tbuckley/cabot-search huggingface dataset:
Association of serum IgM kappa monoclonicity in patients with Sjogren's syndrome with an increased proportion of kappa positive plasma cells infiltrating the labial minor salivary glands.
Authors: H M Moutsopoulos, A G Tzioufas, M K Bai, N M Papadopoulos, C S Papadimitriou
Journal: Annals of the Rheumatic Diseases (1990)

Minor salivary gland biopsy specimens from 11 patients with primary Sjögren9s syndrome with circulating monoclonal IgM kappa cryoglobulins, seven without cryoglobulins, and four patients with rheumatoid arthritis and Sjögren9s syndrome (one with monoclonal and three with polyclonal cryoglobulins) were examined by the peroxidase antiperoxidase bridge technique, using antihuman kappa and lambda antibodies. In 6/11 patients with primary Sjögren9s syndrome and in one patient with Sjögren9s syndrome and rheumatoid arthritis with monoclonal cryoglobulins a predominance of plasma cells containing intracytoplasmic kappa light chains was found (kappa:lambda greater than 3:1). Two of those seven patients had immunohistological features of immunocytomas. In the other five patients with circulating monoclonal cryoglobulins the kappa:lambda ratio of positive cells did not exceed 3:1, while six out of seven patients without cryoglobulins and the patients with rheumatoid arthritis and Sjögren9s syndrome with polyclonal cryoglobulins had almost equal numbers of kappa and lambda stained cells. One of seven patients with primary Sjögren9s syndrome without cryoglobulins had an increased number of lambda light chain positive cells, indicating a non-secretory lambda monoclonal population. These findings suggest that the main area of B cell monoclonal expansion in primary Sjögren9s syndrome may be the affected exocrine glands.
Aortic insufficiency. A result of intermittent migration of aortic valve prosthesis poppet
Authors: D. Kunstadt
Journal: JAMA (1976)

A bizarre mechanism of aortic valve incompetence was observed when the occluder of a Braunwald-Cutter aortic valve prosthesis decreased in diameter, volume, and weight, and from time to time fell into the left ventricle. The patient's symptoms were palpitation, coughing, choking sensations, and fright. An operation disclosed a small, smooth ball with disrupted cloth on all the struts. The residual torn mesh was removed, and the ball was replaced. (<i>JAMA</i>235:2847-2848, 1976)
A Method for Measuring Passive Elastance during Proportional Assist Ventilation
Authors: MAGDY YOUNES, KIMBERLY WEBSTER, JOHN KUN, DANIEL ROBERTS, BRAD MASIOWSKI
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

There are currently no reliable, noninvasive ways to monitor respiratory elastance (E) during assisted ventilation. We describe a method that is suited for proportional assist ventilation (PAV). In this mode, the end of the ventilator's inflation phase occurs during the declining phase of inspiratory effort (Pmus). If the opening of the exhalation valve is delayed, airway pressure (Paw) should initially rise as Pmus continues its decline. When Pmus declines to zero, a Paw plateau should appear. Paw at this point should reflect passive recoil at the prevailing volume. A cohort of 74 ventilator-dependent patients, ventilated in the PAV mode, were studied. Brief end-inspiratory occlusions were applied at random intervals. The magnitude of early change in Paw during the occlusion was inversely related to level of assist (r = 0.7, p < 0.00001). At high assist ( > 75%), Paw was nearly flat or declined slightly, indicating minimal residual Pmus at the onset of occlusion. At lower assist levels, Paw increased exponentially in most patients with an average time constant of 0.21 ± 0.06 s. Extraneous events that may corrupt the measurement (e.g., behavioral responses) were extremely rare ( < 0.5%) in the first 0.25 s. From these findings, we concluded that Paw measured 0.25 s from occlusion onset (P0.25) includes little inspiratory Pmus and is free of extraneous events. E, estimated from P0.25 during PAV (Epav), agreed well (r = 0.92) with passive E measured during controlled ventilation (Ecmv); the average difference (Epav − Ecmv) was ( ± SD) − 0.3 ± 4.9 cm H2O · L− 1, corresponding to 0.9 ± 16.4% of average E. We conclude that Paw measured at 0.25 s from the onset of end-inspiratory occlusion in the PAV mode provides a reliable estimate of passive elastic recoil.
Allowing patients to choose the ethnicity of attending doctors is institutional racism
Authors: N. Moghal
Journal: BMJ (2014)

Nadeem Moghal reflects on a case in which a hospital accepted the request of the parents of a patient that care should be delivered by only a white doctor

On 22 April 1993 the black teenager Stephen Lawrence was murdered by a gang of people, some of whom were finally convicted in 2012. The deficiencies in the police investigation led to the Stephen Lawrence Inquiry, known widely as the Macpherson report, which defined the phrase “institutional racism” as “the collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.”1

This concept continues to be debated, particularly by police services, the focus of the Macpherson report. The definition is intricate, nuanced, and an advance in our understanding of our society. It is relevant to every organisation, private and public. It is a definition against which individual and organisational behaviours can be tested and healthcare services are no exception. NHS organisations …
Changes in liver and spleen volume in alcoholic liver fibrosis of man
Authors: Kazuo Tarao, Hiroshi Hoshino, Ikuko Motohashi, Kazuto Iimori, Setsuo Tamai, Yoshihiko Ito, Seiichi Takagi, Yubo Oikawa, Shiro Unayama, Takuya Fujiwara, Kunio Odagiri, Toshio Ikeda, Kazuhiro Hayashi, Akira Sakurai, Toshiyuki Uchikoshi
Journal: Hepatology (1989)

Alcoholic liver fibrosis is a relatively common form of alcoholic liver disease in Japan. It is regarded by some investigators as a prodromal stage of alcoholic liver cirrhosis, but little is known about the volumes of the liver and spleen in this disease state. Therefore, liver and spleen volumes were measured by computed tomography in 32 patients with alcoholic liver fibrosis in comparison with 10 healthy volunteers. Patients with alcoholic liver fibrosis were divided into three subgroups (13 of Grade 1, 9 of Grade 2 and 10 of Grade 3) according to the severity of fibrosis. The volume was calculated from the sum of the area measurements of successive transverse sections of the two organs. The liver volume (mean +/- S.D.) in Grade 2 alcoholic liver fibrosis (1,281 +/- 112 cm3) was significantly (p less than 0.01) larger than in healthy volunteers (1,017 +/- 73 cm3) and in Grade 1 (1,090 +/- 157 cm3), and the liver volume in Grade 3 (1,490 +/- 132 cm3) was larger than in Grade 2 (p less than 0.01). The mean volume of hepatocytes estimated by a two-dimensional image analysis system was significantly (p less than 0.05) larger in Grade 3 than in Grade 2, and that in Grade 2 was larger than in Grade 1. The spleen volume in Grade 3 (151 +/- 40 cm3) was significantly (p less than 0.01) larger than in healthy volunteers (86 +/- 26 cm3), Grade 1 (89 +/- 38 cm3) and Grade 2 (68 +/- 19 cm3). The presumed reason for hepatic volume increase would be the ballooning of hepatocytes along with increased fibrotic component.
Progressive Loss of Malignant Behavior in Telomerase-Negative Tumorigenic Adrenocortical Cells and Restoration of Tumorigenicity by Human Telomerase Reverse Transcriptase
Authors: Beicheng Sun, Qin Huang, Shengxi Liu, Meizhen Chen, Christina L. Hawks, Lishan Wang, Chuhua Zhang, Peter J. Hornsby
Journal: Cancer Research (2004)

Abstract Replicative senescence/crisis is thought to act as a tumor suppressor mechanism. Although recent data indicate that normal human cells cannot be converted into cancer cells without telomerase, the original concept of senescence as a tumor suppressor mechanism is that senescence/crisis would act to limit the growth of telomerase-negative tumors. We show here that this concept is valid when oncogene-expressing human and bovine cells are introduced into immunodeficient mice using tissue reconstruction techniques, as opposed to conventional subcutaneous injection. Primary human and bovine adrenocortical cells were transduced with retroviruses encoding Ha-RasG12V and SV40 large T antigen and transplanted in immunodeficient mice using tissue reconstruction techniques. Transduced cells were fully malignant (invasive and metastatic) in this model. They had negligible telomerase activity both before transplantation and when recovered from tumors. When serially transplanted, tumors showed progressively slower growth, decreased invasion and metastasis, shortened telomeres, and morphological features of crisis. Whereas telomerase was not essential for malignant behavior, expression of human telomerase reverse transcriptase enabled cells from serially transplanted tumors that had ceased growth to reacquire tumorigenicity. Moreover, telomerase-negative oncogene-expressing cells were tumorigenic only when transplanted using tissue reconstruction techniques; human telomerase reverse transcriptase was required for cells to form tumors when cells were injected subcutaneously. This work provides a new model to study crisis in an in vivo setting and its effects on malignancy; despite having invasive and metastatic properties, cells are eventually driven into crisis by proliferation in the absence of a telomere maintenance mechanism.
Coronary Thrombosis--An Environmental Study
Authors: A. Brown
Journal: BMJ (1962)

This study was made at the request of the Cheshire County Council's Health Committee on considering the County Medical Officer's Annual Report for 1956, in which it was stated (a) that coronary thrombosis was the certified cause of death of 447 males and 111 females, resident in Cheshire, who had died in that year between the ages of 45 and 64 years, and (b) that the percentage of deaths of persons between the ages of 45 and 64 years certified to have been due to coronary thrombosis was 22.4 in that year, and that this percentage had increased in successive years since 1950.Morris et al. (1953) found a negative association between the incidence of coronary heart disease and physical activity at work.Doll and Hill (1956) ascertained that mortality from coronary thrombosis reveals a slight but significant relationship with smoking.Keys (1957) reported that diet, through its fat content, Scope of Inquiry Questions were asked under the following headings: (a) place and manner of death, whether post-mortem examination was made or not; (b) marital state, occupta- tion, spouse, and children, parents, parents-in-law, and lodgers living in the household; (c) illnesses, medicines BRrSIs
Airborne Transmission of Communicable Infection — The Elusive Pathway
Authors: Chad J. Roy, Donald K. Milton
Journal: New England Journal of Medicine (2004)

What does it mean to describe an infection as having airborne transmission, and what are the clinical implications? There is a fitting symmetry between the report by Yu et al. about airborne transmission of the severe acute respiratory syndrome (SARS) in this issue of the Journal (pages 1731–1739) and John Snow's investigation of a cholera epidemic 150 years ago. Snow's independent investigation tested the hypothesis that cholera was waterborne. The official investigation by the General Board of Health in England, however, concluded that transmission in the epidemic was airborne, caused by nocturnal vapors emanating from the Thames River — a . . .
The Management of Bleeding Esophageal Varices
Authors: Joseph F. Dasta
Journal: JAMA (1987)

<h3>To the Editor.—</h3> The article by Cello et al<sup>1</sup>provides an excellent update on the drug and nondrug management of patients with hemorrhaging esophageal varices. In discussing vasopressin therapy, the authors mention that nitroglycerin can ameliorate some of the side effects of vasopressin; however, controlled trials evaluating the efficacy of combination therapy have not been published. Because nitroglycerin may cause an additional decrease in portal pressure, two recently published studies were conducted to evaluate the beneficial effect of nitroglycerin in the setting of acute variceal hemorrhage. Gimson et al<sup>2</sup>randomized 57 patients with acute variceal bleeding into groups, one receiving vasopressin alone (0.4 U/min) and one receiving vasopressin at the same dosage plus intravenous nitroglycerin (40 μg/min titrated to blood pressure, with a maximal dose of 400 μg/min). At the end of 12 hours, cessation of bleeding was statistically more frequent in patients receiving combination therapy than those
Relative importance of sympathetic outflow and insulin in the reactivation of brown adipose tissue lipogenesis in rats adapted to a high-protein diet
Authors: N.H. Kawashita, M.A.F. Moura, M.N. Brito, S.M.R.C. Brito, M.A.R. Garofalo, I.C. Kettelhut, R.H. Migliorini
Journal: Metabolism (2002)
Inoue balloon mitral valvotomy in patients with severe valvular and subvalvular deformity
Authors: James R. Post, Ted Feldman, Jeffrey Isner, Howard C. Herrmann
Journal: Journal of the American College of Cardiology (1995)

This study evaluated the immediate and long-term results of percutaneous Inoue balloon mitral valvotomy in patients with severe valvular and subvalvular deformity.We reviewed the prevalvotomy transthoracic echocardiograms of patients from the North American multicenter Inoue registry with total Massachusetts General Hospital (MGH) echocardiographic scores > or = 10. The echocardiograms were rescored by two investigators to assess valvular and subvalvular morphology to eliminate interinstitutional variability. Ninety patients were originally assigned scores > or = 10. After rescoring, 18 patients (20%) were eliminated, leaving 72 study patients.Balloon mitral valvotomy was technically successful in 69 (96%) of the 72 patients. Mean (+/- SD) mitral valve area increased from 0.9 +/- 0.3 to 1.5 +/- 0.5 cm2. An immediate optimal result, defined as > or = 50% increase in mitral valve area or a final area > or = 1.5 cm2 with no major complications, was achieved in 46 patients (64%). End points for clinical follow-up (events) included mitral valve replacement, repeat valvotomy or death. At a mean follow-up of 22.9 +/- 11.0 months, 22 patients (31%) required mitral valve replacement or a second valvotomy, 9 patients (13%) died, and 32 patients (45%) were in New York Heart Association functional class I or II. Univariate predictors of an immediate optimal result included sinus rhythm, male gender and a lower University of Southern California commissural calcium score. Only sinus rhythm predicted an optimal result by multivariate analysis. Actuarial 3-year event-free survival was 42%. Univariate predictors of event-free survival were a lower grade of mitral regurgitation, lower MGH total echocardiographic score, lower MGH leaflet thickness subscore and lower prevalvotomy left ventricular systolic pressure. Only grade of mitral regurgitation after valvotomy predicted event-free survival by multivariate analysis.Inoue mitral valvotomy in patients with severe valvular and subvalvular deformity has a high technical success rate and good immediate hemodynamic result but a high cardiovascular event rate in follow-up. Mitral valve replacement should be considered in surgical candidates with an MGH total echocardiographic score > or = 10 because it may be able to provide better long-term event-free survival. Balloon valvotomy remains a reasonable palliative therapeutic option for some patients with severe valvular deformity and high surgical risk.
Building Trust in the Power of “Big Data” Research to Serve the Public Good
Authors: Eric B. Larson
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Therapy of Ischemic Cardiomyopathy With the Immunomodulating Agent Pentoxifylline
Authors: Karen Sliwa, Angela Woodiwiss, Veuvette N. Kone, Geoffrey Candy, Danelle Badenhorst, Gavin Norton, Chris Zambakides, Ferande Peters, Rafique Essop
Journal: Circulation (2004)

Background— Inflammatory immune activation commonly occurs in heart failure and may perpetuate this syndrome. We sought to determine whether the immunomodulating agent pentoxifylline enhances left ventricular function in patients with ischemic cardiomyopathy. We also investigated the effect of therapy on levels of brain natriuretic peptide (NT-pro BNP), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and the marker of apoptosis, Fas/Apo-1. Methods and Results— In a single-center, prospective, randomized, double-blind, placebo-controlled study, 38 patients with ischemic cardiomyopathy received pentoxifylline 400 mg TID or placebo in addition to standard therapy. Clinical assessment, radionuclide ventriculography, echocardiography, and blood analyses were performed at baseline and after 6 months. There were no differences in baseline characteristics between the groups. Five patients died (4 in the placebo group). Pentoxifylline treatment resulted in an improvement in functional class ( P &lt;0.005) and an increase in systolic blood pressure ( P &lt;0.05) and left ventricular radionuclide ejection fraction ( P &lt;0.05) compared with the placebo-treated group. There were reductions in plasma concentrations of CRP, NT-pro BNP, TNF-α, and Fas/Apo-1 in the pentoxifylline compared with the placebo-treated group. Conclusions— In patients with heart failure due to ischemic left ventricular dysfunction, the addition of pentoxifylline to standard therapy results in improvements in clinical status and radionuclide ejection fraction, which are accompanied by reductions in plasma markers of inflammation, prognosis, and apoptosis.
Dietary glycemic index, glycemic load, and intake of carbohydrate and rice in relation to risk of mortality from stroke and its subtypes in Japanese men and women
Authors: Shino Oba, Chisato Nagata, Kozue Nakamura, Kaori Fujii, Toshiaki Kawachi, Naoyoshi Takatsuka, Hiroyuki Shimizu
Journal: Metabolism (2010)
Effects of Hyperthermia on Bladder Cancer
Authors: R. R. Hall, R. O. K. Schade, J. Swinney
Journal: BMJ (1974)

A study of the effect of bladder lavage with isotonic fluid at 45 degrees C on proliferative transitional cell carcinoma has shown definite cancericidal changes. These early studies suggest that further investigation of hyperthermia on a larger scale would be worth while.
Histopathological heterogeneity in fulminant hepatic failure
Authors: Cheryl Hanau, Santiago J. Munoz, Raphael Rubin
Journal: Hepatology (1995)

The clinicopathological features of 38 patients admitted consecutively for fulminant hepatic failure were studied. Histopathological material was reviewed in all patients. Both percutaneous and whole livers (either explanted or autopsy specimens) were available in 16 patients: whole livers only in 12 patients and biopsy specimens only in 10 patients. All patients were negative for antibodies to hepatitis C, whereas 24% had hepatitis B infection and 10% had adverse drug reactions. Livers from 75% of patients showed confluent hepatic necrosis. However, there was considerable variability in the extent of necrosis, and biopsy specimens from about 50% of the most severely affected livers showed only minimal bridging necrosis. In patients with massive hepatic necrosis, percutaneous liver biopsy specimens were frequently misleading because of regional inhomogeneities. Interestingly, five patients (13%) had established cirrhosis at the time of diagnosis. The best clinical predictors of survival were age and the maximal grade of encephalopathy. By contrast, neither the severity of confluent hepatic necrosis nor the etiology predicted the decision to transplant or the outcome. There were no differences in the histopathology corresponding to different etiologies. In summary, the approach to the patient with fulminant hepatic failure should be guided principally on clinical grounds, and further classification should be based on pathological and etiologic considerations. However, histological classification and prognosis based on percutaneous biopsy specimens alone may be misleading.
Reviews and Notes: Soulmedicine: Medical Challenges on Life's Uncertain Journey
Authors: Francis A. Neelon
Journal: Annals of Internal Medicine (1996)

Literature of Medicine15 June 1996Reviews and Notes: Soulmedicine: Medical Challenges on Life's Uncertain JourneyFrancis A. Neelon, MDFrancis A. Neelon, MDDuke University Medical Center, Durham, NC 27710Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-12-199606150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail JE Postley. 249 pages. Golden, CO: Love and Logic Pr; 1995. $14.95. ISBN 0-944634-33-8.Ever read a book that you would like to like more than you do? I found Soulmedicine to be such a book.The author, John Postley, a member of the faculty of Columbia University's College of Physicians and Surgeons, is described on the book's cover as “a family doctor in New York City for over twenty-five years.” In his book he presents, in nontechnical language, a considered vision of how patients should seek (and, I guess, how physicians should provide) care in a world devoted to ... Author, Article, and Disclosure InformationAffiliations: Duke University Medical Center, Durham, NC 27710 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1996Volume 124, Issue 12Page: 1097KeywordsEmotionsFearPatient advocacySurgeonsVision ePublished: 15 August 2000 Issue Published: 15 June 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Acquired and specific immunological mechanisms co-responsible for efficacy of polymer-bound drugs
Authors: B Řı́hová, J Strohalm, K Kubáčková, M Jelı́nková, O Hovorka, M Kovář, D Plocová, M Šı́rová, M Št’astný, L Rozprimová, K Ulbrich
Journal: Journal of Controlled Release (2002)