tbuckley/cabot-search huggingface dataset:
Amyloidosis and Hyposplenism with Leukocytosis and Thrombocytosis
Authors: IRA M. JACOBSON
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 October 1983Amyloidosis and Hyposplenism with Leukocytosis and ThrombocytosisIRA M. JACOBSON, M.D., KURT J. ISSELBACHER, M.D.IRA M. JACOBSON, M.D.Search for more papers by this author, KURT J. ISSELBACHER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-4-573_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Gertz and Kyle (1) have recently shown that functional hyposplenism was found in 24% of their patients with primary systemic amyloidosis. The platelet count was over 300 000/mm3 in 77% of their patients but leukocytosis was not mentioned. In a previous series from the same institution (2) 5% to 10% of such patients had platelet counts greater than 500 000/mm3. The leukocyte count was said to be "normal in most patients." We report a patient with primary amyloidosis and hyposplenism, with marked leukocytosis and thrombocytosis.A 72-year-old man had a history of fatigue and weight loss for...References1. GERTZKYLE MR. Hyposplenism in primary systemic amyloidosis. Ann Intern Med. 1983;98:475-7. LinkGoogle Scholar2. KYLEBAYRD RE. Amyloidosis: review of 236 cases. Medicine. 1975;54:271-97. CrossrefMedlineGoogle Scholar3. LIPSONBAYRDWATKINS REC. The post-splenectomy blood picture. Am J Clin Pathol. 1959;32:526-32. CrossrefMedlineGoogle Scholar4. BOYKOPRATTWASS WRH. Functional hyposplenism, a diagnostic clue in amyloidosis: report of six cases. Am J Clin Pathol. 1982;77:745-8. CrossrefMedlineGoogle Scholar5. HURDKATHOLI WR. Acquired functional asplenia: association with spontaneous rupture of the spleen and fatal spontaneous rupture of the liver in amyloidosis. Arch Intern Med. 1980;140:844-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital Boston, MA 02114 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHowell-Jolly bodies and liver-spleen scanning for assessment of splenic filtrative function yields discordant results in renal transplant recipientsPrevalence of depressive symptoms among established vietnamese refugees in the united statesSplenic Function in Amyloidosis 1 October 1983Volume 99, Issue 4Page: 573-573KeywordsAmyloidosisFatigueLeukocytosisPlateletsThrombocytosisWeight loss ePublished: 1 December 2008 Issue Published: 1 October 1983 PDF downloadLoading ...
Ancillary Care Obligations of Medical Researchers
Authors: Neal Dickert
Journal: JAMA (2009)

An investigator planning a study in Africa of the prevalence of pulmonary hypertension in children with severe malaria anticipates that she and her team will encounter significant unmet health needs during the course of the study. She recognizes that study procedures, particularly echocardiography, may identify and diagnose conditions that are not treatable within the local health system due to resource constraints. Aware that some of these needs may be serious, as well as difficult and costly to treat, she asks the bioethics consultation service for assistance in determining the extent to which she as an investigator has a responsibility to provide clinical care for conditions that she finds while conducting the study. This article reviews the issue of investigators' responsibilities to meet participants' needs for ancillary care and argues that investigators can have a responsibility to provide care for a wide range of health needs, including at times care for conditions not connected to the research question or study procedures. That responsibility, however, is significantly limited by the depth of the investigator's relationship with participants and the resource demands of providing such care.
Promoting Science Education
Authors: Marilyn Winkleby
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 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
Pharmacokinetics, pharmacodynamics, efficacy, and safety of a new recombinant asparaginase preparation in children with previously untreated acute lymphoblastic leukemia: a randomized phase 2 clinical trial
Authors: Rob Pieters, Inge Appel, Hans-Juergen Kuehnel, Iris Tetzlaff-Fohr, Uwe Pichlmeier, Inekee van der Vaart, Eline Visser, Rolinda Stigter
Journal: Blood (2008)
Echocardiography predicts embolic events in infective endocarditis∗∗Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
Authors: Shelley Shapiro, Leon Iri Kupferwasser
Journal: Journal of the American College of Cardiology (2001)
Follow up of patients presenting with fatigue to an infectious diseases clinic.
Authors: M. Sharpe, K. Hawton, V. Seagroatt, G. Pasvol
Journal: BMJ (1992)

OBJECTIVES--To determine the symptomatic and functional status during follow up of patients referred to hospital with unexplained fatigue and to identify patient variables associated with persistent functional impairment. DESIGN--Follow up by postal questionnaire six weeks to four years (median 1 year) after initial clinical assessment of patients referred to hospital during 1984-8. SETTING--Infectious diseases outpatient clinic in a teaching hospital. PATIENTS--200 consecutive patients with fatigue of uncertain cause for at least six weeks; 177 fulfilled the inclusion criteria. MAIN OUTCOME MEASURES--Findings at initial assessment; current symptoms, beliefs about the cause of illness, coping behaviours emotional disorder, social variables including membership of self help organizations, and degrees of recovery and functional impairment from questionnaire responses. RESULTS--144 (81%) patients returned completed questionnaires. Initial assessment did not indicate the cause of fatigue, other than preceding infection. The proportion of patients with functional impairment was significantly smaller with longer follow up (33% (11/33) at two to four years, 73% (29/40) at six weeks to six months; chi 2 for trend = 12.5, df = 1; p less than 0.05). Functional impairment was significantly associated with belief in a viral cause of the illness (odds ratio = 3.9; 95% confidence interval 1.5 to 9.9), limiting exercise (3.2; 1.5 to 6.6), avoiding alcohol (4.5; 1.8 to 11.3), changing or leaving employment (3.1; 1.4 to 6.9), belonging to a self help organization (7.8; 2.5 to 23.9), and current emotional disorder (4.4; 2.0 to 9.3). CONCLUSIONS--Short term prognosis for recovery of function was poor but improved with time. Most patients had made a functional recovery by two years after initial clinic attendance. Impaired functioning was more likely with certain patient characteristics. Prospective studies are required to clarify whether these associations are the consequences of a more disabling illness or indicate factors contributing to impaired function.
Erythema nodosum and eosinophilic oesophagitis: more than a chance fassociation?
Authors: S. Ogden, M.E. Denyer, S.M. Wilkinson
Journal: British Journal of Dermatology (2007)

Journal Article Erythema nodosum and eosinophilic oesophagitis: more than a chance fassociation? Get access S. Ogden, S. Ogden Dermatology Department, Hope Hospital, Manchester, U.K. *Gastroenterology Department, St James's University Hospital, Leeds, U.K. †Dermatology Department, Leeds General Infirmary, Leeds, U.K. E‐mail: stephanie.ogden@hotmail.co.uk Search for other works by this author on: Oxford Academic Google Scholar M.E. Denyer, M.E. Denyer Dermatology Department, Hope Hospital, Manchester, U.K. *Gastroenterology Department, St James's University Hospital, Leeds, U.K. †Dermatology Department, Leeds General Infirmary, Leeds, U.K. E‐mail: stephanie.ogden@hotmail.co.uk Search for other works by this author on: Oxford Academic Google Scholar S.M. Wilkinson S.M. Wilkinson Dermatology Department, Hope Hospital, Manchester, U.K. *Gastroenterology Department, St James's University Hospital, Leeds, U.K. †Dermatology Department, Leeds General Infirmary, Leeds, U.K. E‐mail: stephanie.ogden@hotmail.co.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 156, Issue 6, 1 June 2007, Page 1388, https://doi.org/10.1111/j.1365-2133.2007.07913.x Published: 01 June 2007
Competition Commission considers investigating private health market
Authors: N. Hawkes
Journal: BMJ (2011)

The Office of Fair Trading (OFT) is minded to refer the private healthcare market in the United Kingdom to the Competition Commission.

A final decision will be made after an eight week consultation to give interested parties a chance to make representations if they disagree with the referral. One private provider, Nuffield Health, has already backed the OFT, saying that it fully supports its decision and that it is in the interests of the patients who use private healthcare and the industry itself.

The OFT began its investigation in March this year. In a report it says that it found a number of concerns about the way the private healthcare market works. These, individually or in combination, restrict or distort competition and merit further investigation.

A primary concern is a lack of …
Risk of colorectal adenomas in patients with a family history of colorectal cancer: some implications for screening programmes.
Authors: J F Aitken, C J Bain, M Ward, V Siskind, R MacLennan
Journal: Gut (1996)

BACKGROUND AND AIMS: Most colorectal cancers (CRC) arise in colorectal adenomas. A case-control study was conducted to see whether a family history of CRC is associated with a higher prevalence of colorectal adenomas. SUBJECTS: Subjects were drawn from all patients who underwent colonoscopy at the Royal Brisbane Hospital between 1980-1982 and 1985, and included 141 cases with colorectal adenomas diagnosed at colonoscopy and 882 controls who were free of polyps at colonoscopy. METHODS: The prevalence of family history of CRC was compared between patients with adenomas and negative colonoscopy controls. RESULTS: Overall, patients with one first degree relative with CRC were at no greater risk for adenomas at colonoscopy than patients with no family history (odds ratio (OR) = 0.8, 95% confidence intervals (CI) = 0.4, 1.5). Patients with two or more affected first degree relatives had a more than doubled risk for adenomas (OR = 2.3, 95% CI = 0.5, 8.2), and were also more likely to carry moderately or severely dysplastic adenomas (OR = 14.1, 95% CI = 2.0, 62.9). CONCLUSIONS: These findings are consistent with the hypothesis that some families, in addition to those with familial adenomatous polyposis, have an increased susceptibility to develop colorectal adenomas, and that adenomas in such families may have a greater tendency to undergo malignant transformation.
Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study
Authors: Salim Yusuf, Steven Hawken, Stephanie Ôunpuu, Leonelo Bautista, Maria Grazia Franzosi, Patrick Commerford, Chim C Lang, Zvonko Rumboldt, Churchill L Onen, Liu Lisheng, Supachai Tanomsup, Paul Wangai, Fahad Razak, Arya M Sharma, Sonia S Anand
Journal: The Lancet (2005)
Public health in the UK: success or failure?
Authors: S. Lammy
Journal: Journal of the Royal Society of Medicine (2006)

Congratulations for publishing the essay by Gray et al. on public health (March 2006 JRSM1). As a medical student undergoing the rigors of undergraduate medical education, public health is perceived as a triviality when compared to voluminous clinical medicine; and therefore not considered as an academic work out worthy of sweat.

Such an engaging essay has been enlightening by demonstrating that, the phrase `prevention is better than cure' can relate to certain fragments of our world that do not obviously connect to medical practice (e.g. seat-belt usage and the subsequent decrease in associated ward admissions).

This highlights the need for governments to create preventative methods that combat disease and injury that can be accessed by everyone (e.g. obesity needs the government to do more to change our nations thoughts surrounding food consumption and exercise).

But our nation's health is not completely dependent upon public health professionals; and such radical endeavours demand scrutiny and encouragement from everyone.

One could argue further that healthcare professionals should embody noble principles. It is paradoxical that, although smoking bans have been championed by doctors, a significant part of the workforce continues to smoke.
Metformin and Exercise in Type 2 Diabetes
Authors: Normand G. Boulé, Cheri Robert, Gordon J. Bell, Steven T. Johnson, Rhonda C. Bell, Richard Z. Lewanczuk, Raniah Q. Gabr, Dion R. Brocks
Journal: Diabetes Care (2011)

To determine the effect of metformin on the acute metabolic response to submaximal exercise, the effect of exercise on plasma metformin concentrations, and the interaction between metformin and exercise on the subsequent response to a standardized meal.Ten participants with type 2 diabetes were recruited for this randomized crossover study. Metformin or placebo was given for 28 days, followed by the alternate condition for 28 days. On the last 2 days of each condition, participants were assessed during a nonexercise and a subsequent exercise day. Exercise took place in the morning and involved a total of 35 min performed at three different submaximal intensities.Metformin increased heart rate and plasma lactate during exercise (both P≤0.01) but lowered respiratory exchange ratio (P=0.03) without affecting total energy expenditure, which suggests increased fat oxidation. Metformin plasma concentrations were greater at several, but not all, time points on the exercise day compared with the nonexercise day. The glycemic response to a standardized meal was reduced by metformin, but the reduction was attenuated when exercise was added (metformin×exercise interaction, P=0.05). Glucagon levels were highest in the combined exercise and metformin condition.This study reveals several ways by which metformin and exercise therapies can affect each other. By increasing heart rate, metformin could lead to the prescription of lower exercise workloads. Furthermore, under the tested conditions, exercise interfered with the glucose-lowering effect of metformin.
A pharmacodynamic study of the FLT3 inhibitor KW-2449 yields insight into the basis for clinical response
Authors: Keith W. Pratz, Jorge Cortes, Gail J. Roboz, Niranjan Rao, Omotayo Arowojolu, Adam Stine, Yukimasa Shiotsu, Aiko Shudo, Shiro Akinaga, Donald Small, Judith E. Karp, Mark Levis
Journal: Blood (2008)
Light-mediated conversion of nitrogen dioxide to nitric oxide by carotenoids.
Authors: R V Cooney, P J Harwood, L J Custer, A A Franke
Journal: Environmental Health Perspectives (1994)

Plants are more susceptible to the toxic effects of nitrogen dioxide when exposure takes place in the dark. Beta-carotene and other common carotenoids react with nitrogen dioxide in the dark to yield intermediate nitrosating agents consistent with the formation of nitrate esters. Simultaneous exposure of carotenoids to NO2 and light significantly reduced formation of nitrosating intermediates and resulted in the release of nitric oxide (NO) into the gas phase. Light-mediated reduction of NO2 to NO by carotenoids may be an important mechanism for preventing damage in plants exposed to NO2. The formation of nitrosating agents from the reaction of carotenoids with NO2 suggests that their ability to prevent nirosative damage associated with NO2 exposure in both plants and animals may be limited in the absence of light.
Coregulation of NADPH oxidase activation and phosphorylation of a 48-kD protein(s) by a cytosolic factor defective in autosomal recessive chronic granulomatous disease.
Authors: S E Caldwell, C E McCall, C L Hendricks, P A Leone, D A Bass, L C McPhail
Journal: Journal of Clinical Investigation (1988)

The mechanisms regulating activation of the respiratory burst enzyme, NADPH oxidase, of human neutrophils (PMN) are not yet understood, but protein phosphorylation may play a role. We have utilized a defect in a cytosolic factor required for NADPH oxidase activation observed in two patients with the autosomal recessive form of chronic granulomatous disease (CGD) to examine the role of protein phosphorylation in activation of NADPH oxidase in a cell-free system. NADPH oxidase could be activated by SDS in reconstitution mixtures of cytosolic and membrane subcellular fractions from normal PMN, and SDS also enhanced phosphorylation of at least 16 cytosolic and 14 membrane-associated proteins. However, subcellular fractions from CGD PMN plus SDS expressed little NADPH oxidase activity, and phosphorylation of a 48-kD protein(s) was selectively defective. The membrane fraction from CGD cells could be activated for NADPH oxidase when mixed with normal cytosol and phosphorylation of the 48-kD protein(s) was restored. In contrast, the membrane fraction from normal cells expressed almost no NADPH oxidase activity when mixed with CGD cytosol, and phosphorylation of the 48-kD protein(s) was again markedly decreased. Protein kinase C (PKC) activity in PMN from the two patients appeared to be normal, suggesting that a deficiency of PKC is not the cause of the defective 48-kD protein phosphorylation and that the cytosolic factor is not PKC. These results demonstrate that the cytosolic factor required for activation of NADPH oxidase also regulates phosphorylation of a specific protein, or family of proteins, at 48 kD. Although the nature of this protein(s) is still unknown, it may be related to the functional and phosphorylation defects present in CGD PMN and to the activation of NADPH oxidase in the cell-free system.
Drugs to treat rheumatoid arthritis may have cardiovascular benefits
Authors: Janice Hopkins Tanne
Journal: BMJ (2008)

An international study of 4363 patients with rheumatoid arthritis has shown that use of almost all disease modifying agents reduces cardiovascular events ( Arthritis Research and Therapy 2008;10:R30; doi: 10.1186/ar2383).

The study, which looked at disease modifying agents including methotrexate, leflunomide, glucocorticoids, sulfasalazine, and tumour necrosis factor α blockers showed that they reduced these patients’ increased risk of cardiovascular events, perhaps through an anti-inflammatory effect.

The use of malaria drugs and intramuscular gold did not change the risk of cardiovascular disease.

The study, called QUESTRA (questionnaires in standard monitoring of patients with rheumatoid arthritis programme), was led by Antonio Naranjo of the University of Las …
New Treatments for Genital Warts Less Than Ideal
Authors: Kenneth H. Fife
Journal: JAMA (1998)

Objective:To compare the safety and effectiveness of 5% and 1% imiquimod cream with vehicle cream in the treatment of external anogenital warts.Design:Randomized, double-blind, placebo-controlled comparison that evaluated patients for total clearance of their warts. Patients who experienced total clearance were evaluated for recurrence in a 12-week follow-up.Setting:Eleven ambulatory offices, including both private physician offices and referral medical centers.Patients:Three hundred eleven healthy men and women aged 18 years or older with 2 to 50 external anogenital warts were recruited from the practices of investigators, referring physicians, and advertisements. Eighty-two additional patients were screened but did not qualify. Four patients discontinued use of the medication because of adverse effects.Interventions:Five percent imiquimod (Aldara) cream, 1% imiquimod cream, or vehicle cream was applied to all external warts overnight 3 times each week for 16 weeks, or until all treated warts disappeared, whichever occurred first.Main Outcome Measurements:The number of patients experiencing the elimination of all baseline warts and the recurrence rate of these warts. In addition, the reduction in baseline wart area, the duration of therapy required to eliminate warts, and the frequency and severity of adverse reactions were principal measurements.Results:In the intent-to-treat analysis, 54 (50%) of 109 patients who received 5% imiquimod cream, 21 (21%) of 102 of those who received 1% imiquimod cream, and 11 (11%) of 100 patients treated with vehicle cream experienced eradication of all treated baseline warts. The difference between the effectiveness of 5% imiquimod cream and the vehicle cream was statistically significant (P<.001). Of those patients whose warts cleared during therapy, 13% of patients who received 5% imiquimod experienced a recurrence of at least 1 wart. Recurrences occurred in none of the patients who used 1% imiquimod cream and in 10% of patients who used the vehicle cream. Local erythema was the most common adverse reaction, but the majority of patients in each group experienced no or only mild local inflammatory reactions. There were no differences in incidences of flulike symptoms among treatment groups.Conclusions:Five percent imiquimod cream is an effective and safe self-administered therapy for external anogenital warts when applied 3 times a week overnight for up to 16 weeks. The recurrence rate is low.
CHIP protects against cardiac pressure overload through regulation of AMPK
Authors: Jonathan C. Schisler, Carrie E. Rubel, Chunlian Zhang, Pamela Lockyer, Douglas M. Cyr, Cam Patterson
Journal: Journal of Clinical Investigation (2013)

Protein quality control and metabolic homeostasis are integral to maintaining cardiac function during stress; however, little is known about if or how these systems interact. Here we demonstrate that C terminus of HSC70-interacting protein (CHIP), a regulator of protein quality control, influences the metabolic response to pressure overload by direct regulation of the catalytic α subunit of AMPK. Induction of cardiac pressure overload in Chip-/- mice resulted in robust hypertrophy and decreased cardiac function and energy generation stemming from a failure to activate AMPK. Mechanistically, CHIP promoted LKB1-mediated phosphorylation of AMPK, increased the specific activity of AMPK, and was necessary and sufficient for stress-dependent activation of AMPK. CHIP-dependent effects on AMPK activity were accompanied by conformational changes specific to the α subunit, both in vitro and in vivo, identifying AMPK as the first physiological substrate for CHIP chaperone activity and establishing a link between cardiac proteolytic and metabolic pathways.