tbuckley/cabot-search huggingface dataset:
Treatment of Gram-Negative Bacillary Meningitis in Adults
Authors: JAMES J. RAHAL
Journal: Annals of Internal Medicine (1972)

Among adults, Gram-negative bacillary meningitis (excluding that due to Hemophilus influenzae) is most frequently associated with chronic systemic disease or invasive procedures of the central nervous system, including accidental trauma. Literature of the past 20 years reports mainly single cases and suggests a high mortality despite antibiotics use. Optimal antimicrobial therapy should provide wide Gram-negative activity and effective cerebrospinal fluid concentrations before sensitivity data are available. Thus chloramphenicol, polymyxin B, kanamycin, carbenicillin, and gentamicin are the most useful agents for initial treatment. The diffusion of kanamycin and gentamicin from blood to cerebrospinal fluid is inconsistent, and intrathecal administration is warranted when aminoglycosides or polymyxins are used for the treatment of adults. The use of two drugs may be most effective as initial therapy. Antibiotics should be selected for the central nervous system pharmacology, compatibility, and antimicrobial spectra of the most effective agents.
Abstract 2952: Aberrant accumulation of 2-hydroxyglutarate in human breast cancer with myc activation
Authors: Prachi Mishra
Journal: Cancer Research (2014)

Abstract Metabolite addiction of tumors may represent an Achilles heel for cancer cells and an opportunity for therapeutic intervention. Recently, using an untargeted discovery approach and validation of key metabolites, we characterized the metabolomic profile of human breast tumors and uncovered intrinsic metabolite signatures in these tumors. Importantly, the oncometabolite, 2-hydroxyglutarate (2HG), accumulated in a subset of tumors and human breast cancer cell lines. 2HG reached millimolar concentrations comparable to those in isocitrate dehydrogenase (IDH)-mutant gliomas, despite the absence of IDH mutations. Instead, we discovered a significant association between increased 2HG levels and MYC pathway activation in breast cancer, which was corroborated in human mammary epithelial and breast cancer cells with inducible MYC overexpression and knockdown. Further analyses showed a global increase of DNA methylation in 2HG-high tumors and identified a poor survival tumor subtype with distinct DNA methylation, high tissue 2HG, and heightened occurrence in African-American patients. Tumors of this subtype had a stem cell-like transcriptional signature with WNT and MYC pathway activation. These tumors over-expressed glutaminase, suggesting a functional relationship between glutamine and 2HG metabolism in breast cancer. Accordingly, 13C-labeled glutamine was metabolized into 2HG in cells with aberrant 2HG accumulation, whereas pharmacologic and siRNA-mediated inhibition of glutaminase markedly reduced 2HG. Our findings highlight 2HG as a candidate breast cancer oncometabolite associated with MYC activation and poor prognosis. Citation Format: Prachi Mishra. Aberrant accumulation of 2-hydroxyglutarate in human breast cancer with myc activation. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2952. doi:10.1158/1538-7445.AM2014-2952
Surfactant abnormalities in idiopathic pulmonary fibrosis, hypersensitivity pneumonitis and sarcoidosis
Authors: A. Günther, R. Schmidt, F. Nix, M. Yabut-Perez, C. Guth, S. Rosseau, C. Siebert, F. Grimminger, H. Morr, H.g. Velcovsky, W. Seeger
Journal: European Respiratory Journal (1999)

Bronchoalveolar lavage fluids (BALF) from patients with idiopathic pulmonary fibrosis (IPF; n=36), hypersensitivity pneumonitis (HP; n=32) and sarcoidosis (n=44) were investigated for their surfactant properties and compared to healthy control subjects (n=29). The phospholipid (PL) and protein concentration, the PL:protein ratio, PL subclasses, and the surfactant apoproteins (SP)A and SP-B were quantified in BALF. Large surfactant aggregates (LSA) were measured by means of ultracentrifugation and assayed for surface activity using the pulsating bubble surfactometer. As compared to controls, SP-A concentrations, LSA content and PL:protein ratios were significantly decreased in all groups, whereas PL and SP-B concentrations remained unchanged. Changes in the phospholipid profile, with reduced percentages of phosphatidylcholine (not significant) and phosphatidylglycerol and increased fractions of phosphatidylinositol and sphingomyelin (p&lt;0.05), occurred more in IPF than in HP, and not in sarcoidosis. Surface activity was found to be severely impaired in IPF (minimum surface tension (gamma min) approximately 15-20 mN x m(-1)), but only modestly affected in HP and sarcoidosis (gamma min approximately 5 mN x m(-1)) compared to controls (gamma min approximately 0 mN x m(-1)). Reconstitution of pelleted surfactant material with soluble BALF proteins further increased gamma min values. In conclusion, moderate changes in biochemical and physical surfactant properties are encountered in hypersensitivity pneumonitis and sarcoidosis, but pronounced disturbances occur in idiopathic pulmonary fibrosis.
The First Nation-Wide Survey on the Prevalence of Asthma for School Children by Using ISAAC Questionnaire in Japan
Authors: M. Akashi, Y. Ohya, M. Futamura, N. Kojima, M. Narita, K. Akiyama, K. Takahashi, T. Nakagawa, F. Kobayashi, A. Eboshida, H. Nakamura, H. Odajima, Y. Adachi, A. Akasawa
Journal: Journal of Allergy and Clinical Immunology (2006)
Around every tumour there's a person
Authors: S. Singh
Journal: BMJ (1998)

Mr A has a nasty carcinoma of the bladder for which the standard recommended treatment was radical dissection of bladder, prostate, and both testicles. There is, however, nothing standard about Mr A.

Mr A, who is in his mid 40s, registered with us over a year ago. A local practice had jettisoned him. Although this is conjecture, I think that it was because of his demanding nature. He came to us requesting benzodiazepines, which is never a good start to a long term doctor and patient relationship. He is Spanish, and his long term partner comes from the Philippines. Both are very intelligent and articulate.

His main complaints at the outset were that the pain of the carcinoma was relentless and that every time he urinated it “was like passing razor blades, except worse.” He hated the tumour. What he hated even more, however, was the fact that everybody—or at least nearly every doctor—pushed …
Cell-Free Fetal DNA in Maternal Blood
Authors: Joe Leigh Simpson, Farideh Bischoff
Journal: JAMA (2004)

N THIS ISSUE OF THE JOURNAL, THE FINDINGS REPORTED in the study by Dhallan and colleagues 1 on enhancing recovery of cell-free DNA in maternal blood have major clinical implications. Developing a reliable, transportabletechnologyforcell-freeDNAanalysisimpacts2crucial areas—prenatal genetic diagnosis and cancer detection and surveillance. In prenatal genetic diagnosis, detecting a fetal abnormality without an invasive procedure (or with fewer invasive procedures) is a major advantage. Likewise incancersurveillance(eg,inpatientswithleukemia),monitoring treatment without having to perform a bone marrow aspiration for karyotype also would be of great benefit. Prenatal genetic diagnosis has been available in the United Statessince1968,whenchromosomalabnormalitiesandmetabolictraitsproveddetectablebyanalysisofamnioticfluidcells obtainedbyamniocentesis.Themostcommonindicationfor prenatal genetic testing is maternal age older than 35 years; other indications include prior trisomic offspring, balanced parental chromosomal rearrangements, or increased risk for a mendelian trait. The standard approach is to offer women either second-trimester amniocentesis or first-trimester chorionic villus sampling, which are comparable or nearly comparable in safety. The high diagnostic accuracy of these techniques must be balanced against the risks of undergoing an invasiveprocedure. 2 Estimatesforprocedure-relatedfetalloss
Uncovering Cultural Bias in Ethics Consultation
Authors: Nancy S. Jecker
Journal: The American Journal of Bioethics (2001)

promise in complex clinical or corporate settings. It also demands that I be knowledgeable about current Catholic teaching and its pastoral implications and applications. Finally, it demands that I respect the deeply held opinions of others even when I might disagree with them, and that I hold in special regard the needs of the poor and marginalized, whomever they might be. References Agich, G. J. 2001. The question of method in ethics consultation. The American Journal of Bioethics 1(4): 31–41.
Journal expresses concern about validity of breast cancer study
Authors: Susan Mayor
Journal: BMJ (2010)

Lancet Oncology has issued an “expression of concern” about the validity of a paper it published in 2007 showing that gene signatures predict the response of breast cancer to neoadjuvant chemotherapy (www.thelancet.com/journals/lanonc/article/PIIS1470-2045(10)70185-6/fulltext). It issued the notice after the authors responsible for the statistical analysis failed to respond to queries about their methods and one author was suspended from his university post.

Two of the study’s authors—Richard Iggo, from the University of St Andrews, Scotland, and Herve Bonnefoi, from Geneva …
Subdural haematoma as a complication of spinal anaesthetic.
Authors: T M Jack
Journal: BMJ (1982)

As long as the cervix is unfavourable, oxytocin is of doubtful value and the high dosages required may lead to water intoxication.Therefore, systemic or local administration of prostaglandins is preferred.We have obtained excellent results with intravenous infusion of prostaglandin E,,1 and others have reported successes with intracervical instillation of a single dose of 0 5 mg prostaglandin E, sus- pended in viscous gel.2Intravaginal prostaglandin F2e (2-5 mg) gel shortens labour con- siderably without increasing fetal distress or hypertonicity.3Once the membranes have ruptured, however, insertion of a catheter into the extra-amniotic space is technically impossible (A Calder, personal communica- tion), and the results obtained with oral prostaglandin E2 are contradictory.4One new technique that might reduce the risk of infection deserves mention-that is, continuous intravaginal infusion (lavage) of a weak solution of polyvinylpyrrolidone and iodine (Iso-Betadine).This method was originally proposed by Saling,6 and prelimin- ary results are encouraging.
Acupuncture wins BMA approval
Authors: M. Silvert
Journal: BMJ (2000)

Acupuncture should become more widely available on the NHS and family doctors should be trained in some of its techniques, a BMA inquiry has concluded. The therapy has proved effective in treating back and dental pain, nausea and vomiting, and migraine, the BMA's Board of Science and Education has found after a two year study.

Acupuncture is one of the most frequently requested of the complementary therapies. Up to five million people may have consulted a therapist specialising in complementary or alternative medicine in the past year, the report says. …
[PUBLISHING VERBATIM REPORTS.]
Authors: G. Betton Massey
Journal: JAMA (1992)

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
Molecular population genetics of ref(2)P, a locus which confers viral resistance in Drosophila
Authors: M. L. Wayne, D. Contamine, M. Kreitman
Journal: Molecular Biology and Evolution (1996)

The ref(2)P locus (2-54.2) is polymorphic for two allelic forms in natural populations of Drosophila melanogaster, ref(2)Po and ref(2)Pp. The latter allele confers resistance to the rhabdovirus sigma infecting wild populations. Previous work, based on a small sample of prescreened restrictive (resistant) and permissive (susceptible) alleles, identified a large number of amino acid replacement changes (7) relative to synonymous changes (1). Such protein variability could be the result of variation-enhancing selection. To further test the selection hypothesis, we have examined the DNA sequences of ten randomly chosen lines of D. melanogaster and one line of D. simulans. Nine of the ten lines are permissive; D. simulans does not harbor the virus. The melanogaster alleles contain 4 synonymous changes, 19 noncoding changes, and 13 amino acid replacement changes, indicating a relatively high level of polymorphism. Three sequenced restrictive alleles have nearly identical sequences, indicating that they are relatively young. Compared to the permissive alleles, they share only a complex deletion at codon 34, CAG-AAT to GGA, which our analysis indicates to be the site conferring the restrictive phenotype. Patterns of polymorphism and divergence differ from neutral predictions by several criteria for the amino terminal region, which contains the complex deletion (codons 1-91), but not the remainder of the protein (codons 92-599). We find a higher rate of evolution on the D. melanogaster lineage than on the D. simulans lineage. The relatively large amount of both replacement and silent polymorphism in the permissive alleles and the lack of divergence between permissive and restrictive alleles suggests that the sigma virus and ref(2)P may be engaged in an evolutionary race in which new restrictive alleles are continually arising but are relatively short-lived.
Cardiology and the Quality of Medical Practice
Authors: William L. Winters
Journal: JAMA (1991)

THE ARTICLE prepared for this issue of JAMA by the Cardiology Working Group 1 is more evidence from concerned citizens (medical and nonmedical) of the need to explore the issues of and search for solutions to the escalation of health care costs that threaten the solvency of our health care system. The Cardiology Working Group is composed of distinguished individuals from the fields of medicine, law, business, and economics. It is my understanding that this article is a distillation of discussions held by this group over a period of many months. Their concern for the appropriate utilization of proved effective and beneficial resources in our medical care system is succinctly articulated. I believe what they are searching for is value in health care. Value is a personal measure of benefit, as well as a measure of cost. Value in health is subjective and, in many instances, undefined or unknown. Value
Tumour suppressor genes and risk of metastasis in ovarian cancer.
Authors: W S Lowry, R J Atkinson
Journal: BMJ (1993)

The silent onset of ovarian cancer often leads to metastatic spread before diagnosis can be made. The cause remains unknown, but molecular studies are beginning to reveal some mechanisms. Inactivation of tumour suppressor genes is thought to be responsible for initiating many forms of cancer. Studies of allele loss indicate areas of genome where inactivation may occur. We recently examined the relation between the clinical stage of epithelial ovarian cancer and allele loss at three loci on chromosome 17: progressive loss was detected with advancing stages of disease.' The clinical stage of a tumour defines the extent of the disease and is the best determinant of prognosis for most forms of cancer. It depends on the time elapsed before diagnosis, hence the value placed on early detection. The histopathological grade, however, better describes the intrinsic nature of the tumour: well differentiated tumours are slow growing whereas undifferentiated, anaplastic tumours metastasise rapidly. Thus poorly differentiated tumours tend to be diagnosed at a more advanced stage. At the molecular level one might anticipate less damage to genetic material with well differentiated tumours.
Stimulation of liver regeneration and function after partial hepatectomy in cirrhotic rats by continuous infusion of recombinant human hepatocyte growth factor
Authors: Masaki Kaibori, A-Hon Kwon, Manabu Nakagawa, Tu Wei, Shoji Uetsuji, Yasuo Kamiyama, Tadayoshi Okumura, Naomi Kitamura
Journal: Journal of Hepatology (1997)
Multiple Choledochoduodenal Fistulas in the Periampullary Region
Authors: M. Tanaka, S. Ikeda
Journal: Endoscopy (1982)

Five patients with two periampullary choledochoduodenal fistulas diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) are described. In two patients both fistulas were on the oral prominence of the papilla, whereas in the remaining three, one of the two fistulas was more proximal. All five patients presented with right upper abdominal pain, which was associated with chills, fever and jaundice in two. ERCP revealed choledocholithiasis in two patients, cholecystolithiasis in one, hepatocholedocholithiasis in one, and bile duct dilatation without stone in one. A previous history of pain episodes accompanied by jaundice was obtained in four cases, and surgical bougienage of the papilla had been performed during previous common bile duct exploration in two, which may be responsible for the occurrence of multiple fistulas by possible false passage.
The Forcible Feeding of the Insane
Authors: Wm. W. Herbert
Journal: BMJ (1894)

FORCIBLE FEEDING' OF THE INSANE.[MARcI 3, 189.to get rid of it, and this ns rapidly as possible.The case already quoted (corroborated( as it call be by many otliers) indicates h1owv difticult this task is; for here we ha%,ve ian individual spending year after year under eare- fully selected climatic conditions, with " considertable improvement" of the local signs and general symiiptoms resulting, and yet witlh the bacilli al)pparently unaffected tlhrouglhout.Ilowever pleasant it may be for suchl a patient to pass a winiter in the sunny Soutlh, it is perfectly futile to expect that thiis slhort period of time is sufficient to influence tlhese organisms.T1'le too eommnon practice of sending tubercle-bacillary subjects to spent( a few montlhs here or a few months thiere, in the h1ope that time bacilli will thiereby be vanquislhed, is but (lallying witlh the disease.Those wlho cannot afford to go in for a, very prolonged, or may be perpetual course of climnatic treatmneint, lhad far better hiusband their slender resourees, and remain in this country in the society of their relatives and friends, and surrounded by hiome comforts.
PMO-013 Lack of awareness of nice guidelines on alcohol presentations among physicians involved in the medical take at a large district general hospital
Authors: D Tate, D Haldar, M Hegde
Journal: Gut (2012)

<h3>Introduction</h3> NICE have provided a framework to assess and manage alcohol related admissions and alcoholic hepatitis. The study aimed to assess the knowledge of, and compliance with these guidelines in a busy district general hospital. <h3>Methods</h3> All physicians (f1 to consultant) involved in the medical take were sent an email survey via the website http://www.surveymonkey.com in January 2011. Six questions were posed to assess appreciation of the new guidelines with regards to the assessment of the alcohol withdrawal syndrome, correct prescription of parenteral thiamine and risk stratification, recognition and the specific management of alcoholic hepatitis. Free text and multiple choice questions were used. 39 doctors completed the survey; 15 were consultants and 24 junior doctors. <h3>Results</h3> 100% of respondants correctly identified three symptoms or signs of the alcohol withdrawal syndrome. However only 13% recognised that the correct length of prescription of parenteral thiamine was at least 5 days in suspected Wernike9s encephalopathy. Only 40% identified the Maddrey score as a risk stratifier for alcoholic hepatitis and just 10% realised how high the mortality of the condition was during an acute admission. 49% appreciated that the specific medical management of alcoholic hepatitis was steroids or pentoxyphylline. 21% of respondants would have discharged a patient with severe alcoholic hepatitis (Maddrey 32) from hospital. Results of responses from Consultants alone were broadly similar to the above pooled results. <h3>Conclusion</h3> The burden of alcohol-related health problems on the NHS cannot be understated. National statistics report over a million acute admissions where an alcohol-related disease, injury or condition was the primary reason for hospital admission or a secondary diagnosis, in 2009/2010—this is over double the number in 2002/2003. The results raise concern about the awareness of the management of alcohol related conditions among general physicians, especially the specific management of alcoholic hepatitis. Such patients thus suffer delays in diagnosis and management, possibly even increased morbidity; these delays lead to increased length of stay and repeated, expensive inpatient attendances. The role of the Gastroenterologist may be to be pro-active, rather than reactive in co-ordinating education, and service provision in this field. A guideline is in development locally that will be available to acute physicians via the intranet; it aims to simplify the managemet of alcohol-use disorder presentations. We aim to audit these presentations after introduction of the guideline and expect to show a significant improvement in standards. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <i>Alcohol-Use Disorders</i>. NICE, 2010. http://www.ias.org.uk/resources/ukreports/reports.html
Comparison of techniques for measuring baroreflex sensitivity in man.
Authors: D S Goldstein, D Horwitz, H R Keiser
Journal: Circulation (1982)

Because discrepancies about baroreflex sensitivity in essential hypertension may have resulted from the use of different measurement techniques, we assessed the extent to which the results of different techniques agree in the same subjects. The eight techniques studied were the change in RR interval per unit change in systolic pressure during the Valsalva maneuver, upon release of the Valsalva maneuver, after injection of phenylephrine and after injection of nitroglycerin; the changes in RR interval and in systolic pressure per mm Hg externally applied neck suction; and the changes in RR interval and systolic pressure per mm Hg externally applied neck pressure. The average intercorrelation among these measures in 30 subjects was statistically significant (r = 0.36, p less than 0.01), but suggests that variance in one measure accounted for an average of about 13% of the variance in other measures. Standard deviations among subjects were often as large as the mean, indicating important interindividual variability as well. These findings demonstrate that baroreflex sensitivity varies widely among subjects and that different techniques for measuring baroreflex sensitivity probably measure different aspects of baroreflex function.