tbuckley/cabot-search huggingface dataset:
Effectiveness of platelet transfusions after plasma exchange in adult thrombotic thrombocytopenic purpura: A report of two cases
Authors: P. Coppo, K. Lassoued, X. Mariette, D. Gossot, E. Oksenhendler, C. Adrie, E. Azoulay, B. Schlemmer, J.P. Clauvel, A. Bussel
Journal: American Journal of Hematology (2001)

Abstract Plasma infusion (PI) and plasma exchange (PE) are the most efficient treatment of thrombotic thrombocytopenic purpura (TTP), allowing achievement of complete remission in 60 to 90% of cases. Life‐threatening bleeding, related to severe thrombocytopenia, is one of the main complications of the disease. Thrombocytopenia may also preclude invasive procedures such as splenectomy, which may be required during the management of TTP. Platelet concentrates transfusions are usually thought to worsen the disease, especially if not associated with the appropriate treatment of this latter, and thus should be avoided. We report hereon 2 patients with TTP who experienced a surgical procedure i.e., a cholecystectomy for a cholecystitis, and a splenectomy for a refractory TTP. In both patients, the surgical procedure was preceded by a 60 mL/kg plasma exchange with solvent/detergent treated plasma as replacement fluid, followed by platelet transfusion, with a corrected count increment of 57.1% (Patient 1) and 69.3% (Patient 2). Using this sequential treatment, the patients did not experience any deterioration of their status. Both patients had a favorable outcome after surgery. However, until such a procedure will be validated on a larger series of patients, it should be restricted to patients presenting with a refractory life‐threatening thrombocytopenia and/or requiring surgery or any kind of invasive procedure. Am. J. Hematol. 68:198–201, 2001. Published 2001 Wiley‐Liss, Inc.
Antibiotic Therapy for the Irritable Bowel Syndrome
Authors: Jan Tack
Journal: New England Journal of Medicine (2011)

The irritable bowel syndrome (IBS) is one of the most common conditions seen in clinical practice. The number of effective pharmacologic agents for IBS is limited, and therapeutic innovation is hampered by a lack of complete understanding of the pathophysiology of the syndrome, which is probably heterogeneous.1 Alterations in the bacterial flora are increasingly considered to be a relevant pathogenetic factor.2 Consequently, probiotics are being studied as treatment for IBS, but the magnitude of improvement in symptoms with probiotics is limited.2 Some studies have suggested that there are beneficial effects with poorly absorbed antibiotics, but the results of the studies . . .
Tissue factor pathway inhibitor gene delivery using HVJ-AVE liposomes markedly reduces restenosis in atherosclerotic arteries
Authors: X Yin
Journal: Cardiovascular Research (2002)

Objective: Tissue factor pathway inhibitor (TFPI), as a primary inhibitor of TF-induced coagulation, reduces neointimal formation and luminal stenosis by inhibiting coagulation and thrombosis after vessel wall injury. Here, we investigated the effect of TFPI gene delivery with a HVJ-AVE liposome vector on restenosis in atherosclerotic arteries after angioplasty in rabbits. We also evaluated the safety of the novel gene therapeutic strategy to prevent restenosis. Methods: Local iliac artery atherosclerosis was induced by a combination of balloon denudation and high-cholesterol diet in Japanese white rabbits, which were then subjected to angioplasty. Infusion of an HVJ-AVE liposome containing the TFPI gene or an "empty" pcDNA 3.1 expression vector, or HVJ-liposome vector only, or saline was performed at the site of angioplasty using a Dispatch® catheter. Quantitative angiography and histopathology were performed before and after gene delivery and at 4 weeks follow-up. The safety of the gene therapy was evaluated over a 6-month observation period. Results: TFPI mRNA and protein were detected in local TFPI gene transferred vessels after gene transfer. The mean minimal luminal diameter of the TFPI group was markedly greater than that of the control groups (P<0.01) at 4 weeks after gene transfer. The mean neointimal area, the ratio of the neointimal to medial areas, and percent of stenosis in the TFPI group were all significantly reduced compared with the control groups (each P<0.01). The external elastic luminal area, internal elastic luminal area, and luminal area were larger in the TFPI groups versus controls (each P<0.01). Thrombosis was found in five empty plasmid control group animals, but in only one in the TFPI group (P = 0.05). The systemic coagulation status of the treated animals were not significantly changed in either the TFPI group or the control groups; no toxicity was observed after HVJ-AVE liposome-mediated TFPI gene transfer. Conclusions: HVJ-AVE liposome-mediated TFPI gene transfer significantly reduced neointimal hyperplasia, inhibited thrombosis, and attenuated vascular remodeling and lumimal stenosis after angioplasty in atherosclerotic arteries without any significant adverse effects.
Transphrenic dissemination of actinomycosis.
Authors: C J Zeebregts, A H van der Heyden, E E Ligtvoet, J P Wagenaar, H F Hoitsma
Journal: Thorax (1996)

Thoracic actinomycosis is an uncommon disease and often presents difficulty in diagnosis. Two cases are presented in which thoracic actinomycosis produced fistulae between the thoracic and abdominal cavities. Surgical drainage and high dose penicillin for at least 4-6 months was the treatment of choice.
Reduction of coronary reserve: a mechanism for angina pectoris in patients with arterial hypertension and normal coronary arteries.
Authors: D Opherk, G Mall, H Zebe, F Schwarz, E Weihe, J Manthey, W Kübler
Journal: Circulation (1984)

The pathogenesis of angina pectoris in patients with left ventricular hypertrophy secondary to arterial hypertension and with normal coronary arteries remains uncertain. We measured coronary blood flow (argon method) in 12 control subjects and in 16 patients with arterial hypertension at rest and after intravenous administration of dipyridamole (0.5 mg/kg). In the patients with arterial hypertension, coronary blood flow response to dipyridamole was markedly reduced (p less than .001 as compared with control values). During coronary vasodilation there was a linear correlation between coronary resistance and left ventricular end-diastolic pressure (r = .67, p less than .001). Left ventricular catheter biopsy specimens did not reveal alterations in myocardial microvasculature. These findings suggest that reduction of coronary reserve may be an important contributor to the pathogenesis of angina pectoris in these patients.
MAGNETOCARDIOGRAPHY CAN IDENFITY ‘LOCAL’ VENTRICULAR CONDUCTION DELAY IN PATIENTS WITH LV DYSFUNCTION AND CLBBB/IVCD ON ECG: COMPARISON WITH ‘ISOLATED’ CLBBB
Authors: Shogo Oishi, Hiroshi Takaki, Shuji Hashimoto, Wataru Shimizu, Masaru Sugimachi, Shiro Kamakura
Journal: Journal of the American College of Cardiology (2010)
Liposomes Embark on Rescue Mission to Make Highly Toxic Drugs More Useful
Authors: Chris Anne Raymond
Journal: JAMA (1987)

DRUGS ARE intended to "rescue" patients from disease, but liposome technology may rescue some drugs whose use now is limited by dose-related toxicity, according to investigators conducting or planning clinical trials of liposomal formulations for this purpose. While questions remain about the feasibility and efficacy of liposome-encapsulated drugs, they are further along the path to the bedside than many other targeted drug-delivery systems. (Please see accompanying article.) One recent review predicts that more than a dozen therapies based on this technique will reach market within the decade (<i>Sci Am</i>, January 1987, pp 103-111). Liposomes are based on a simple principle: oil and water don't mix. Phospholipids, the stuff of cell membranes, are amphipathic—they have a hydrophilic head and a hydrophobic tail. Adding water to phospholipids forces them to form bilayered vesicles, resulting in the formation of small lipid membranes enclosing water. During vesicle formation, lipid-soluble drug molecules can be incorporated
Lack of effect of antineutrophil cytoplasmic antibodies associated with ulcerative colitis on superoxide anion production from neutrophils.
Authors: P Gionchetti, M Vecchi, F Rizzello, M Ferretti, C Calabresi, A Venturi, M B Bianchi, C Brignola, R A Sinico, R De Franchis, M Miglioli, M Campieri
Journal: Gut (1997)

BACKGROUND: Antineutrophil cytoplasmic antibodies (ANCAs) from patients with vasculitidis can induce neutrophils to release oxygen radicals in vitro. ANCAs with a perinuclear pattern of immunofluorescence are found in most patients with ulcerative colitis, but several findings are against ANCAs having a pathogenetic role in this disease. AIMS: To evaluate the influence of ANCAs associated with ulcerative colitis on the respiratory burst activity of neutrophils. PATIENTS: Serum samples were obtained from 14 patients with ulcerative colitis, seven of whom showed positivity for p-ANCAs, three patients with vasculitidis, two with positivity for p-ANCAs, and one for c-ANCAs, and seven healthy volunteers. METHODS: A positive ANCA serology was determined with a standard indirect immunofluorescence assay. Purified immunoglobulins (IgGs) were prepared from serum samples by DEAE-Affigel blue chromatography. Human neutrophils were prepared by dextran-Ficoll-Hypaque separation. Superoxide anion (O2-.) generation was measured by following the superoxide dismutase inhibitable reduction of ferricytochrome. RESULTS: There were no significant differences among samples from ulcerative colitis IgG p-ANCA positive, ulcerative colitis IgG p-ANCA negative patients, and controls on O2-. production, whereas ANCA positive IgG from vasculitidis significantly enhanced O2-. release (p &lt; 0.001). CONCLUSIONS: p-ANCAs associated with ulcerative colitis have no effect on the respiratory burst activity of normal human neutrophils in vitro. These results reinforce the hypotheses that ANCAs are unlikely to contribute to the pathogenesis of ulcerative colitis.
Care of physically handicapped young adults
Authors: R. Hull, M A. Hall
Journal: BMJ (1988)

with peripheral vascular disease before and after the recent introduction of percutaneous trans- luminal angioplasty and identified a new group of patients who could be treated.'Referral for angio- graphy was increased by 66%, but the rate of surgery performed remained static at about 22%.A further 24% were treated by percutaneous trans- luminal angioplasty.Lamberton documents an impressive 87% early clinical success rate with 80% patency at one year.2Mortality (1-2%) was associated with using the procedure in a group including patients with critically ischaemic limbs and poor general health.We now have more to offer patients with mild to moderate claudication than the simple sound advice to stop smoking and keep walking.Thrombolysis is not a treatment for stable claudication.If sudden severe claudication or rest pain develops, however, the limb may have been
Bringing Diagnosis Into the Quality and Safety Equations
Authors: Mark L. Graber, Robert M. Wachter, Christine K. Cassel
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
Tc-99m HMPAO Leukocyte and Tc-99m Nanocolloid Scintigraphy in Posttraumatic Bone Infection
Authors: MIKLÓS PAPÓS, FERENC BARÁT, GYÖRGY NÁRAI, JÓZSEF DILLMANN, JENÖ LÁNG, LÁSZLÓ CSERNAY
Journal: Clinical Nuclear Medicine (1998)

Posttraumatic osteomyelitis was investigated in 23 patients using nuclear medicine techniques. Tc-99m hexamethylpropilene amine oxime (HMPAO)-labeled leukocyte scintigraphy was performed in 11 patients, and Tc-99m nanocolloid scanning was performed in the other 12 patients. The scintigraphic findings were compared with clinical, laboratory, radiologic, and bacteriologic results. The findings on leukocyte imaging were consistent with the clinical symptoms in 7 of 11 patients, with the laboratory pattern in 7 of 10 patients, with the radiologic findings in 7 of 11 patients, and with the results of bacteriology in 6 of 7 patients. The findings on nanocolloid scintigraphy corresponded with the clinical symptoms in 9 of 12 patients, with the laboratory pattern in 8 of 10 patients, with the radiologic findings in 8 of 12 patients, and with the bacteriology in 4 of 5 patients. The results suggest that both methods were of similar value for the detection of chronic posttraumatic osteomyelitis regardless of whether the process was active. Conversely, on the basis of semiquantitative analysis of the images, leukocyte scintigraphy seemed to characterize the grade of inflammation better than did nanocolloid scintigraphy.
Decreased Polymorphonuclear Leukocyte Deformability in NIDDM
Authors: Zsolt Pécsvarády, Timothy C Fisher, Christine H Darwin, Agnes Fabók, Teresita S Maqueda, Mohammed F Saad, Herbert J Meiselman
Journal: Diabetes Care (1994)

OBJECTIVE To determine the rheological properties of polymorphonuclear leukocytes (PMN) from non-insulin-dependent diabetes mellitus (NIDDM) patients. RESEARCH DESIGN AND METHODS The deformability of PMN from 33 NIDDM subjects, 13 with impaired glucose tolerance (IGT), and 22 with normal glucose tolerance (NGT) was studied. A Cell Transit Analyzer that measures the transit time of PMN through 8-(xm pores was used. Studies were performed under three different conditions: J) basal state; 2) after incubation with cytochalasin B (20 μM) to dissociate f-actin from the cytoskeleton; and 3) following activation with N-formyl-methionyl-leucyl-phenylalanine (fMLP, 1 nM). RESULTS PMN from diabetic patients were more rigid (i.e., had longer transit time) than those from subjects with NGT or IGT under basal conditions and after cytochalasin B, but not after stimulation with fMLP. The deformability of PMN from subjects with IGT was similar to those of the NGT group. In the pooled data, basal transit time correlated with age; systolic and diastolic blood pressure; HbA1c; and serum creatinine, cholesterol, and triglyceride concentrations (r = 0.29, 0.34, 0.37, 0.48, 0.25, 0.36, 0.29, respectively, P &amp;lt; 0.05 for each). Hypertensive diabetic patients had less deformable PMN than normotensive ones. No relation was found between PMN deformability and the duration of diabetes, type of treatment, or the presence of retinopathy. CONCLUSIONS These data indicate increased rigidity of PMN in NIDDM that may contribute to development of microcirculatory disturbances and microangiopathy.
Benefits of Adding a Drug to a Single-Agent or a 2-Agent Chemotherapy Regimen in Advanced Non–Small-Cell Lung Cancer
Authors: Catherine Delbaldo, Stefan Michiels, Nathalie Syz, Jean-Charles Soria, Thierry Le Chevalier, Jean-Pierre Pignon
Journal: JAMA (2004)

Randomized trials have demonstrated that adding a drug to a single-agent or to a 2-agent regimen increased the tumor response rate in patients with advanced non-small-cell lung cancer (NSCLC), although its impact on survival remains controversial.To evaluate the clinical benefit of adding a drug to a single-agent or 2-agent chemotherapy regimen in terms of tumor response rate, survival, and toxicity in patients with advanced NSCLC.Data from all randomized controlled trials performed between 1980 and 2001 (published between January 1980 and October 2003) comparing a doublet regimen with a single-agent regimen or comparing a triplet regimen with a doublet regimen in patients with advanced NSCLC. There were no language restrictions. Searches of MEDLINE and EMBASE were performed using the search terms non-small-cell lung carcinoma/drug therapy, adenocarcinoma, large-cell carcinoma, squamous-cell carcinoma, lung, neoplasms, clinical trial phase III, and randomized trial. Manual searches were also performed to find conference proceedings published between January 1982 and October 2003.Two independent investigators reviewed the publications and extracted the data. Pooled odds ratios (ORs) for the objective tumor response rate, 1-year survival rate, and toxicity rate were calculated using the fixed-effect model. Pooled median ratios (MRs) for median survival also were calculated using the fixed-effect model. ORs and MRs lower than unity (<1.0) indicate a benefit of a doublet regimen compared with a single-agent regimen (or a triplet regimen compared with a doublet regimen).Sixty-five trials (13 601 patients) were eligible. In the trials comparing a doublet regimen with a single-agent regimen, a significant increase was observed in tumor response (OR, 0.42; 95% confidence interval [CI], 0.37-0.47; P<.001) and 1-year survival (OR, 0.80; 95% CI, 0.70-0.91; P<.001) in favor of the doublet regimen. The median survival ratio was 0.83 (95% CI, 0.79-0.89; P<.001). An increase also was observed in the tumor response rate (OR, 0.66; 95% CI, 0.58-0.75; P<.001) in favor of the triplet regimen, but not for 1-year survival (OR, 1.01; 95% CI, 0.85-1.21; P =.88). The median survival ratio was 1.00 (95% CI, 0.94-1.06; P =.97).Adding a second drug improved tumor response and survival rate. Adding a third drug had a weaker effect on tumor response and no effect on survival.
Down-regulation of HLA-A and HLA-Bw6, but not HLA-Bw4, allospecificities in leukemic cells: an escape mechanism from CTL and NK attack?
Authors: Christian Demanet, Arend Mulder, Veronique Deneys, Maria J. Worsham, Piet Maes, Frans H. Claas, Soldano Ferrone
Journal: Blood (2003)
Polyarteritis Nodosa
Authors: David E. Dines
Journal: JAMA (1964)

POLYARTERITIS NODOSA is a progressive and uniformly fatal disease. The classic picture is one of multisystem involvement with fever, polyneuritis, renal, dermal, and pulmonary involvement, and a chronic course. The following is a report of a patient with polyarteritis nodosa with widespread disease given long-term anticoagulant therapy. The improvement has been so marked on long-term anticoagulants that the report was felt to be justified. <h3>Report of a Case</h3> A 32-year-old engineer was admitted on May 22, 1960, to Presbyterian Hospital in Denver with acute onset of right upper quadrant pain associated with spiking fever and a tender, enlarged liver. The complete work-up yielded negative results except for a 4+ cephalin flocculation and test done with Rose Bengal I 131 which showed hepatic dysfunction compatible with hepatitis. There was no icterus. An exploratory laparotomy was performed on June 10, 1960, and a biopsy specimen of the liver disclosed subacute toxic hepatitis
An ultrasound Doppler technique for the noninvasive determination of the pressure gradient in the Björk-Shiley mitral valve.
Authors: J Holen, S Simonsen, T Frøysaker
Journal: Circulation (1979)

The accuracy in determining the pressure gradient in the Björk-Shiley mitral implant from noninvasive ultrasound Doppler data was explored in nine adult patients. Manometric and ultrasound data were collectd simultaneously, and identical diastolic periods were used to compare the manometric gradient (delta Pm) with the gradient obtained from ultrasound data (delta Pu). In the nine patients the mean diastolic value of delta Pm ranged from 2-12.5 mm Hg and the difference between the mean diastolic values of delta Pm and delta Pu was 0.3 +/- 1.0 mm Hg(SD). The results of the investigation indicated that the method is accurate and reliable in the nonivasive determination of the mean diastolic gradient in the Björk-Shiley mitral implant.
Manual of Intensive Care Medicine
Authors: Richard W. Carlson
Journal: JAMA (1985)

This manual is a collection of critical care topics. The text is geared toward a bedside approach to diagnosis and treatment and should be a valuable tool for practicing clinicians, especially house officers who may provide direct care to critically ill patients. The chapters are organized so that need to know items can be quickly indexed. The text begins with descriptions of commonly performed special procedures, including endotracheal intubation and central venous, arterial, and pulmonary artery catheterizations. Indications for each procedure are delineated, as are contraindications and complications. Some practical but often overlooked comments are also included. For example, an 8-mm or larger endotracheal tube should be used if bronchoscopy is considered, and the tendency for pulmonary catheters to migrate peripherally as the catheter softens because of body temperature is discussed.  Diagrams are kept to a minimum and are simple, eg, anatomy of the great vessels and the neck and
TBX5 drives Scn5a expression to regulate cardiac conduction system function
Authors: David E. Arnolds, Fang Liu, John P. Fahrenbach, Gene H. Kim, Kurt J. Schillinger, Scott Smemo, Elizabeth M. McNally, Marcelo A. Nobrega, Vickas V. Patel, Ivan P. Moskowitz
Journal: Journal of Clinical Investigation (2012)

Cardiac conduction system (CCS) disease, which results in disrupted conduction and impaired cardiac rhythm, is common with significant morbidity and mortality. Current treatment options are limited, and rational efforts to develop cell-based and regenerative therapies require knowledge of the molecular networks that establish and maintain CCS function. Recent genome-wide association studies (GWAS) have identified numerous loci associated with adult human CCS function, including TBX5 and SCN5A. We hypothesized that TBX5, a critical developmental transcription factor, regulates transcriptional networks required for mature CCS function. We found that deletion of Tbx5 from the mature murine ventricular conduction system (VCS), including the AV bundle and bundle branches, resulted in severe VCS functional consequences, including loss of fast conduction, arrhythmias, and sudden death. Ventricular contractile function and the VCS fate map remained unchanged in VCS-specific Tbx5 knockouts. However, key mediators of fast conduction, including Nav1.5, which is encoded by Scn5a, and connexin 40 (Cx40), demonstrated Tbx5-dependent expression in the VCS. We identified a TBX5-responsive enhancer downstream of Scn5a sufficient to drive VCS expression in vivo, dependent on canonical T-box binding sites. Our results establish a direct molecular link between Tbx5 and Scn5a and elucidate a hierarchy between human GWAS loci that affects function of the mature VCS, establishing a paradigm for understanding the molecular pathology of CCS disease.
Blisters over burn scars in a child
Authors: R. PEDRAGOSA, S. SERRANO, J. CAROL-MURILLO, J.V. HERNANDEZ, J. VIDAL
Journal: British Journal of Dermatology (1986)

We present the case of an 11‐month‐old baby with a burn that healed normally over a month, but subsequently developed successive crops of blisters over the scar. There were no changes in his general condition. Clinical, immunological, histological and ultrastructural studies provided a diagnosis of mechanical dermatitis produced by microtrauma. Electron microscopy studies revealed the sub‐epidermal nature of the blisters and the presence of underlying fibrin deposits.