tbuckley/cabot-search huggingface dataset:
The Circulatory Response to the Valsalva Maneuver of Patients with Mitral Stenosis with and without Autonomic Blockade
Authors: DAVID G. GREENE, IVAN L. BUNNELL
Journal: Circulation (1953)

Patients with clinically significant mitral stenosis have been demonstrated to differ from other subjects in their circulatory responses to the Valsalva maneuver. During forced expiration most patients with mitral stencsis are able to maintain systolic pressure in the brachial artery at a level equal to or greater than the resting value, whereas most control subjects cannot. Autonomic blockade does not affect the ability of patients with mitral stenosis to maintain systolic pressure, whereas it abolishes such ability, when it is present, in control subjects. The unique response of patients with mitral stenosis under autonomic blockade is attributed to the physiologic consequences of the volume of blood in the dilated left atrium.
The exposure of nonsmoking and smoking mothers to environmental tobacco smoke during different gestational phases and fetal growth.
Authors: Jan Dejmek, Ivo Solansk y, Katerina Podrazilová, Radim J Srám
Journal: Environmental Health Perspectives (2002)

We studied the impact of maternal exposure to environmental tobacco smoke (ETS) on birth weight (BW), low birth weight (LBW), and intrauterine growth retardation (IUGR) according to self-reported maternal smoking habits in a sample of 6,866 singleton births. We obtained data about parental characteristics and maternal active smoking (AS) and passive smoking at delivery via maternal questionnaires and medical records. We used three categories of smoking habits (nonsmokers and those who smoked 1-10 or >10 cigarettes per day) and defined ETS exposure as greater than or equal to 5 cigarettes per day smoked by others in the mother's presence. We used multiple regression and logistic regression procedures with adjustment for many associated covariates. We observed a significant reduction of the mean BW in infants of AS mothers. This reduction was only marginal for mothers who stopped smoking after recognizing their pregnancy. ETS exposure in 1,797 of 5,507 nonsmoking mothers reduced the mean BW of their infants by 53 g [95% confidence interval (CI), 24-82 g]. ETS exposure also significantly reduced BW in babies of AS mothers by 92 g (CI, 21-113 g) compared with BW of ETS-nonexposed AS mothers. The adjusted odds ratio (AOR) of LBW for ETS-exposed AS mothers was two times the LBW risk of ETS-nonexposed AS mothers(2.02; CI, 1.11-3.67); the AOR of ETS-exposed nonsmoking mothers was 1.51 (CI, 1.02-2.26). The AOR of IUGR for this group did not differ from unity (1.08; CI, 0.82-1.43). However, ETS exposure increased the AOR of IUGR for AS mothers from 1.64 (CI, 1.06-2.53) to 2.13 (CI, 1.70-2.67). ETS exposure reduced the BW of infants of nonsmoking mothers and contributed to additional BW reduction in infants of AS mothers. ETS exposure increased the risk of LBW but not that of IUGR in babies of nonsmoking mothers.
Proportional assist ventilation in acute respiratory failure: effects on breathing pattern and inspiratory effort.
Authors: P Navalesi, P Hernandez, A Wongsa, D Laporta, P Goldberg, S B Gottfried
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Proportional assist ventilation (PAV) is a new mode of assisted ventilation which, by applying pressure in proportion to volume (volume assist, VA) and flow (flow assist, FA), should specifically reduce the inspiratory effort needed to overcome respiratory system elastance (Ers) and resistance (Rrs), respectively. The aims of this study were to determine (1) the effects of varying the level of VA on breathing pattern, inspiratory effort, and work of breathing, and (2) the interaction between VA and FA. In eight intubated patients with acute respiratory failure, four levels of VA (20 to 80% Ers) with and without a fixed amount of FA (approximately 50% Rrs) were evaluated. Compared with spontaneous breathing, VA increased tidal volume (VT) while respiratory rate (RR) was unchanged or fell slightly. The increase in minute ventilation (VE) was small and not significant. The addition of FA further increased VT while RR was significantly reduced so that VE remained unchanged. Increasing VA produced a graded reduction in inspiratory effort, reflected by decreases in the pressure-time integral of the diaphragm and the inspiratory muscles. These were further reduced when FA was added. VA decreased the elastic work of breathing (Wel) whereas resistive work (Wres) tended to increase so that the fall in total work (W/tot) was less than expected. At each VA setting, the addition of FA significantly reduced Wres and, as a result, Wtot. These results demonstrate that PAV can improve breathing pattern while reducing inspiratory effort by specifically decreasing Wel and Wres, and that VA and FA should be used together to optimize reductions in Wtot and the efficacy of assistance provided.
The Carpal Tunnel Syndrome: Diagnostic Utility of the History and Physical Examination Findings
Authors: Jeffrey N. Katz
Journal: Annals of Internal Medicine (1990)

Study Objective: To assess the value of a history and physical examination findings in diagnosing the carpal tunnel syndrome, and to determine whether constellations of clinical findings identify patients at high or low risk for the carpal tunnel syndrome. Design: Comparison of diagnostic tests with neurophysiologic testing. Setting: Patients with upper extremity complaints of diverse causes referred to a neurophysiology laboratory for diagnostic studies. Methods: Before nerve conduction testing, a history, demographic and physical examination data, and a hand pain diagram were obtained from each patient. Diagrams were categorized as indicating the classic carpal tunnel syndrome, or as probable, possible, or unlikely to indicate the carpal tunnel syndrome. Associations between clinical data and nerve conduction results were examined in univariate and multivariate analyses. Results: Of 110 patients in the study, 44 (40%) had the carpal tunnel syndrome. Individually, the best predictors were hand pain diagram rating (positive predictive value, 0.59; 95% CI, 0.48 to 0.68) and Tinel sign (positive predictive value, 0.55; CI, 0.45 to 0.65). The combination of a positive Tinel sign and a probable or classic diagram rating had a positive predictive value of 0.71; CI, 0.53 to 0.85. Other findings from physical examination and the history were less useful. Just 9% of patients under 40 years of age with possible or unlikely diagram ratings had the carpal tunnel syndrome. Conclusions: With the exceptions of age, Tinel sign, and hand pain diagram rating, findings from the physical examination and the history had limited diagnostic utility. Patients under 40 years of age with possible or unlikely diagram ratings were at low risk for the carpal tunnel syndrome. This finding, which should be confirmed in an independent population, suggests that subsets of patients may be managed without nerve conduction studies.
The incidence and risks of liver biopsy in non-cirrhotic patients: An evaluation of 3806 biopsies
Authors: J.-F. Huang, M.-Y. Hsieh, C.-Y. Dai, N.-J. Hou, L.-P. Lee, Z.-Y. Lin, S.-C. Chen, L.-Y. Wang, M.-Y. Hsieh, W.-Y. Chang, M.-L. Yu, W.-L. Chuang
Journal: Gut (2007)

<h3>Objective.</h3> Few studies have examined the relationship between gout and erectile dysfunction (ED). We investigated whether patients with gout exhibited an increased risk of ED. <h3>Methods.</h3> This longitudinal nationwide cohort study investigated the incidence and risk of ED in 19,368 men with gout who were newly diagnosed between January 2002 and December 2008. A total of 77,472 controls without gout were randomly selected from the general population and frequency-matched according to age and sex. The patients were followed up from the date on which they were included in the study cohort to the date of an ED event, censoring, or December 31, 2010. We conducted the Cox proportional hazard model to estimate the effects of gout on ED risk including age and comorbidities. <h3>Results.</h3> The gout cohort exhibited a 1.21-fold adjusted HR of subsequent ED development compared with the non-gout cohort (95% CI 1.03–1.44). The incidence of ED increased with age in both cohorts and was higher among the patients in the gout cohort than among those in the non-gout cohort. Compared to the patients without gout and comorbidities, the patients with both gout and any type of comorbidity exhibited a 2.04-fold risk of developing ED (95% CI 1.63–2.57). Further, the patients with gout who had numerous comorbidities exhibited the dose-response effect in developing ED. <h3>Conclusion.</h3> This nationwide cohort study revealed that ED risk is significantly higher in patients with gout than in the general population.
John Douglas Mitchell
Authors: A. Campbell
Journal: BMJ (2011)

<h3>Objective</h3> Serum α-fetoprotein (AFP) is the most commonly used biomarker for screening hepatocellular carcinoma (HCC) but fails to detect about half of the patients. Thus, we investigated if circulating microRNAs (miRNAs) could outperform AFP for HCC detection. <h3>Design</h3> A retrospective cohort study. <h3>Setting</h3> Two clinical centres in China. <h3>Participants</h3> The exploration phase included 96 patients with HCC who received primary curative hepatectomy, and the validation phase included 29 hepatitis B carriers, 57 patients with HCC and 30 healthy controls. <h3>Main outcome measures</h3> Expression of miRNAs was measured by real-time quantitative reverse transcription–PCR. Areas under receiver operating characteristic curves were used to determine the feasibility of using serum miRNA concentration as a diagnostic marker for defining HCC. A multivariate logistic regression analysis was used to evaluate performances of combined serum miRNAs. <h3>Results</h3> In the exploration phase, miRNA profiling on resected tumour/adjacent non-tumour tissues identified miR-15b, miR-21, miR-130b and miR-183 highly expressed in tumours. These miRNAs were also detectable in culture supernatants of HCC cell lines and in serum samples of patients. Remarkably, these serum miRNAs were markedly reduced after surgery, indicating the tumour-derived source of these circulating miRNAs. In a cross-centre validation study, combined miR-15b and miR-130b demonstrated as a classifier for HCC detection, yielding a receiver operating characteristic curve area of 0.98 (98.2% sensitivity and 91.5% specificity). The detection sensitivity of the classifier in a subgroup of HCCs with low AFP (&lt;20 ng/ml) was 96.7%. The classifier also identified early-stage HCC cases that could not be detected by AFP. <h3>Conclusion</h3> The combined miR-15b and miR-130b classifier is a serum biomarker with clinical value for HCC screening.
The Preoperative Treatment of Severely Anemic Patients with a Perfluorochemical Oxygen-Transport Fluid, Fluosol-DA
Authors: Kevin K. Tremper, Alan E. Friedman, Edward M. Levine, Ron Lapin, Debra Camarillo
Journal: New England Journal of Medicine (1982)

We gave a perfluorochemical oxygen-transport fluid and plasma expander, Fluosol-DA, to seven severely anemic patients before surgery to determine its effectiveness in supplementing oxygen transport. The dose of Fluosol in the five patients completing the study was 20 ml per kilogram of body weight. When the patients breathed low levels of supplemental oxygen (mean partial pressure of arterial oxygen +/- S.D., 101 +/- 25 torr), the perfluorochemical carried a small amount of oxygen, but when they received pure oxygen (arterial oxygen pressure, 361 +/- 65 torr) it carried approximately 0.8 per cent of oxygen (by volume). This increase accounted for 7 +/- 3 per cent of the patients' arterial oxygen content and 24 +/- 7 per cent of their oxygen consumption. The cardiac index and left ventricular stroke-work index decreased, whereas the oxygen delivery increased, although these changes were not statistically significant. Significant changes included a 22 per cent increase in oxygen consumption, a 59 per cent increase in mixed venous oxygen tension, and an increase in mixed venous hemoglobin saturation to 90 +/- 6 per cent. We conclude that at ambient oxygen tensions fluosol acts primarily as a volume expander, whereas at higher tensions (greater than 300 torr) it contributes substantially to the oxygen-delivery system.
Frank Richard Stanford Kellett
Authors: H J Brown
Journal: BMJ (2004)

Former malariologist World Health Organization (b Simla, northern India, 1916; q Calcutta 1940; DPH), died from prostate cancer on 7 May 2004.

During the second world war Dr Kellett served in India and the Middle East. After the war he joined the Colonial Medical Service and served as a medical officer in St Lucia, British West Indies, for two years. He was then posted to Trinidad to work on the malaria eradication programme. He was a co-author of a number of papers on insecticides of malaria. He later joined the World Health Organization in New Delhi, where he was malariologist for the whole of the Far East. He leaves a wife, Kathleen, and three children.
Sorting Through the Arguments on Breast Screening
Authors: Michael G. Marmot
Journal: JAMA (2013)

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
257 THE PLGF/VEGFR-1 PATHWAY CONTRIBUTES TO LIVER VESSEL ANOMALIES IN HEPATOCELLULAR CARCINOMA: POSSIBLE RELEVANCE TO THE NOTCH4 PATHWAY
Authors: A. Tijeras-Raballand, J.-O. Contreres, P. Hainaud, C. Le Hènaff, B.I. Levy, M. Pocard, E. Dupuy
Journal: Journal of Hepatology (2011)
Redox signaling mediates symbiosis between the gut microbiota and the intestine
Authors: Andrew S Neish, Rheinallt M Jones
Journal: Gut Microbes (2014)

The microbiota that populates the intestinal tract affects many physiological processes, such as cell proliferation, epithelial barrier function, and immune responses. However, the molecular mechanisms by which the microbiota influences these events remain unknown. It was recently reported by our research group that specific taxa of intestinal bacteria induce the rapid and transient enzymatic production of reactive oxygen species (ROS) within enterocytes. Whereas NADPH oxidase 2 (Nox2) catalyzed ROS generation in response to microbial perception by bone marrow-derived phagocytes is well-studied, the function of ROS generated by Nox1 in enterocytes in response to microbial signals is not fully understood. It is established that ROS can act as signaling molecules in diverse transduction pathways by the rapid and transient oxidation of oxidant-sensitive thiol groups harbored within sensor regulatory proteins. Because commensal-bacterial-stimulated ROS generation in enterocytes has been shown to induce a wide range of physiological processes, in our recent manuscript, we proposed a paradigm wherein the influence of the microbiota on intestinal physiology is mediated in part by redox-dependant signaling.
Compensation for Vaccine Injury-Reply
Authors: Alan R. Nelson
Journal: JAMA (1985)

<h3>In Reply.—</h3> Dr Bader makes some excellent points. The AMA Commission on Vaccine Injury Compensation has shared many of his concerns, as has the American Medical Association Council on Legislation. Consequently, the AMA draft legislation states that "if a claimant within 60 days notifies the secretary of objection to a decision made by the Office of Vaccine Injury Compensation, there shall be a prompt agency hearing and adjudication in accordance with Section 554, Title V, United States Code." A second level of appeals exists in the US Court of Appeals for the District of Columbia if the secretary's final order in disposition of a claim is thought to be inadequate. The Council on Legislation felt that this recourse would protect the interests of the claimant and, at the same time, avoid the inherent disadvantages in the tort system. The Ad Hoc Commission also recommended that a limit be placed on
Intravascular Ultrasound-Guided Endovascular Stenting for Celiac Artery Complicated With Hepatic Hypoperfusion After Acute Type B Aortic Dissection
Authors: Nobuaki Kobayashi, Masamichi Takano, Akihiro Shirakabe, Noritake Hata, Hiroshi Kawamata, Kyoichi Mizuno
Journal: Journal of the American College of Cardiology (2012)

![Figure][1] 

![Figure][1] 

[Video 1][2]

Sitting Position



![Figure][1] 

[Video 2][3]

Supine Position



![Figure][1] 

[Video 3][4]

Supine Position



![Figure][1] 

[Video 4][5]

Left Lateral Decubitus Position



A 63-year-old woman was admitted with acute aortic
Servier found to have breached industry code over disclosure of trial results
Authors: J. Wise
Journal: BMJ (2014)

The drug company Servier Laboratories has been found to have breached the UK industry’s code of practice for failing to disclose details of clinical trials within the required timeframe.1

The Prescription Medicines Code of Practice Authority also found that the French company’s failure to disclose some of its trial results had brought discredit on and reduced confidence in the drug industry.

An anonymous member of the public complained to the authority after the publication of …
Pyrazinoate Excretion in the Chimpanzee. RELATION TO URATE DISPOSITION AND THE ACTIONS OF URICOSURIC DRUGS
Authors: George M. Fanelli, I. M. Weiner
Journal: Journal of Clinical Investigation (1973)

These experiments were designed to define the renal disposition of pyrazinoic acid in a nonhuman primate that is phylogenetically close to man and to relate this to the effects of pyrazinoate on urate excretion. The renal clearance of pyrazinoate was almost always greater than the simultaneous glomerular filtration rate at plasma concentrations ranging from 1.9 to 960 mug/ml. Some inhibitors of tubular secretion, probenecid, MK-282 (an experimental, potent uricosuric drug), p-aminohippurate, iodopyracet, sulfinpyrazone, and mersalyl, reduced clearances of pyrazinoate to values far below filtration rate. Chlorothiazide, allopurinol, and salicylate did not. The clearance of pyrazinoate was not influenced by changes in urine flow. It is concluded that pyrazinoate is actively secreted and actively reabsorbed. Pyrazinoate had a dual effect on urate excretion. At concentrations in plasma less than 10 mug/ml there was a concentration related fall in urate/inulin clearance ratio, reaching values of 10-20% of control. Over the range of 10-100 mug/ml in plasma, the clearance of urate remained maximally depressed. At higher concentrations of pyrazinoate there was a concentration related increase in urate/inulin clearance ratio such that at pyrazinoate levels above 600 mug/ml a definite uricosuric response was obtained. Prior administration of pyrazinoate to give plasma levels of 20-140 mug/ml completely or almost completely prevented uricosuric responses to probenecid, PAH, chlorothiazide, and sulfinpyrazone. Iodopyracet, mersalyl, salicylate and N-acetyl-4-dibutylsulfamoyl-3-trifluoromethylbenzenesulfonamide (MK-282) retained significant uricosuric action, but the activities were probably less than normal. The results are consistent with a model of urate transport involving high rates of bidirectional transtubular flux.
Insect-sting encephalopathy.
Authors: A N Gale
Journal: BMJ (1982)

beta-blocker treatment (acebutolol 300 mg, atenolol 200 mg, and propranolol 160 mg daily, respectively).In each patient T-wave inversion was present in leads II, III, aVF, and V4-6: after exercise as well as at rest (supine and stand- ing) in case 1, only at rest in case 2, and only after exercise in case 3. Two weeks after beta-blocker treatment was stopped the T waves became normally upright in each patient, though in case 1 they could again be inverted after the patient had been standing for 15 minutes.Full cardiovascular investigation while the patients were not receiving any treatment included haemodynamic assessment, left ventricular and selective coronary angiography, arterial and coronary sinus lactate measurements, a pacing test, and provocation with ergometrine (500 ixg intravenously).There was no evidence of coronary artery stenosis, coronary artery spasm, myo- cardial ischaemia, or other cardiovascular abnormality.A maximal treadmill test (Bruce protoCOl2) was normal in all the patients.The effects on the electrocardiogram of acute treatment with acebutolol 800 mg by mouth over 12 hours (case 1) and propranolol 10 mg intravenously (cases 2 and 3) were studied.The T waves remained upright in each case both at rest (supine or standing) and on exercise testing, immediately and 20 minutes after exercise.A further course of chronic treatment with acebutolol 300 mg, atenolol 200 mg, and propranolol 320 mg respectively for three weeks reproduced the original T-wave inversion in cases 1 and 2 but not in case 3 (figure).After treatment was stopped again the T waves became upright Chronic treatment No treat-ment Caise 2 Case 3 41~~~~~~~~~~~.. ... ...... T.2Elietoarigrm otindinte.heeptins.spieledb5beoe.a.adimeiteyafe.b)eerie in all patients, though in case 1 they could again be inverted on standing.T waves were not inverted in any patient by hyperventilation, but in case I hyperventilation normalised the inversion induced by standing when the patient was not receiving treatment.