tbuckley/cabot-search huggingface dataset:
P173 Management of sputum eosinophil-negative patients in a severe asthma clinic
Authors: G. Tavernier, C. Pris-Picard, R. Gore, R. Niven
Journal: Thorax (2010)

Asthma is a heterogeneous disease that requires physicians to further phenotype their patients in order to offer carefully customised treatment. Among recent and rapidly evolving tools at clinicians9 disposal are sputum analysis for several markers of inflammation, particularly sputum eosinophil count has become a marker widely used. Sputum differential cell counting was introduced in our severe asthma clinic to help further phenotype our patients with a view to first reducing sputum eosinophils below 3% by augmenting anti-inflammatory therapy, and attempting steroid withdrawal once subjects became sputum eosinophil negative (E−). This report investigates its impact on the management of patients with negative sputum eosinophilia at baseline. To date, 264 patients have been investigated for sputum eosinophils, using induction with nebulised sodium chloride if necessary and suitable. Of these, 71 had 2 or more valid results enabling us to assess how these subjects were managed following their initial negative cell count results. Out of 42 patients initially E−, 36 remained E−. Twenty-seven were offered a trial of reduction in steroid therapy: 2 patients stopped IM triamcinolone (both remained E−); 20 patients had decreased oral prednisolone treatment (15 remained E−) 5 patients decreased inhaled steroid therapy (all remained E−). Despite negative sputum at baseline, five patients were given a trial of triamcinolone, to confirm their absence of response to steroids, of these 4 remained E−, whilst surprisingly 1 patient became E+. In those E− at baseline, 64% had a reduction in steroid therapy. Of these more than 80% remained E−, despite reduced therapy, whilst 20% had recurrence of E+. For 83% of those who became E+, there were strong indications that their initial dose of maintenance oral steroids was probably already optimal. It is surprising that five patients were offered a trial of IM triamcinolone despite initial negative sputum eosinophils. However, it has been recently reported that increased steroid therapy in sputum non-eosinophilic patients still had positive impact on reducing markers of inflammation different from sputum eosinophils. It was possible to reduce steroid therapy without losing asthma control for 80% of patients initially E−.
Oxazaphosphorine bioactivation and detoxification: the role of xenobiotic receptors
Authors: Duan Wang, Hongbing Wang
Journal: Acta Pharmaceutica Sinica B (2012)

Oxazaphosphorines, with the most representative members including cyclophosphamide, ifosfamide, and trofosfamide, constitute a class of alkylating agents that have a broad spectrum of anticancer activity against many malignant ailments including both solid tumors such as breast cancer and hematological malignancies such as leukemia and lymphoma. Most oxazaphosphorines are prodrugs that require hepatic cytochrome P450 enzymes to generate active alkylating moieties before manifesting their chemotherapeutic effects. Meanwhile, oxazaphosphorines can also be transformed into non-therapeutic byproducts by various drug-metabolizing enzymes. Clinically, oxazaphosphorines are often administered in combination with other chemotherapeutics in adjuvant treatments. As such, the therapeutic efficacy, off-target toxicity, and unintentional drug–drug interactions of oxazaphosphorines have been long-lasting clinical concerns and heightened focuses of scientific literatures. Recent evidence suggests that xenobiotic receptors may play important roles in regulating the metabolism and clearance of oxazaphosphorines. Drugs as modulators of xenobiotic receptors can affect the therapeutic efficacy, cytotoxicity, and pharmacokinetics of coadministered oxazaphosphorines, providing a new molecular mechanism of drug–drug interactions. Here, we review current advances regarding the influence of xenobiotic receptors, particularly, the constitutive androstane receptor, the pregnane X receptor and the aryl hydrocarbon receptor, on the bioactivation and detoxification of oxazaphosphorines, with a focus on cyclophosphamide and ifosfamide.
Diagnosis and Management of Lytic Lesions in Bone
Authors: Ed Berg
Journal: JAMA (1982)

<h3>To the Editor.—</h3> In reference to the article by Carrera et al to fluoroscopic percutaneous bone biopsy (1981; 246:884), several comments should be made. The authors are to be commended for the use of this simple technique that has been in vogue for a number of years, as is documented in their bibliography. One notes that their description of ten patients in one year's time from two major teaching hospitals does not represent a large series and would indicate that the authors are rather conservative in the use of percutaneous bone biopsy. However, we think that a multidisciplinary approach of surgeon, pathologist, and radiologist, rather than solely radiological consultation, should be used in the diagnosis and management of lytic lesions in bone, particularly those involving long bones as advocated by Evarts<sup>1</sup>and Ottolenghi.<sup>2</sup>One reason is that consideration should be given to internal fixation with impending pathological fractures
ÆSTIVO-AUTUMNAL MALARIA. THE EXTRACELLULAR RELATION OF THE CRESCENTIC BODIES TO THE RED CORPUSCLE AND THEIR METHOD OF SECURING ATTACHMENT
Authors: Mary R. Lawson
Journal: The Journal of Experimental Medicine (1918)

AEstivo-autumnal parasites, including the crescentic bodies, are always extracellular; that is, they are attached to the external surface of the red corpuscles. Crescentic bodies attach themselves to the red corpuscles just as the younger parasites do, by encircling, with their cytoplasm, mounds of hemoglobin substance. These hemoglobin mounds may be seen protruding through various portions of the crescentic bodies, as well as at the periphery of the parasites. The base of the mounds is occasionally outlined by the chromatin or pigment granules. The hemoglobin mounds protruding through the body proper of the crescentic bodies do not seem to alter the general outline of the parasites. The outline of the parasites may be traced through the transparent mounds. Whenever attaching pseudopodia are observed they are seen to arise from the cytoplasm of the parasites and may be in the form of loops or strings. When the crescents are attached they proceed to dissolve the hemoglobin to make it available for utilization, assimilating what is required for nutrition, the waste product being in the form of pigment granules. After the hemoglobin mounds, to which the crescents are attached, have been decolorized by parasitic action, an appearance is obtained which has been described by most observers as vacuolization of the crescentic body. These observers believe the picture to be one of degeneration. The decolorized mounds or vacuoles ("achromatic areas") seen in connection with malarial parasites correspond to the nutrition vacuoles of the common amebae, and possibly the malarial parasite may, like these amebae, secrete reserve food.
New Definition of Myocardial Infarction Puts Biomarkers Front and Center
Authors: Mike Mitka
Journal: JAMA (2012)

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
Rewarding healthcare teams
Authors: K. Bloor, A. Maynard
Journal: BMJ (1998)

The American economist Robert Solow argued that labour markets “cannot be understood without taking account of the fact that participants, on both sides, have well developed notions of what is fair and what is not.”1 This may explain why many NHS trusts in Britain have been reluctant to implement local pay mechanisms and performance related pay. As a result the creation of the NHS internal market has not led to a more efficient market for clinical labour. Indeed, opportunities have been missed—the recent review of the distinction award system, for example, paid little attention to incentives for efficiency.2 Nevertheless, the present government is retaining the purchaser-provider split and is likely to continue to seek efficiencies. With care and a common sense approach, economics can contribute to the analysis and improvement of the clinical labour market.

Some approaches to the analysis of labour markets reflect Solow's common sense approach. Efficiency wage models, for example, accept that workers …
Abstract 3149: 4E-BP1 loss of function in pancreatic carcinogenesis
Authors: Rania Azar, Christiane Susini, Corinne Bousquet, Stephane Pyronnet
Journal: Cancer Research (2010)

Abstract Inactivation of the transcription factor Smad4/DPC4 gene is a frequent event that correlates with aggressiveness of pancreatic adenocarcinomas. We have previously shown that the stress-inducible translational inhibitor 4E-BP1 is a target of Smad4 essential for TGFbeta-mediated inhibition of cell proliferation. Here, we show that 4E-BP1 expression parallels that of Smad4 through the graded stages of pancreatic cancer progression. 4E-BP1 amount transiently increases in human PanIN-1 and PanIN-2 lesions, but is dramatically diminished in PanIN-3 and invasive carcinomas. A similar pattern of 4E-BP1 expression is seen in PanINs from pancreas of mice that carry a pancreas-specific mutated Kras allele (Kras-Pdx1/cre mice). Furthermore, we show in vitro that 4E-BP1 expression is efficiently induced under hypoxia in Smad4+/+, but not in Smad4−/− pancreatic duct cells. We further reveal that, at the molecular level, Smad4 cooperates with HIF1-alpha to induce 4E-BP1 gene transcription in hypoxic cells. Thus, it appears that pancreatic duct cells which carry Smad4 loss are no longer capable of inducing 4E-BP1 under stress conditions. This may have important consequences in pancreatic carcinogenesis as 4E-BP1 is viewed as a stress-inducible factor whose function is to block cellular protein synthesis to concentrate resources on an appropriate stress response aimed at restraining carcinogenesis. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3149.
TCT-403 Percutaneous Ultrasound-Guided Thrombin Injection as a Safe and Efficacious Primary Treatment of Iatrogenic Femoral Pseudoaneurysms for the Interventional Cardiologist
Authors: Daniel Chen, Anthony Sammel, Pankaj Jain, Nigel Jepson, Paul Batt
Journal: Journal of the American College of Cardiology (2012)
Hemolysis in typhoid fever.
Authors: A. La Grutta, V. Balsamo, F. Mollica
Journal: BMJ (1967)

of enzyme deficiency or sickling must be borne in mind.Allergic reactions and haemo- lytic symptoms have been reported in G-6-PD-deficient subjects after administration of a number of drugs, and even salicylates have been incriminated.'The physician who is not on the lookout for this eventuality may consider it a complication of the original con- dition for which he was consulted.As prob- ably more than 10% of these people are
Potential Mechanisms Causing Delayed Effects of Respiratory Syncytial Virus Infection
Authors: PETER J. M. OPENSHAW
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Respiratory syncytial virus (RSV) and measles virus are both paramyxoviruses. Children who have been admitted to hospital with acute RSV bronchiolitis often suffer from recurrent wheezing in later childhood; much more rarely, measles causes a delayed central nervous system infection (e.g., subacute sclerosing panencephalitis [SSPE]) appearing up to 7 yr after the acute disease. Whether postmeasles SSPE is the equivalent of post-RSV wheezing has never been determined. The purpose of this review is to speculate regarding the causal or linked mechanisms that might be responsible for the association between severe infantile RSV infection and later respiratory symptoms. RSV bronchiolitis usually affects children less than 6 mo of age and has a peak incidence at 2 to 4 mo (1). During the postnatal period, the lungs are developing rapidly and undergoing alveolar septation. Bronchiolitis is the commonest severe insult to the lungs during this critical window and might cause long-term effects by delaying or preventing normal postnatal development. This may result in smaller lungs that are subsequently more susceptible to disease and infection. For measles, it is clear that persistent infection is the cause of SSPE; for RSV, it is not yet clear whether bronchiolitis is a marker of susceptibility to later wheezing disorders or itself causes delayed effects. This article reviews the immunobiology of RSV and some of the immunologic and virologic mechanisms that could explain the link between early infection and the subsequent development of respiratory disease.
Review: Differences in efficacy and acceptability exist for 12 new-generation antidepressants for major depression
Authors: Tim Usherwood
Journal: Annals of Internal Medicine (2009)

Source Citation Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009;373:746-58. 19185342
Comparison of glucose tolerance categories according to World Health Organization and American Diabetes Association diagnostic criteria in a population-based study in Brazil. The Japanese-Brazilian Diabetes Study Group.
Authors: S G Gimeno, S R Ferreira, L J Franco, M Iunes
Journal: Diabetes Care (1998)

OBJECTIVE: To compare the prevalence of different categories of glucose tolerance in a Japanese-Brazihan population using World Health Organization (WHO) and American Diabetes Association (ADA) diagnostic criteria. RESEARCH DIVISION AND METHODS: The analyses were based on the data obtained from a study conducted in a representative sample of the Japanese-Brazilian population composed of 647 subjects (40-79 years) who were submitted to a 2-h oral glucose tolerance test. Prevalence of glucose tolerance categories and the level of agreement (K statistics) were obtained using WHO and ADA criteria. Cardiovascular risk profile of the subjects with different diagnostic categories were compared. RESULTS: Similar prevalences of diabetes were found considering both criteria (WHO, 20.3%; ADA, 19.2%). The prevalence of impaired glucose tolerance (IGT) by WHO criteria was 14.7%, contrasting with 7.4% of impaired fasting glucose (IFG) by ADA criteria. Subjects with discordant diagnostic categories by the criteria, considered at risk for diabetes (IGT/IFG), showed a worse metabolic profile than the concordant normal subjects. However, subjects with discordant diagnoses who had IGT or diabetes by WHO criteria but who were normal by ADA criteria exhibited a higher number of cardiovascular risk factors (higher blood pressure and triglyceride and low HDL cholesterol) than those who were discordant (IFG/diabetes) by ADA criteria but normal by WHO criteria. CONCLUSIONS: Although the number of diabetic subjects was similar between the criteria, those identified as being at risk for diabetes were quite distinct. Fewer subjects were classified as having IFG by ADA criteria than as having IGT by WHO criteria. Abnormal glucose tolerance based on WHO criteria seems to identify a worse cardiovascular profile than abnormal tolerance based on ADA criteria. Follow-up studies are necessary to know the prognostic significance of IFG to predict subsequent diabetes.
Effect of surgical reduction of left ventricular outflow obstruction on hemodynamics, coronary flow, and myocardial metabolism in hypertrophic cardiomyopathy.
Authors: R O Cannon, C L McIntosh, W H Schenke, B J Maron, R O Bonow, S E Epstein
Journal: Circulation (1989)

To assess the impact of operative reduction of left ventricular outflow obstruction in hypertrophic cardiomyopathy, measurements of great cardiac vein flow, oxygen and lactate content, left ventricular pressures, and cardiac index were measured at rest and during pacing stress in 20 consecutive patients (13, myotomy-myectomy; six, mitral valve replacement; one, both myotomy-myectomy and mitral valve replacement) who underwent both preoperative and postoperative studies. All had angiographically normal epicardial coronary arteries. Operation resulted in reduction in outflow gradient (64 +/- 38 to 4 +/- 7 mm Hg, p less than 0.001) and in left ventricular systolic pressure (186 +/- 32 to 128 +/- 22 mm Hg, p less than 0.001) and was associated with reduction in great cardiac vein flow (101 +/- 26 to 78 +/- 16 ml/min, p less than 0.001) and oxygen consumption in the anterior left ventricle and septum (11.9 +/- 4.1 to 8.4 +/- 1.9 ml O2/min, p less than 0.001) in the basal state. During rapid atrial pacing, 13 of 20 patients experienced chest pain postoperatively, whereas all 20 developed chest pain during preoperative pacing, with an improvement in pacing anginal threshold (or heart rate 150 if no chest pain was experienced) of 16 +/- 18 beats/min (p less than 0.001). The peak great cardiac vein flow (161 +/- 41 to 131 +/- 45 ml/min, p less than 0.025) and myocardial oxygen consumption (19.4 +/- 6.1 to 14.3 +/- 5.5 ml O2/min, p less than 0.005) during pacing, which correlated directly with the severity of the basal left ventricular gradient (p = 0.011 and p = 0.002, respectively), were also reduced by surgery. Lactate metabolism during pacing changed from net production before surgery to net consumption after operation (-17 +/- 47.6 to 4.4 +/- 29.8 mumol/min, p less than 0.01), with six of 20 patients producing lactate after surgery compared with 13 of 20 before surgery (p = 0.06). The six patients with the highest peak great cardiac vein flow (greater than 175 ml/min) during preoperative pacing had greater symptom and metabolic benefit during pacing after surgery compared with the 14 patients with lower peak coronary flow. Postpacing left ventricular end-diastolic pressure (30 +/- 7 to 23 +/- 7 mm Hg, p less than 0.001) and pulmonary artery wedge pressure (24 +/- 6 to 20 +/- 5, p less than 0.001) were reduced after surgery.(ABSTRACT TRUNCATED AT 400 WORDS)
Another look at visual standards and driving
Authors: W. Westlake
Journal: BMJ (2000)

Paper p 990 

The law in the United Kingdom requires that a car driver must be able to read, in good daylight with the aid of corrective lenses if necessary, a vehicle number plate containing letters and figures 79.4 mm high at a distance of 20.5 metres. This is a test of binocular static visual acuity and corresponds to a geometric visual angle of 6/15 Snellen acuity. (In the United States this translates into the equivalent of the 20/20 notation, in which the measurement is expressed at a test distance of 20 feet rather than 6 metres as in the Snellen notation. In other parts of Europe people use both the Snellen notation and a system of expressing the visual angle as a decimal fraction—for example 6/6=1 6/12=0.5 6/60=0.1. The rest of the world uses the Snellen notation.) Because of differences in letter types the driving visual test is clinically similar to a Snellen acuity of approximately 6/10.1

These tests should be performed with both eyes open because the acuity of the better eye when tested separately is often different from the binocular visual acuity. This is the result of interactions …
Inferior-Vena-Caval Thrombosis in Malignant Renal Lesions
Authors: Elliot Leiter
Journal: JAMA (1966)

Renal tumors are the most common malignancy associated with inferior-vena-caval occlusion. The level of obstruction is usually in the middle third of the vena cava. Middle vena-caval occlusion should be suspected when, in addition to the usual signs of inferior-vena-caval obstruction, the presence of albuminuria, hematuria, nephrotic syndrome, or hepatic dysfunction is demonstrated. Four cases presented here illustrate the clinical syndrome. Intravenous urography and inferior-vena-caval roentgenography are the most useful diagnostic aids. Retrograde pyelography, nephrotomography, and renal arteriography may occasionally be necessary.
Stem Cells and Their Potential for Clinical Application
Authors: Paulette Mehta
Journal: JAMA (2008)

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
Longitudinal estimates of pulmonary function decline in grain workers.
Authors: P Pahwa, A Senthilselvan, H H McDuffie, J A Dosman
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

We conducted a cohort analysis of longitudinal changes in pulmonary function test values in male grain elevator workers in five regions of Canada over a 6-yr period involving three observations. Pulmonary function tests were obtained approximately each 3 yr during an observation interval called a "cycle". The periods of the cycles were 1978-81 (Cycle I), 1981-84 (Cycle II), and 1984-87 (Cycle III), respectively. Data on respiratory symptoms and pulmonary function tests were collected on the same 881 workers in Cycles I and II (mean ages +/- SE: 37.0 +/- 0.48 yr at Cycle I), on the same 1,294 workers in Cycles I, II, and III (34.6 +/- 0.34 yr at Cycle I), and on the same 1,021 workers in Cycles II and III (33.9 +/- 0.38 yr at Cycle II) for a total of 3,196 workers with two or more observations over the 6-yr period. The proportion of current smokers decreased from Cycle I to Cycle III. Autoregression analysis of longitudinal changes in lung function data showed that predictors of FEV1 were height, years in the industry, smoking status, and geographic region. The mean annual losses in FEV1 (FVC) were 28.7 ml (26.4 ml), 38.4 ml (41.9 ml), and 41.7 ml (32.3 ml) for nonsmokers, ex-smokers, and current smokers, respectively. The annual loss of FEV1 (FVC) was 9.2 ml (21.1 ml) for those who were in the grain industry for less than 5 yr and 52.6 ml (60.8 ml) for those who were exposed for 20 yr or more.(ABSTRACT TRUNCATED AT 250 WORDS)