tbuckley/cabot-search huggingface dataset:
The Clinical Spectrum and Therapeutic Management of Hypocomplementemic Urticarial Vasculitis: Data From a French Nationwide Study of Fifty‐Seven Patients
Authors: Marie Jachiet, Béatrice Flageul, Alban Deroux, Alain Le Quellec, François Maurier, Florence Cordoliani, Pascal Godmer, Claire Abasq, Leonardo Astudillo, Pauline Belenotti, Didier Bessis, Adrien Bigot, Marie‐Sylvie Doutre, Mikaël Ebbo, Isabelle Guichard, Eric Hachulla, Emmanuel Héron, Géraldine Jeudy, Noémie Jourde‐Chiche, Denis Jullien, Christian Lavigne, Laurent Machet, Marie‐Alice Macher, Clotilde Martel, Sara Melboucy‐Belkhir, Cécile Morice, Antoine Petit, Bernard Simorre, Thierry Zenone, Laurence Bouillet, Martine Bagot, Véronique Frémeaux‐Bacchi, Loïc Guillevin, Luc Mouthon, Nicolas Dupin, Selim Aractingi, Benjamin Terrier
Journal: Arthritis & Rheumatology (2014)

Hypocomplementemic urticarial vasculitis (HUV) is an uncommon vasculitis of unknown etiology that is rarely described in the literature. We undertook this study to analyze the clinical spectrum and the therapeutic management of patients with HUV.We conducted a French nationwide retrospective study that included 57 patients with chronic urticaria, histologic leukocytoclastic vasculitis, and hypocomplementemia. We assessed clinical and laboratory data and evaluated the patients' cutaneous and immunologic responses to therapy. We evaluated treatment efficacy by measuring the time to treatment failure.Urticarial lesions were typically more pruritic than painful and were associated with angioedema in 51% of patients, purpura in 35%, and livedo reticularis in 14%. Extracutaneous manifestations included constitutional symptoms (in 56% of patients) as well as musculoskeletal involvement (in 82%), ocular involvement (in 56%), pulmonary involvement (in 19%), gastrointestinal involvement (in 18%), and kidney involvement (in 14%). Patients with HUV typically presented with low C1q levels and normal C1 inhibitor levels, in association with anti-C1q antibodies in 55% of patients. Hydroxychloroquine or colchicine seemed to be as effective as corticosteroids as first-line therapy. In patients with relapsing and/or refractory disease, rates of cutaneous and immunologic response to therapy seemed to be higher with conventional immunosuppressive agents, in particular, azathioprine, mycophenolate mofetil, or cyclophosphamide, while a rituximab-based regimen tended to have higher efficacy. Finally, a cutaneous response to therapy was strongly associated with an immunologic response to therapy.HUV represents an uncommon systemic and relapsing vasculitis with various manifestations, mainly, musculoskeletal and ocular involvement associated with anti-C1q antibodies, which were found in approximately half of the patients. The best strategy for treating HUV has yet to be defined.
From the Office of the General Counsel. Occurrence vs claims-made medical professional liability insurance policies. Fundamental differences in the concept of coverage
Authors: I. D. Johnson
Journal: JAMA (1991)

DECISIONS regarding medical professional liability insurance, also known as malpractice insurance, require an understanding of the fundamental differences between the two types of insurance coverage available to physicians. In addition to a discussion of the distinctions between the basic types of coverage, this article will detail several coverage problems that physicians can encounter. <h3>Occurrence Coverage</h3> Two basic types of medical professional liability coverage are available: occurrence and claims-made. The concept of occurrence coverage is relatively straightforward: occurrence policies cover a physician (ie, the insurer will defend the physician and pay out, if necessary, on claims that are asserted against the physician) for claims arising from incidents that occurred during the period of time the physician was covered by the policy. An<i>incident</i>(also variably called a<i>medical incident</i>) is typically defined by insurers as an act or omission that causes injury or damage to another and that arises during the
Long-term Use of Nicotine Gum Is Associated With Hyperinsulinemia and Insulin Resistance
Authors: Bjo¨rn Eliasson, Marja-Riitta Taskinen, Ulf Smith
Journal: Circulation (1996)

Background Insulin sensitivity and cardiovascular risk profile were examined in 20 healthy, nonobese, middle-aged men who were long-term users of nicotine-containing chewing gum and in 20 matched control subjects who did not use nicotine. Methods and Results Long-term use of nicotine-containing chewing gum was associated with insulin resistance and hyperinsulinemia. The degree of insulin sensitivity correlated negatively to the extent of nicotine use measured as plasma cotinine levels. Conclusions These findings suggest that nicotine is the major constituent in cigarette smoke that leads to insulin resistance, metabolic abnormalities associated with the insulin resistance syndrome, and increased cardiovascular morbidity. Thus, the use of nicotine replacement therapy during smoking cessation should be transient and limited.
Effect of Metoprolol Administration on Renal Sodium Handling in Experimental Congestive Heart Failure
Authors: Gerald F. DiBona, Linda L. Sawin
Journal: Circulation (1999)

Long-term metoprolol therapy improves cardiac performance and decreases mortality in patients with chronic congestive heart failure (CHF). This study examined the effect of long-term metoprolol therapy on renal sodium handling in an experimental rat model of CHF.Rats with left coronary ligation and myocardial infarction-induced CHF were treated with metoprolol (1.5 mg. kg-1. h-1) or vehicle for 3 weeks by osmotic minipump. They were then evaluated for their ability to excrete a short-term sodium load (5% body weight isotonic saline infusion over 30 minutes) and a long-term sodium load (change from low- to high-sodium diet over 8 days). All CHF rats had left ventricular end-diastolic pressure >10 mm Hg, and heart weight/body weight ratios averaged 0.68+/-0.02% (versus control of approximately 0.40%). Compared with vehicle CHF rats (n=19), metoprolol CHF rats (n=18) had lower basal values of mean arterial pressure (122+/-3 versus 112+/-3 mm Hg) and heart rate (373+/-14 versus 315+/-9 bpm) and decreased heart rate responses to intravenous doses of isoproterenol. During short-term isotonic saline volume loading, metoprolol CHF rats excreted 54+/-4% more of the sodium load than vehicle CHF rats. During long-term dietary sodium loading, metoprolol CHF rats retained 28+/-3% less sodium than vehicle CHF rats.Metoprolol treatment of rats with CHF results in an improved ability to excrete both short- and long-term sodium loads.
Rifampin-lnduced Organic Brain Syndrome
Authors: Thomas H. Pratt
Journal: JAMA (1979)

RIFAMPIN, a semisynthetic antibiotic derived from rifamycin B, is a frequently employed antituberculous agent used in conjunction with one or more other drugs in the treatment of tuberculosis. It is also recognized to be effective in eliminating meningococci from the nasopharynx of asymptomatic carriers ofNeisseria meningitidis.1Rifampin acts by inhibiting DNA-dependent bacterial RNA polymerase in susceptible organisms.2The more commonly encountered side effects caused by rifampin include gastrointestinal disturbances, eg, nausea, vomiting, diarrhea, and heartburn. A case of acute organic brain syndrome was associated with rifampin administration in the treatment of pulmonary tuberculosis.  Report of a Case  A 60-year-old man with no history of psychiatric disorders was admitted to the Veterans Administration Hospital on transfer from a local private hospital with a diagnosis of pulmonary tuberculosis demonstrated by the presence of acid-fast bacilli on Zeihl-Neelsen stain of sputum and subsequently by culture. He had no history of
Electrocardiographic localization of coronary artery narrowings: studies during myocardial ischemia and infarction in patients with one-vessel disease.
Authors: R M Fuchs, S C Achuff, L Grunwald, F C Yin, L S Griffith
Journal: Circulation (1982)

To investigate the accuracy of the 12-lead ECG in localizing the site of coronary artery narrowings, we reviewed abnormal ECGs obtained during myocardial infarction, spontaneous angina or exercise stress testing in 134 patients with angiographically documented one-vessel disease. The presence of Q waves, ST-segment elevation and T-wave inversion in leads I, aVL and V1--V4 were all highly correlated with the presence of left anterior descending coronary artery disease (p less than 0.001), and the same ECG findings in leads II, III and aVF were associated with right (RCA) or circumflex coronary artery (LCx) narrowings (p less than 0.001). In contrast, ST depression alone was not useful in predicting the site of coronary artery narrowing. Q waves correctly identified the location of the coronary disease in 98% of cases, ST elevation in 91%, T-wave inversion in 84%, and ST depression in 60%. No electrocardiographic criteria distinguished RCA from LCx disease, even in patients with a right-dominant circulation. These findings should lead to a better understanding of the value and limitations of the 12-lead ECG in localizing coronary artery disease.
Shoulder Pain in a Young Break-Dancer Evaluated With Bone Scintigraphy
Authors: Jabour J. Khoury, Norman Loberant, Jacqueline Jerushalmi
Journal: Clinical Nuclear Medicine (2009)

We report the case of an 18-year-old male breakdancer evaluated with bone scintigraphy for shoulder pain. Bone scintigraphy showed intense tracer uptake in both sholders. Dance-related injury is well described in the literature, and classically involves the feet and ankles, but breakdance injuries, which may involve any part of the body, have been reported only infrequently. We report here a case of shoulder injury related to breakdance demonstrated on bone scintigraphy.
BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma.
Authors: Ruben Niesvizky, David S. Jayabalan, Paul J. Christos, Jessica R. Furst, Tara Naib, Scott Ely, Jessica Jalbrzikowski, Roger N. Pearse, Faiza Zafar, Karen Pekle, April LaRow, Richard Lent, Tomer Mark, Hearn J. Cho, Tsiporah Shore, Jeffrey Tepler, John Harpel, Michael W. Schuster, Susan Mathew, John P. Leonard, Madhu Mazumdar, Selina Chen-Kiang, Morton Coleman
Journal: Blood (2007)
DNR in the OR
Authors: Charles Couper
Journal: JAMA (1992)

ABSTRACT To the Editor. —Though Walker1 eloquently defends a terminally ill patient's right not to be resuscitated, his argument for maintaining the do not resuscitate (DNR) order in the operating room (OR) oversimplifies the role of anesthesia and the anesthesiologist. Anesthesia is a completely artificial state induced and maintained by the anesthesia provider. From the onset of the procedure, the patient may require  to avoid an adverse outcome, even if otherwise healthy. At what point resuscitation becomes extraordinary is never clear, as the events that can lead to an intraoperative arrest often resemble events that occur in the course of routine anesthesia. The burden falls on the anesthesiologist, who basically is a consultant and whose relationship with the patient may last only a few hours, to make this ultimate decision.The use of regional techniques also frequently requires routine resuscitation. Hypotension is almost a certain side effect when spinal
Even Better Kinase Inhibitors for Chronic Myeloid Leukemia
Authors: Charles L. Sawyers
Journal: New England Journal of Medicine (2010)

The clinical success of imatinib in patients with chronic myeloid leukemia (CML), which was first reported 9 years ago,1 catalyzed a systemwide shift in the development of cancer drugs to include molecularly targeted therapies. According to one recent estimate, approximately 200 such drugs are now in the clinical-development pipeline. First approved for interferon-resistant CML, imatinib quickly became the standard of care in patients with newly diagnosed CML on the basis of the drug's remarkable efficacy (complete cytogenetic remissions in some 70% of patients) with minimal toxic effects when used as initial therapy.2 Success of that magnitude is rare in oncology. . . .
Danazol for the Treatment of Refractory Autoimmune Thrombocytopenia in Systemic Lupus Erythematosus
Authors: STERLING G. WEST
Journal: Annals of Internal Medicine (1988)

Study Objective: To determine the efficacy of danazol therapy in patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to other therapies. Design: Noncontrolled clinical trial, with a minimum of 8 weeks of therapy, the maximum determined by clinical response. Setting: Referral-based rheumatology clinic at an army medical center. Patients: Sequential sample of six patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to high-dose glucocorticoids. Four patients also failed splenectomy, or cytotoxic drugs, or both. Interventions: Danazol, 200 mg four times per day, was added to the previous therapeutic regimen for at least 2 months. Measurements and Main Results: All six patients had normal platelet counts within 6 weeks of starting danazol treatment. After resolution of thrombocytopenia for at least 1 month, immunosuppressive medications were tapered; one patient had a relapse. During an average follow-up of 12 months, the danazol dose was lowered in the five remaining patients but could not be discontinued without recurrence of thrombocytopenia. During danazol therapy, platelet-bound IgG antibodies and circulating immune complexes did not decrease significantly. Danazol was well tolerated. Conclusions: Danazol appears to be a useful adjunctive treatment for refractory autoimmune thrombocytopenia associated with systemic lupus erythematosus.
Lithium Carbonate Toxicity
Authors: Abraham Flemenbaum
Journal: JAMA (1974)

To the Editor.—  The article of F. A. Herrero on lithium carbonate toxicity (226:1109, 1973) deserves comment. Some authorities believe lithium carbonate is one of the most underused neuroleptic drugs.  Though considered safe within the appropriate therapeutic range (0.6 to 1.2 mEq/liter), it is always important to know about idiosyncrasies, so that physicians may take appropriate measures. Awareness of these unusual cases, however, should be created without stimulating exaggerated fears that may inhibit use in cases where lithium is clearly indicated.  Both the report and the editorial note fail to recognize recent findings suggesting that appropriate treatment for acute manic episodes should include phenothiazines or butyrophenones. This treatment method is more effective in controlling the initial symptoms of hyperactivity during the waiting period of seven to ten days necessary for lithium activity. It also decreases the need for blood lithium levels as high as 1.5 mEq/liter, thus lowering the risk
Comparison of maximal acid output and gastrin response to meals in Chinese and Scottish normal and duodenal ulcer subjects.
Authors: S K Lam, M Hasan, W Sircus, J Wong, G B Ong, R J Prescott
Journal: Gut (1980)

Maximal acid output (MAO) after pentagastrin stimulation and gastrin response to a standard meal was studied in 100 control and 200 duodenal ulcer subjects from each of two ethnic groups, Scots and Chinese. The acid output was significantly higher in the Scots than in the Chinese for both controls and duodenal ulcer patients. Despite correction for differences in body stature by expressing MAO as a function of the body weight, these differences persisted. In 45 pairs of closely matched patients with duodenal ulcer, the differences between the two ethnic groups remained significant, irrespective of whether MAO was expressed in absolute or weight corrected values. This indicates that differences in age, sex, family history, or duration of illness did not account for differences in acid output. In 20 pairs of normal control and 45 pairs of duodenal ulcer patients the fasting and post-prandial serum gastrin levels did not differ, significantly between the two ethnic groups. The proportion of acid normosecretors was significantly higher in the Chinese duodenal ulcer patients than in the Scottish. The reason for these differences in the gastric acid output between the two ethnic groups is not known and needs to be studied further.
Lung Cancer Screening
Authors: Bridget M. Kuehn
Journal: JAMA (2010)

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
Substance P is released from the endothelium of normal and capsaicin-treated rat hind-limb vasculature, in vivo, by increased flow.
Authors: V Ralevic, P Milner, O Hudlická, F Kristek, G Burnstock
Journal: Circulation Research (1990)

The rat hind-limb vasculature releases substance P when subjected to a rapid increase in flow through the vascular bed. This release also occurs during high flow after rats have been capsaicinized, when loss of substance P-containing nerve fibers was verified by immunohistochemistry. Air treatment, a procedure shown by transmission electron microscopy to have removed endothelial cells from the arteries but not arterioles or capillaries of the hind-limb preparations, eliminated this release. Thus, the substance P released is unlikely to arise from perivascular nerves but rather from arterial endothelial cells.
Acute Pneumonia During the 1968 Influenza Epidemic.
Authors: William H. Wood
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Acute Pneumonia During the 1968 Influenza Epidemic.William H. Wood, M.D., Emanuel Wolinsky, M.D.William H. Wood, M.D.Search for more papers by this author, Emanuel Wolinsky, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-797_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHong Kong influenza was diagnosed in Cleveland during the last week in November 1968. The 65 acute pneumonia admissions to the adult medical service of Cleveland Metropolitan General Hospital, Cleveland, Ohio, during the period of peak frequency of influenza in the city were analyzed, with emphasis on the bacterial cause and the autopsy findings in the 9 fatal cases. These results were compared with the experience of previous years. History of an influenza-like illness preceding the pneumonia was present in a majority of the cases and was documented by elevated or paired rises in hemagglutination inhibition titers against Influenza A2/Hong... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: William H. Wood, M.D.; Emanuel Wolinsky, M.D.Affiliations: Cleveland, Ohio. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 797-797KeywordsAutopsyBacterial pneumoniaHemagglutinationMedical servicesPneumonia ePublished: 1 December 2008 Issue Published: 1 May 1970 PDF downloadLoading ...
Abstract 564: A &amp;gt;50KDa soluble factor from the stroma-derived conditioned media contributes to resistance towards BCR-ABL inhibitors in CML via the JAK-STAT3 pathway
Authors: Rajesh R. Nair, Joel H. Tolentino, Raul F. Argilagos, Javier Pinilla-Ibarz, Lori A. Hazlehurst
Journal: Cancer Research (2010)

Abstract Soluble factors and extracellular matrices from the bone marrow stroma, provides the essential microenvironment that contributes to the persistence of minimal residual disease found in patients with Chronic Myeloid Leukemia (CML), under treatment with tyrosine kinase inhibitors. We previously showed that in CML cells, bone marrow stroma-derived conditioned medium (CM) is sufficient to cause resistance to BCR-ABL inhibitors in a STAT3-dependent manner. In this study, we show that development of resistance in CM correlated with increased STAT3 phosphorylation and increased STAT3 DNA binding in CML cells. The activation of Stat3 in the context of CM was persistent even in the presence of BCR-ABL inhibitors. Moreover, the increase in DNA binding resulted in increased transcriptional activity of STAT3 and increased expression of MCL-1, Bcl-xl and Cyclin D1 in cells exposed to CM. We also found that CM-mediated increase in STAT3 activation requires JAK activity, since use of a pan JAK inhibitor sensitized the cells to BCR-ABL inhibitor in CM. Surprisingly, neutralizing the activity of IL-6, G-CSF and VEGF in the CM did not reverse the protection afforded by CM against BCL-ABL inhibitors. Furthermore, utilizing size exclusion filter columns, we were able to show that CM retentates that were higher than 50 kDa, was sufficient to duplicate the protective effects of CM against BCR-ABL inhibitor. Finally, we could show that CD34+ cells from BCR-ABL patients when exposed to CM showed an increase in STAT3 phosphorylation and this correlated with resistance to Nilotinib-mediated cell death. In conclusion, a greater than 50 KDa factor in CM leads to JAK-STAT3 activation, which is necessary and sufficient to confer resistance to CML cells against BCR-ABL inhibitors. 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 564.
EDUCATION IN PHYSICAL THERAPY IN THE STATE OF PENNSYLVANIA
Authors: FRANK H. KRUSEN
Journal: JAMA (1934)

Although, in certain centers, the practice of physical therapy has made remarkable strides during the past five years, widespread knowledge of the subject is still lacking. Elbert Hubbard has said: "A man is usually down on that which he is not up on." Education in physical therapy has progressed sufficiently so that the rank and file of physicians have gained sufficient knowledge of the subject to be no longer blindly antagonistic to physical therapy as a whole. Molander<sup>1</sup>has said: "There is lack of appreciation as to the vastness of the field of physical therapy. It ramifies through every phase of medicine." Shaull<sup>2</sup>has pointed out that "the attempt to evaluate physical therapy as a whole should be abandoned"; that it is just as difficult to answer the question "What do you think of physical therapy?" as it is to answer the question "What do you think of