b>: Review of ambulance and hospital records; detailed review of automated external defibrillator rhythm strips of patients in whom no shock was advised. <b>Setting</b>: Scottish Ambulance Service; all cardiopulmonary resuscitation attempts after cardiorespiratory arrest during 1988-94 included in the Heartstart Scotland database. <b>Subjects</b>: 414 cardiorespiratory arrest patients with no pulse or breathing on arrival of ambulance personnel, no bystander cardiopulmonary resuscitation performed, and more than 15 minutes from time of arrest to arrival of ambulance. Patients were stratified into those with "shockable" and "non-shockable" rhythms. <b>Main outcome measures</b>: Return of spontaneous circulation, or survival to reach hospital alive, or survival to discharge, or all three. <b>Results</b>: No patient with a non-shockable rhythm who met the entry criteria for analysis survived a resuscitation attempt. Review of the defibrillator rhythm strips of these patients failed to find any case in which the tracing was deemed compatible with survival. <b>Conclusions</b>: On the basis that it would be inappropriate to initiate vigorous resuscitation in patients who can be identified as "dead" and beyond help an algorithm was prepared to guide ambulance personnel.
Heterogeneity in Phenotype of Usher-Congenital Hyperinsulinism Syndrome
Authors: Angham N. Al Mutair, Klaus Brusgaard, Bassam Bin-Abbas, Khalid Hussain, Naila Felimban, Adnan Al Shaikh, Henrik T. Christesen
Journal: Diabetes Care (2012)

To evaluate the phenotype of 15 children with congenital hyperinsulinism (CHI) and profound hearing loss, known as Homozygous 11p15-p14 Deletion syndrome (MIM #606528). Prospective clinical follow-up and genetic analysis by direct sequencing, multiplex ligation-dependent probe amplification, and microsatellite markers. Genetic testing identified the previous described homozygous deletion in 11p15, USH1C:c.(90+592)_ABCC8:c.(2694-528)del. Fourteen patients had severe CHI demanding near-total pancreatectomy. In one patient with mild, transient neonatal hypoglycemia and nonautoimmune diabetes at age 11 years, no additional mutations were found in HNF1A, HNF4A, GCK, INS, and INSR. Retinitis pigmentosa was found in two patients aged 9 and 13 years. No patients had enteropathy or renal tubular defects. Neuromotor development ranged from normal to severe delay with epilepsy. The phenotype of Homozygous 11p15-p14 Deletion syndrome, or Usher-CHI syndrome, includes any severity of neonatal-onset CHI and severe, sensorineural hearing loss. Retinitis pigmentosa and nonautoimmune diabetes may occur in adolescence.
Coronary Artery Injury Due to Catheter Ablation in Adults
Authors: Kurt C. Roberts-Thomson, Daniel Steven, Jens Seiler, Keiichi Inada, Bruce A. Koplan, Usha B. Tedrow, Laurence M. Epstein, William G. Stevenson
Journal: Circulation (2009)

Currently, only anecdotal information exists on the presentation and outcome of coronary arterial injury after ablation procedures.Four patients who sustained coronary artery injury of a cohort of patients undergoing 4655 consecutive ablation procedures (0.09%) are described. The patients' mean age was 45+/-11 years, and 1.8+/-0.5 prior ablation attempts had been unsuccessful. Coronary injury occurred from epicardial ventricular tachycardia ablation in 2 patients (irrigated radiofrequency ablation in one and cryoablation in the other) and ablation within the middle cardiac vein with irrigated radiofrequency in 2 patients. All involved branches of the right coronary artery. Acute occlusion presenting with ST-segment elevation immediately after ablation was recognized during the procedure in 2 cases. Occlusion failed to respond to nitroglycerin or balloon dilation, and stenting was required in both cases. Acute myocardial infarction occurred 2 weeks after epicardial ablation as a result of occlusion of a right ventricular branch of the right coronary artery giving rise to the posterior descending coronary artery in 1 patient. A moderate asymptomatic stenosis was seen on angiography after epicardial cryoablation in 1 patient. All patients recovered and remained asymptomatic from the coronary injury and arrhythmias during 37+/-53 months of follow-up.Coronary arterial injury after ablation procedures is rare. It may present acutely or several weeks after an ablation procedure. Acute occlusion appears to require coronary stenting. Unanticipated anatomic variations can predispose to coronary injury.
Thrombelastographic changes and early rebleeding in cirrhotic patients with variceal bleeding
Authors: T N Chau, Y W Chan, D Patch, S Tokunaga, L Greenslade, A K Burroughs
Journal: Gut (1998)

Routine coagulation tests do not necessarily reflect haemostasis in vivo in cirrhotic patients, particularly those who have bleeding varices. Thrombelastography (TEG) can provide a global assessment of haemostatic function from initial clot formation to clot dissolution.To evaluate TEG changes in cirrhotic patients with variceal bleeding and their association with early rebleeding.Twenty cirrhotic patients with active variceal bleeding had serial TEG and routine coagulation tests daily for seven days. The TEG variables before the day of rebleeding (n = 6) were compared with those of patients without rebleeding (n = 14).Baseline characteristics of the rebleeding and non-rebleeding groups were comparable apart from a higher incidence of uncontrolled infection on the day of rebleeding in the rebleeding group (p = 0.007). The patients in the rebleeding group were more hypocoagulable before the day of rebleeding as shown by longer r (42 v 24 mm, p < 0.001) and k (48 v 13 mm, p < 0.001) and smaller a (12 v 38 degrees, p < 0.001) compared with the mean of daily results of the non-rebleeding group. Routine coagulation tests, however, showed no significant differences between the two groups.The results of serial TEG measurements suggest that hypocoagulability may be associated with early rebleeding in cirrhotic patients.
Causes of Myocardial Infarction
Authors: Domingo Baitlon
Journal: JAMA (1975)

<h3>To the Editor.—</h3> The classification in the informative article by Drs Cheitlin, McAllister, and DeCastro (231:951, 1975) was designed to be "an inclusive listing of all conditions, however unusual, that can result in acute myocardial infarction." I would like to call attention to other unusual causes: tumor embolism to the coronary artery originating in the lung resulting in fatal myocardial infarction (192:256, 1965), tumor embolism from a squamous carcinoma primary in the lung resulting in fatal coronary occlusion,<sup>1</sup>and metastases from a testicular teratoma through a patent foramen ovale lodged in the left ventricle causing coronary embolism, with death attributed to extensive cerebral infarction.<sup>2</sup> While reference is made to coronary embolism resulting from cardiac myxoma, the possibility of acute myocardial infarction caused by emboli from other neoplastic lesions should be recognized.
Impaired hepatic glycogen synthesis in glucokinase-deficient (MODY-2) subjects.
Authors: G Velho, K F Petersen, G Perseghin, J H Hwang, D L Rothman, M E Pueyo, G W Cline, P Froguel, G I Shulman
Journal: Journal of Clinical Investigation (1996)

All glucokinase gene mutations identified to date have been localized to exons that are common to the pancreatic and hepatic isoforms of the enzyme. While impaired insulin secretion has been observed in glucokinase-deficient subjects the consequences of this mutation on hepatic glucose metabolism remain unknown. To examine this question hepatic glycogen concentration was measured in seven glucokinase-deficient subjects with normal glycosylated hemoglobin and 12 control subjects using 13C nuclear magnetic spectroscopy during a day in which three isocaloric mixed meals were ingested. The relative fluxes of the direct and indirect pathways of hepatic glycogen synthesis were also assessed using [1-13C]glucose in combination with acetaminophen to noninvasively sample the hepatic UDP-glucose pool. Average fasting hepatic glycogen content was similar in glucokinase-deficient and control subjects (279+/-20 vs 284+/-14 mM; mean+/-SEM), and increased in both groups after the meals with a continuous pattern throughout the day. However, the net increment in hepatic glycogen content after each meal was 30-60% lower in glucokinase-deficient than in the control subjects (breakfast, 46% lower, P < 0.02; lunch, 62% lower, P = 0.002; dinner; 30% lower, P = 0.04). The net increment over basal values 4 h after dinner was 105 +/-18 mM in glucokinase-deficient and 148+/-11 mM in control subjects (P = 0.04). In the 4 h after breakfast, flux through the gluconeogenic pathway relative to the direct pathway of hepatic glycogen synthesis was higher in glucokinase-deficient than in control subjects (50+/-2% vs 34+/-5%; P = 0.038). In conclusion glucokinase-deficient subjects have decreased net accumulation of hepatic glycogen and relatively augmented hepatic gluconeogenesis after meals. These results suggest that in addition to the altered beta cell function, abnormalities in liver glycogen metabolism play an important role in the pathogenesis of hyperglycemia in patients with glucokinase-deficient maturity onset diabetes of young.
Haiti's devastated health services unable to cope with scale of catastrophe left by earthquake
Authors: P. Moszynski
Journal: BMJ (2010)

The full extent of the devastation caused by the earthquake on 12 January in Haiti has yet to be assessed, but some first responders believe it could be the worst natural disaster in recent years.

The International Federation of the Red Cross estimates that over three million people have been affected by the 7.2 magnitude quake, which struck the most populated area of the country and has laid waste to most of the capital, Port au Prince.

The federation says the most urgent needs at this time are “search and rescue, field hospitals, emergency health, water purification, emergency shelter, logistics and telecommunications.”

Oxfam …
A Prospective Evaluation of Plasma Prostate-Specific Antigen for Detection of Prostatic Cancer
Authors: Peter H. Gann
Journal: JAMA (1995)

To evaluate the validity of prostate-specific antigen (PSA) in identifying men who subsequently were or were not clinically diagnosed with prostate cancer, assess optimal test cutoff, measure lead time, and estimate relative risks (RRs) associated with discrete PSA levels.Nested case-control study of men providing plasma samples before a 10-year follow-up.The Physicians' Health Study, an ongoing randomized trial that enrolled 22,071 men aged 40 to 84 years in 1982.A total of 366 men (cases) diagnosed with prostate cancer and 1098 men (three controls per case), matched by age, randomly selected from all cohort members at risk at the time of case diagnosis.Sensitivity and specificity for each year of follow-up and for aggressive and nonaggressive cancers separately.At a cutoff of 4.0 ng/mL, sensitivity for the entire 10-year follow-up was 46% for total cases. Sensitivities for detection of total, aggressive, and nonaggressive cancers occurring in the first 4 years were 73%, 87%, and 53%. Overall, specificity was 91% and changed little by year of follow-up. Optimal validity was achieved at a cutoff of 3.3 ng/mL. Estimated mean lead time for all cancers was 5.5 years. Only 40% of cancers detected more than 5 years from baseline were nonaggressive. Compared with men with PSA levels less than 1.0 ng/mL, those with PSA levels between 2.0 and 3.0 ng/mL had an RR of 5.5 (95% confidence interval, 3.7 to 9.2).A single PSA measurement had a relatively high sensitivity and specificity for detection of prostate cancers that arose within 4 years. Prostate-specific antigen values less than the usual cutoff were associated with substantial increases in risk compared with the lowest levels. Final evaluation of PSA screening must also consider cost and the ability of current treatments to improve the prognosis of screen-detected cases.
Hyperinsulinemia and Macrosomia in the Fetus of the Diabetic Mother
Authors: Robert Schwartz, Philip A Gruppuso, Kathleen Petzold, Donald Brambilla, Vilho Hiilesmaa, Kari A Teramo
Journal: Diabetes Care (1994)

OBJECTIVE To determine 1) whether macrosomia in the fetus of the diabetic mother is related to fetal hyperinsulinemia and 2) whether hyperinsulinemia and macrosomia are related to maternal metabolic control. RESEARCH DESIGN AND METHODS Normal pregnant women (n = 95) were compared with insulin-treated pregnant women (n = 155), who were subdivided according to White's class, hypertension, and mode of delivery. All women were treated to achieve optimal metabolic control. HbA1c was determined at each visit. At delivery, umbilical plasma was analyzed for glucose, insulin antibodies, total insulin, free insulin, C-peptide, proinsulin components, and total and individual amino acids. RESULTS Macrosomia, defined as &amp;lt;2 standard deviation units (97.75%), was found in 10–27% of the diabetic groups. It was not related to maternal mass or size, but was significantly correlated with umbilical total insulin, free insulin, and C-peptide. Proinsulin components were not different among groups. Amino acids also were not different. Glycosylated hemoglobin was a weak predictor of birth weight and fetal hyperinsulinism. CONCLUSIONS Macrosomia in the fetus of the diabetic mother remains inadequately explained. In a large population of pregnant women with strict metabolic control, macrosomia was mainly independent of glycosylated hemoglobin. Nevertheless, fetal hyperinsulinism remains the driving force for excessive fetal growth. The stimulus for fetal insulin excess in humans remains to be defined.
Innovation in Safety, and Safety in Innovation
Authors: Dan Eisenberg, Sherry M. Wren
Journal: JAMA Surgery (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA 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