tbuckley/cabot-search huggingface dataset:
Diagnosis and management of pulmonary embolism
Authors: S. T. Lapner, C. Kearon
Journal: BMJ (2013)

#### Summary points

Pulmonary embolism is one manifestation of venous thromboembolism, the other being deep vein thrombosis. Pulmonary embolism occurs when a deep vein thrombosis breaks free, passes through the right side of the heart, and lodges in the pulmonary arteries. About 90% of pulmonary emboli come from the legs, with most involving the proximal (popliteal or more central) veins. Prevention of pulmonary embolism therefore requires both prevention of venous thromboembolism and effective treatment of deep vein thrombosis when it occurs. There is a wealth of high quality individual studies and meta-analyses to guide the diagnosis and treatment of pulmonary embolism, and we provide an overview and synthesis of that evidence in this review.

#### Sources and selection criteria

We searched Medline and the Cochrane Collaboration for up to date systematic reviews, meta-analyses, and high quality randomised controlled trials pertaining to the epidemiology, diagnosis, and treatment of pulmonary embolism. We also drew on the recently published guidelines on diagnosis and treatment of pulmonary embolism from the National Institute for Health and Clinical Excellence (NICE) and on treatment for venous thromboembolism from the American College of Chest Physicians.

Symptomatic venous thromboembolism occurs in 1–2 per 1000 adults each year, with about a third …
Platanus acerifolia pollinosis and food allergy
Authors: E. Enrique
Journal: Allergy (2002)

In Mediterranean areas, oral allergy syndrome (OAS) occurs independently of an associated birch pollinosis; moreover, on occasions it presents with no other associated pollinosis. The aim of this study was to assess the possible association of OAS with Platanus acerifolia pollinosis.We evaluated consecutive patients seen for pollinosis in an allergy department. Seven hundred and twenty patients were selected on the basis of seasonal or perennial rhinitis, or asthma, or both. Respiratory and food allergies were studied in all patients. Clinical history was recorded and examinations and skin prick tests were performed with a battery of available common inhalant allergens and plant-derived food allergens. Specific IgE levels to P. acerifolia pollen extract and food allergens tested were measured. Molecular masses of the IgE-binding proteins and cross-reactivity among the P. acerifolia pollen and different food extracts were also determined.Of the 720 patients evaluated, 61 (8.48%) were sensitized to P. acerifolia pollen. Food allergy was observed in 32 (52.45%) of the 61 patients sensitized to P. acerifolia pollen. Food allergens most frequently implicated were hazelnuts, peach, apple, peanuts, maize, chickpea and lettuce. Enzyme allergosorbent (EAST)-inhibition showed high inhibition values when P. acerifolia pollen extract was used as free phase. On the contrary low inhibition was observed when plant-derived food allergens were used as free phase and P. acerifolia pollen extract as solid phase.Cross-reactivity was observed among P. acerifolia pollen and plant-derived foods. OAS in these patients may have been caused by primary respiratory sensitization.
Moving from peanut extract to peanut components: towards validation of component‐resolved IgE tests
Authors: J. A. Aalberse, Y. Meijer, N. Derksen, T. van der Palen‐Merkus, E. Knol, R. C. Aalberse
Journal: Allergy (2013)

Abstract Background Replacement of peanut extracts by recombinant peanut components is an important step in allergy serologic testing. Criteria are needed for the unbiased inclusion of patients into a study to validate such a replacement. Methods Plasma samples from 64 peanut‐positive children (42 reactors, 22 nonreactors in a double‐blind, placebo‐controlled food challenge) were used to compare IgE reactivity to six recombinant peanut allergens with reactivity to natural peanut proteins extracted at neutral or low pH . We tested the hypothesis that poor extractability of Ara h 9 and other basic allergens at neutral pH leads to under‐representation of patients with such sensitization. Results IgE reactivity to the components did not fully explain IgE reactivity to peanut extract in 5 of 32 reactors with IgE to peanut extract ≤100 kU A /l. IgE reactivity to components was stronger than to the extract in 11 plasma samples, which was largely due to a low Ara h 8 reactivity of the extract. IgE reactivity to Ara h 9 was much lower than reactivity to other basic proteins, some of which bound IgE well in the RAST , but lost IgE reactivity upon immunoblotting. Conclusions Conventional peanut extracts are deficient in significant IgE‐binding components. The inclusion of patients for a validation study should be based on serology performed with improved peanut reagents to avoid a bias against these under‐represented, potentially important allergens. To judge clinical relevance of an allergen, the reagent used for inclusion of patients needs to be efficient in detecting IgE to this component.
Prolactin increases SMN expression and survival in a mouse model of severe spinal muscular atrophy via the STAT5 pathway
Authors: Faraz Farooq, Francisco Abadía Molina, Jeremiah Hadwen, Duncan MacKenzie, Luke Witherspoon, Matthew Osmond, Martin Holcik, Alex MacKenzie
Journal: Journal of Clinical Investigation (2011)

Spinal muscular atrophy (SMA) is an autosomal recessive neurodegenerative disease that is characterized by the loss of motor neurons, resulting in progressive muscle atrophy. It is caused by the loss of functional survival motor neuron (SMN) protein due to mutations or deletion in the SMN1 gene. A potential treatment strategy for SMA is to upregulate levels of SMN protein. Several agents that activate STAT5 in human and mouse cell lines enhance SMN expression from the SMN2 gene and can compensate, at least in part, for the loss of production of a functional protein from SMN1. Here, we have shown that prolactin (PRL) increases SMN levels via activation of the STAT5 pathway. PRL increased SMN mRNA and protein levels in cultured human and mouse neuronal cells. Administration of STAT5-specific siRNA blocked the effects of PRL, indicating that the PRL-induced transcriptional upregulation of the SMN-encoding gene was mediated by activation of STAT5. Furthermore, systemic administration of PRL to WT mice induced SMN expression in the brain and spinal cord. Critically, PRL treatment increased SMN levels, improved motor function, and enhanced survival in a mouse model of severe SMA. Our results confirm earlier work suggesting STAT5 pathway activators as potential therapeutic compounds for the treatment of SMA and identify PRL as one such promising agent.
Medical Medals—Request for Assistance.
Authors: Horatio R. Storer
Journal: JAMA (1895)

Newport, R. I., Jan. 15, 1895. <h3>To the Editor:</h3> —In the course of an enumeration of the medals illustrating medicine that have continuously appeared in the<i>American Journal of Numismatics</i>since January, 1889, several questions have occurred which I have failed to settle, and concerning which I shall be very glad for aid. British America: Dr. Richard Noble Starr, of Caradoc, Canada. What were his dates of birth and death? Dr. Orrin C. Wood, of Montreal. His middle name, and dates? Central America: Dr. Perfecto G. Bustamente, of Gaudalajara, Mexico. His middle name, and dates? South America: Dr. Alacombe, Puerto Cabello, Venezuela. Who was this person? If a medical man, his dates and full name? Dr. Pedro Ascarrinus, of Bolivia. His dates and city of residence? Dr. Juan Adriano Chasas, of Asuncion, Paraguay. Was he a physician or a lawyer? If the former, his dates? The United States: Dr. C.
An elderly man who suddenly lost consciousness
Authors: R. Ramaraj
Journal: BMJ (2009)

While walking on the beach, a 76 year old man lost consciousness suddenly and woke up to find his family looking over him. He had no convulsions, tongue biting, or urinary or faecal incontinence. He did not recall the event, but his daughter reported that he fell over without warning. He had no history of losses of consciousness, but he did admit to occasional chest pain and breathlessness on exertion. He took no regular drugs. Electrocardiography showed sinus rhythm with no ST/T changes. His pulse rate was regular at 68 beats/min, and his blood pressure was 132/76 mm Hg. Pulses were equal in all four extremities, and pedal oedema was not present. His venous pressure was not raised. On auscultation, his lungs were clear. He had delayed and subdued carotid upstrokes with a loud, late peaking, systolic crescendo-decrescendo murmur over the sternal border near the second intercostal space. The second heart sound was faintly audible. ### Short answers
New indexes for assessing aortic regurgitation with two-dimensional Doppler echocardiographic measurement of the regurgitant aortic valvular area.
Authors: C Veyrat, A Lessana, G Abitbol, A Ameur, R Benaim, D Kalmanson
Journal: Circulation (1983)

Direct examination of the aortic orifice at the level of the aortic valves (aortic valvular orifice area, AVOA) in the short-axis plane was performed with a 3 MHz two-dimensional pulsed Doppler echocardiographic apparatus. The AVOA was mapped with the Doppler gate to detect or rule out the presence of a regurgitant aortic valvular area (RAVA) established by recording of abnormal diastolic Doppler signals on a "yes or no" basis. A group of 12 normal subjects and 83 patients, including 40 patients with aortic regurgitation proven by aortography, were investigated with this procedure. In the 38 patients with aortic regurgitation diagnosed by Doppler echocardiography (diagnostic sensitivity 95%, specificity 100%), planimetric measurements of the RAVA and AVOA were performed with calculation of two indexes: the RAVA/square meter of body surface area and the RAVA/AVOA ratio. These indexes correlated well with independently performed angiographic grading on a three-point scale (r = .87 for the RAVA, .88 for the RAVA/AVOA; p less than .001), with highest significance of differences in mean values among each grade of severity found for the RAVA/AVOA (p less than .001). In addition, Doppler echocardiography identified the anatomic valvular site of the lesion, and we confirmed the site during surgery.
Antenatal Magnesium Sulfate and Outcomes for School-aged Children—Reply
Authors: Lex W. Doyle, Peter J. Anderson, Katherine J. Lee
Journal: JAMA (2015)

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
Ablation of capsaicin sensitive afferent nerves impairs defence but not rapid repair of rat gastric mucosa.
Authors: M A Pabst, E Schoninkle, P Holzer
Journal: Gut (1993)

Capsaicin sensitive afferent neurones have previously been reported to play a part in gastric mucosal protection. The aim of this study was to investigate whether these nociceptive neurones strengthen mucosal defence against injury or promote rapid repair of the damaged mucosa, or both. This hypothesis was examined in anaesthetised rats whose stomachs were perfused with ethanol (25 or 50% in saline, wt/wt) for 30 minutes. The gastric mucosa was inspected 0 and 180 minutes after ethanol had been given at the macroscopic, light, and scanning electron microscopic level. Rapid repair of the ethanol injured gastric mucosa (reduction of deep injury, partial re-epithelialisation of the denuded surface) took place in rats anaesthetised with phenobarbital, but not in those anaesthetised with urethane. Afferent nerve ablation as a result of treating rats with a neurotoxic dose of capsaicin before the experiment significantly aggravated ethanol induced damage as shown by an increase in the area and depth of mucosal erosions. Rapid repair of the injured mucosa, however, as seen in rats anesthetised with phenobarbital 180 minutes after ethanol was given, was similar in capsaicin and vehicle pretreated animals. Ablation of capsaicin sensitive afferent neurones was verified by a depletion of calcitonin gene related peptide from the gastric corpus wall. These findings indicate that nociceptive neurones control mechanisms of defence against acute injury but are not required for rapid repair of injured mucosa.
Mosaicism in a Mother with a Mongol Child
Authors: C. E. Blank, E. Gemmell, M. D. Casey, M. Lord
Journal: BMJ (1962)

Furthermore, had the extent of the epidemic been more fully appreciated it might have been possible to co-ordinate the work of the various practitioners in the district and to have advised upon the use of such protective measures as gamma-globulin.Summary Details of an epidemic of infectious hepatitis occurring in a village community are reported.The source of infection appeared to be the village primary school, where at least one food-handler was affected and toilet facilities were not regarded as ideal.The epidemic was subsequently characterized by a high incidence of spread to family contacts of the children originally affected.Although the clinical course was mild in children, a young married woman developed acute hepatic necrosis and died.It is believed that the extent of the epidemic was far greater than the 61 cases reported would indicate, and it is suggested that some form of notification of infectious hepatitis is desirable in order to improve our knowledge of the aetiology and epidemiology of this disease.We wish to record our thanks to Drs.P. C. Green, R. H. Kipping, W. J. Low, and H. N.
RNA Transfer by Electroporation into Mature Dendritic Cells Leading to Reactivation of Effector-Memory Cytotoxic T Lymphocytes: A Quantitative Analysis
Authors: Miran Javorovic, Heike Pohla, Bernhard Frankenberger, Thomas Wölfel, Dolores J. Schendel
Journal: Molecular Therapy (2005)

Previous studies have analyzed transfer of RNA-encoded tumor-associated antigens (TAAs) into immature dendritic cells (DCs) because of their exceptional ability to internalize antigens. Concerns have been raised regarding the use of immature DCs in clinical studies because of their capacity to tolerize T cells. Therefore, we focused on optimizing RNA transfer into mature DCs using the method of electroporation and obtained high protein expression in 90% of mature DCs. Particular emphasis was placed on quantifying RNA transfer. Reconstitution of peptide-MHC (pMHC) ligands on RNA-pulsed DCs was measured with the help of effector-memory cytotoxic T lymphocytes (CTLs) specific for the melanoma-associated antigens tyrosinase and mutated cyclin-dependent kinase 4. In contrast to single-species RNA, transfer of native tumor-derived RNA or amplified tumor RNA into DCs resulted in very low or no capacity to reactivate these CTLs. A correlation was found between TAA message levels in tumor-derived RNA and pMHC ligand reconstitution on DCs. These results demonstrate that even TAAs with highly immunogenic mutated epitopes are not necessarily transferred when tumor-derived RNA is transfected into the DCs, thereby resulting in a lack of DC capacity to reactivate some preexisting effector-memory CTLs.
Federal Standards for Diagnostic X-ray Equipment
Authors: Robert G. Britain
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The federal performance standard for diagnostic x-ray equipment was published in its final form on Aug 15, 1972, and becomes effective on August 1 of this year. Some statements in a recent letter (227:203, 1974), for example, were apparently made on the basis of earlier proposed policies concerning the assembly and reassembly of x-ray equipment, which have since been revised. Mr. Nields stated that, under the federal standard, uncertified diagnostic x-ray equipment currently in use may not be resold or otherwise reintroduced into commerce after Aug 1, 1974. Under the revised proposal, uncertified x-ray equipment may continue to be resold without upgrading to meet the standard as late as Aug 1, 1979. It is anticipated that a final ruling on the policy will be published in the near future. The letter stated correctly that the performance standard will apply to x-ray equipment manufactured after Aug 1, 1974, and will
Role of the Lateral Mammillary Nucleus in the Rat Head Direction Circuit
Authors: Hugh T Blair, Jeiwon Cho, Patricia E Sharp
Journal: Neuron (1998)

We recorded head direction (HD) cells from the lateral mammillary nucleus (LMN) and anterior thalamus (ATN) of freely behaving rats and also made bilateral lesions of LMN while recording HD cells from ATN. We discovered that the tuning functions of LMN HD cells become narrower during contraversive head turns, but not ipsiversive head turns, compared to when the head is not turning. This narrowing effect does not occur for ATN HD cells. We also found that the HD signal in LMN leads that in ATN by about 15–20 ms. When LMN was lesioned bilaterally, HD cells in ATN immediately lost their directional firing properties and never recovered them. Based on these findings, we argue that LMN may be an essential component of an attractor–integrator network that participates in generating the HD signal.
Effects of Catecholamines and their Interaction with Other Hormones on Cyclic 3′,5′-Adenosine Monophosphate of the Kidney
Authors: Nama P. Beck, Sarah W. Reed, H. V. Murdaugh, Bernard B. Davis
Journal: Journal of Clinical Investigation (1972)

Catecholamines have several physiological effects on the kidney. These include: (a) stimulation of renin synthesis in the cortex: (b) antidiuresis by beta adrenergic agents; and (c) diuresis by alpha adrenergic stimulation. The role of cyclic 3',5'-adenosine monophosphate (cyclic AMP) in the renal actions of catecholamines was evaluated by measuring the effects of several adrenergic agents on cyclic AMP concentration in the dog kidney. Beta adrenergic activity increased cyclic AMP concentration in the renal cortex, a finding consistent with the hypothesis that beta-adrenergic stimulation augments renin synthesis by increasing cyclic AMP generation. Beta adrenergic stimulation, like vasopressin, increased cyclic AMP concentration in the renal medulla. This suggests that beta adrenergic stimulation causes antidiuresis by augmenting cyclic AMP generation in the renal medulla. Alpha adrenergic activity inhibited the effect of vasopressin to stimulate cyclic AMP generation. These results support the hypothesis that the diuretic effect of alpha adrenergic stimulation is mediated by inhibition of the effect of vasopressin to increase cyclic AMP generation.
Impact of Papillary Muscle Relocation as Adjunct Procedure to Mitral Ring Annuloplasty in Functional Ischemic Mitral Regurgitation
Authors: Henrik Jensen, Morten O. Jensen, Morten H. Smerup, Stefan Vind-Kezunovic, Steffen Ringgaard, Niels T. Andersen, Rikke Vestergaard, Per Wierup, J. Michael Hasenkam, Sten L. Nielsen
Journal: Circulation (2009)

Background— The optimal surgical treatment in functional ischemic mitral regurgitation (FIMR) remains controversial. Recently, a posterior papillary muscle relocation (PMR) technique as adjunct procedure to ring annuloplasty has been proposed to prevent recurrent FIMR. In the present study, we used 3D cardiac MRI to assess the impact of relocating both papillary muscles as adjunct procedure to downsized ring annuloplasty on mitral leaflet coaptation geometry in FIMR pigs. Methods and Results— Eleven FIMR pigs were randomized to downsized ring annuloplasty (RA; n=6) or RA combined with PMR (RA+PMR, n=5). In the RA+PMR group, a 2–0 Gore-Tex suture was attached to each trigone, exteriorized through the corresponding papillary muscle, mounted on an epicardial pad, and tightened to relocate the myocardium adjacent to the anterior and posterior papillary muscles 5 and 15 mm, respectively. Using 3D MRI, the impact from these interventions on leaflet geometry was assessed. The distance from the posterior papillary muscle to the anterior trigone was reduced significantly more (median values) in the RA+PMR compared with RA animals at end-diastole (−7.9% versus 3.8%, P &lt;0.01) and end-systole (−9.7% versus 2.5%, P =0.02). Accordingly, lateral tethering of the coaptation point (median values) was reduced significantly more in RA+PMR compared with RA animals (−42.8% versus −29.1%, P &lt;0.01). Conclusions— Adding papillary muscle relocation to downsized ring annuloplasty reduced lateral leaflet tethering in a porcine experimental model of FIMR. Therefore, this technique holds promise for reducing persistent and recurrent FIMR in patients.
Evolution of the cycloidea gene family in Antirrhinum and Misopates
Authors: C. P. Vieira, J. Vieira, D. Charlesworth
Journal: Molecular Biology and Evolution (1999)

Studies at the nucleotide level on the nuclear flower development gene cycloidea (cyc) in seven Antirrhinum, two Misopates, one Linaria, one Cymbalaria, and one Digitalis species revealed that cyc is a member of a gene family composed of at least five apparently functional genes. The estimated ages of the duplication events that created this gene family are from 7.5 Myr to more than 75 Myr. We also report the first estimates of DNA sequence diversity for species of Antirrhinum and Misopates. Low between-species variability suggests that this group of species may have diverged recently.