tbuckley/cabot-search huggingface dataset:
Reye's syndrome in the British Isles: first annual report of the joint British Paediatric Association and Communicable Disease Surveillance Centre surveillance scheme.
Authors: S Hall, M Bellman
Journal: BMJ (1984)

Reye's syndrome is a severe acute paediatric disorder character- ised by encephalopathy with pronounced cerebral oedema and by diffuse fatty infiltration of the viscera, particularly the liver.'It may occur at any age in childhood.Typically a previously normal child has a viral type prodromal illness followed in a few days by vomiting, altered consciousness, and often convulsions.The liver may be enlarged and there may be evidence of hepatic dysfunction, with raised activities of transaminase, raised blood ammonia concentrations, and sometimes hypoglycaemia and a prolonged prothrombin time.At necropsy the liver is enlarged, pale, and fatty, and histological examination shows diffuse, panlobular microvesicular fatty infiltration.Fatty changes may also be seen in skeletal muscle, heart, and kidneys.Characteristic ultrastructural cellular changes have been described.2The aetiology of Reye's syndrome is unknown, but it is thought to represent an abnormal reaction to a viral infection in a genetically susceptible host, possibly modified by exo- genous toxins.3Influenza B and A and varicella zoster have been the most consistently associated viruses, although Reye's syndrome has been reported after many other viral infections.3Much of the epidemiological information about Reye's syndrome comes from the United States, where the Centers for Disease Control have maintained national surveillance for over 10 years.In Britain some data on Reye's syndrome in children under 3 years old were obtained from the National Childhood Encephalopathy Study.4In view of the lack of epidemiological knowledge about Reye's syndrome in children of all ages in the British Isles, a joint voluntary Reye's syndrome reporting scheme was started by the British Paediatric Associa- tion and the Communicable Disease Surveillance Centre in August 1981 with the aim of (a) documenting the occurrence and describing the characteristics of Reye's syndrome in the British Isles and monitoring long term trends; and (b) providing a central case register and serum and tissue bank for clinical or laboratory research.This paper reports the results obtained in the first year of the surveillance scheme, August
Gallstone disease: From genes to evidence-based therapy
Authors: Frank Lammert, Juan-Francisco Miquel
Journal: Journal of Hepatology (2008)

The number of gallstone patients is increasing in ageing populations with a high prevalence of metabolic syndrome and obesity. Recently variants of hepatic ATP binding cassette transporters have been identified as genetic susceptibility factors for gallstone disease, pointing to novel means for risk assessment and prevention. Although laparoscopic cholecystectomy is the mainstay of therapy for symptomatic gallbladder stones, the clinical management of gallstone disease is changing rapidly, with an increase in day case surgery and the advent of transluminal endoscopic surgery. Here, we summarize the molecular and genetic mechanisms of gallstone formation as well as the current evidence-based algorithms for diagnosis and therapy of gallbladder and bile duct stones.
Nitric oxide and protein kinase G act on TRPC1 to inhibit 11,12-EET-induced vascular relaxation
Authors: Peng Zhang, Yan Ma, Yan Wang, Xin Ma, Yu Huang, Ronald A. Li, Song Wan, Xiaoqiang Yao
Journal: Cardiovascular Research (2014)

Vascular endothelial cells synthesize and release vasodilators such as nitric oxide (NO) and epoxyeicosatrienoic acids (EETs). NO is known to inhibit EET-induced smooth muscle hyperpolarization and relaxation. This study investigates the underlying mechanism of this inhibition. Through measurements of membrane potential and arterial tension, we show that 11,12-EET induced membrane hyperpolarization and vascular relaxation in endothelium-denuded porcine coronary arteries. These responses were suppressed by S-nitroso-N-acetylpenicillamine (SNAP) and 8-Br-cGMP, an NO donor and a membrane-permeant analogue of cGMP, respectively. The inhibitory actions of SNAP and 8-Br-cGMP on 11,12-EET-induced membrane hyperpolarization and vascular relaxation were reversed by hydroxocobalamin, an NO scavenger; ODQ, a guanylyl cyclase inhibitor; and KT5823, a protein kinase G (PKG) inhibitor. The inhibitory actions of SNAP and 8-bromo cyclic GMP (8-Br-cGMP) on the EET responses were also abrogated by shielding TRPC1-PKG phosphorylation sites with an excessive supply of exogenous PKG substrates, TAT-TRPC1S172 and TAT-TRPC1T313. Furthermore, a phosphorylation assay demonstrated that PKG could directly phosphorylate TRPC1 at Ser172 and Thr313. In addition, 11,12-EET failed to induce membrane hyperpolarization and vascular relaxation when TRPV4, TRPC1, or KCa1.1 was selectively inhibited. Co-immunoprecipitation studies demonstrated that TRPV4, TRPC1, and KCa1.1 physically associated with each other in smooth muscle cells. Our findings demonstrate a novel role of the NO-cGMP-PKG pathway in the inhibition of 11,12-EET-induced smooth muscle hyperpolarization and relaxation via PKG-mediated phosphorylation of TRPC1.
Biosynthesis of thromboxane in patients with systemic sclerosis and Raynaud's phenomenon.
Authors: I A Reilly, L Roy, G A Fitzgerald
Journal: BMJ (1986)

Thromboxane A2, the predominant cyclo-oxygenase product of arachidonic acid in platelets, is a potent vasoconstrictor and platelet agonist. Analysis of urinary metabolites by gas chromatography and mass spectrometry is a specific non-invasive method of measuring the biosynthesis of thromboxane that avoids the problem of platelet activation ex vivo. Excretion of the major urinary thromboxane metabolite, 2,3-dinor-thromboxane B2, was significantly increased (p less than 0.001) in 10 patients (nine women) with systemic sclerosis complicated by Raynaud9s phenomenon compared with healthy controls (486 (SD 88) v 162 (38) ng/g creatinine) and increased further in the patients (to 1007 (212) ng/g creatinine) during application of a cold stimulus sufficient to induce digital vasoconstriction. Consistent with an increase in platelet-vascular interactions in vivo, excretion of a prostacyclin metabolite was also significantly increased (p less than 0.005) in the patients with systemic sclerosis (248 (39) v 112 (10) ng/g creatinine) and tended to increase further on cooling. Biosynthesis of thromboxane is increased in patients with systemic sclerosis and may exacerbate digital vasospasm that such patients develop when cold. This observation and the concomitant increase in the formation of prostacyclin provide a rationale for evaluating compounds that prevent the synthesis of thromboxane A2 or inhibit its action while preserving the potential homoeostatic role of prostacyclin.
Pneumocystis carinii Pneumonia Treated with Pyrimethamine and Sulfadiazine
Authors: HENRY B. KIRBY
Journal: Annals of Internal Medicine (1971)

Pentamidine isethionate has been considered the only effective agent in the treatment of Pneumocystis carinii pneumonia. Its toxicity makes it less than the ideal drug. Pyrimethamine and sulfadiazine have been as effective as pentamidine in the treatment of P. carinii pneumonia in experimental animals. Results of prior reported treatment in human disease are reviewed. Three consecutive patients with biopsy-proved P. carinii pneumonia who were admitted to the medical service at the University of Texas Medical Branch Hospitals, Galveston, and treated with pyrimethamine and sulfadiazine are reported. Two patients were clinically cured and have had long-term follow-up. One patient showed clinical improvement with therapy but died of unknown causes shortly after completion of treatment; autopsy was not performed. The encouraging results obtained with the use of pyrimethamine and sulfadiazine indicate the need for further clinical trial with these readily available and relatively nontoxic antimicrobial agents.
Superiority of dobutamine over dopamine for augmentation of cardiac output in patients with chronic low output cardiac failure.
Authors: H S Loeb, J Bredakis, R M Gunner
Journal: Circulation (1977)

Dobutamine is a newly developed catecholamine reported to have minimal direct vascular effects relative to its inotropic activity and to have less chronotropic and arrhythmogenic properties than other catecholamines used in the treatment of low output states. In this study, the acute hemodynamic effects of dobutamine were compared to those of dopamine in 13 patients with chronic low output cardiac failure. At dosages adjusted to achieve similar increments in cardiac output, dobutamine reduced left ventricular filling pressure (LVEP) from 24 +/- 2 mm Hg (SEM) to 17+/- 2 mm Hg, while dopamine increased LVEP to 30 +/- 3 mm Hg and in six patients caused arterial O2 saturation to fall below 90%. This poor response to dopamine was probably the result of its vasoconstrictive effects and illustrates the potential advantages of using a cardioselective agent such as dobutamine when the desired goal of therapy is to improve ventricular function by direct inotropic stimulation.
Distribution of Hyaluronan During Extracellular Matrix Remodeling in Human Restenotic Arteries and Balloon-Injured Rat Carotid Arteries
Authors: Reimer Riessen, Thomas N. Wight, Christopher Pastore, Courtney Henley, Jeffrey M. Isner
Journal: Circulation (1996)

Background The glycosaminoglycan hyaluronan (HA) is present in developing tissues and healing wounds and forms a loose, hydrated extracellular matrix (ECM) that promotes processes such as cell migration. To investigate the potential contribution of HA to the pathogenesis of restenosis, we studied (1) human lesions obtained by directional atherectomy and (2) experimentally induced neointima formation in balloon-injured rat carotid arteries. Methods and Results A biotinylated proteoglycan fragment that binds specifically to HA was used to stain atherectomy specimens from 29 human restenotic lesions (mean restenosis interval, 6.0±4.4 months) and 8 human primary lesions. The loose myxoid ECM typical of human restenotic arteries demonstrated intense, diffuse staining for HA. The intensity was inversely related to the density of immunostaining for collagen types I and III and was lowest in hypocellular primary atherosclerotic plaque. Among 24 rat carotid arteries retrieved 3, 7, 14, 28, 42, or 56 days after balloon injury and immunostained as well for proliferating cell nuclear antigen, staining for HA in the neointima reached a maximum 7 days after balloon injury and was associated with the presence of proliferating, PCNA-positive smooth muscle cells. Conclusions Hyaluronan is a characteristic constituent of the loose myxoid ECM in human restenotic arteries and of the neointima in experimentally injured arteries. The presence of hyaluronan may be a marker for an initial phase of the extracellular matrix remodeling that occurs during the development of a fibroproliferative lesion and could facilitate biological processes such as cell migration.
Effect of Changes in Ventricular Rate on Cardiac Output and Central Pressures at Rest and During Exercise in Patients with Artificial Pacemakers
Authors: S. Bevegard, B. Jonsson, I. Karlof, H. Lagergren, E. Sowton
Journal: Cardiovascular Research (1967)

The stroke volume and central pressures were measured at rest and during exercise in 22 patients with heart block, aged between 14 and 78 years. The immediate and later effects of changes in ventricular rate produced by artificial pacemaking are described, and their significance is discussed.
Transduction and selection of human T cells with novel CD34/thymidine kinase chimeric suicide genes for the treatment of graft-versus-host disease
Authors: Michael P Rettig, Julie K Ritchey, Todd E Meyerrose, Jeffrey S Haug, John F DiPersio
Journal: Molecular Therapy (2003)

Clinical trials evaluating the herpes simplex virus thymidine kinase (HSV-tk)/ganciclovir (GCV) suicide gene therapy system for the control of graft-versus-host disease (GVHD) have been limited by low transduction efficiencies and inefficient selection procedures. In this study, we designed and evaluated a novel chimeric suicide gene consisting of the extracellular and transmembrane domains of human CD34 and full-length HSV-tk (DeltaCD34-tk). High-efficiency transfer of DeltaCD34-tk to primary human T cells was accomplished after a single exposure to VSV-G-pseudotyped, Moloney murine leukemia virus-based retrovirus 48 h after activation of human PBMCs with anti-CD3 and anti-CD28 antibodies immobilized on magnetic beads. Using an optimized 5-day transduction and selection procedure, transduction efficiencies averaged 71%, with isolation purities greater than 95% and yields exceeding 90%. The immunoselected T cells were selectively eliminated by GCV (IC(50) approximately 3 nM), maintained a normal subset composition, exhibited a polyclonal TCR Vbeta family repertoire, and contained 5 or 6 vector copies per transduced cell when optimally transduced. No increase in GCV sensitivity was observed upon incorporation of highly active mutant HSV-tk enzymes into the DeltaCD34-tk suicide gene. T cells modified with the DeltaCD34-tk gene using the optimized protocol should improve the overall efficacy of the HSV-tk/GCV suicide gene therapy method of GVHD control.
Congenital heart disease in low birth weight infants.
Authors: D L Levin, P Stanger, J A Kitterman, M A Heymann
Journal: Circulation (1975)

In this study of low birth weight infants (less than 2500 g), we compared the birth weight distribution of patients with patent ductus arteriosus associated with prematurity with that of patients having congenital heart disease other than patent ductus arteriosus. Among 1436 low birth weight infants 37 infants had congenital heart disease other than patent ductus arteriosus and 198 had isolated ductus arteriosus. Infants with congenital heart disease had a mean birth weight of 2018 grams (standard deviation = 370 g) which was significantly greater than that of infants with patent ductus arteriosus. Four of the 37 infants with congenital heart disease other than ductus arteriosus were among 1150 low birth weight infants born in this institution, an incidence of 3.5/1000 live low birth weight infants. Seventy-eight of the 198 infants with patent ductus arteriosus were among 1150 low birth weight infants born in this institution, an incidence of 70/1000 live low birth weight infants. Twenty-one of the 37 infants with congenital heart disease were of appropriate weight for gestational age and 16 were small for gestational age.
Retinoic acid induces homing of protective T and B cells to the gut after subcutaneous immunization in mice
Authors: Swantje I. Hammerschmidt, Michaela Friedrichsen, Jasmin Boelter, Marcin Lyszkiewicz, Elisabeth Kremmer, Oliver Pabst, Reinhold Förster
Journal: Journal of Clinical Investigation (2011)

Diarrheal diseases represent a major health burden in developing countries. Parenteral immunization typically does not induce efficient protection against enteropathogens because it does not stimulate migration of immune cells to the gut. Retinoic acid (RA) is critical for gut immunity, inducing upregulation of gut-homing receptors on activated T cells. In this study, we have demonstrated that RA can redirect immune responses elicited by s.c. vaccination of mice from skin-draining inguinal LNs (ingLNs) to the gut. When present during priming, RA induced robust upregulation of gut-homing receptors in ingLNs, imprinting gut-homing capacity on T cells. Concurrently, RA triggered the generation of gut-tropic IgA+ plasma cells in ingLNs and raised the levels of antigen-specific IgA in the intestinal lumen and blood. RA applied s.c. in vivo induced autonomous RA production in ingLN DCs, further driving efficient induction of gut-homing molecules on effector cells. Importantly, RA-supplemented s.c. immunization elicited a potent immune response in the small intestine that protected mice from cholera toxin–induced diarrhea and diminished bacterial loads in Peyer patches after oral infection with Salmonella. Thus, the use of RA as a gut-homing navigator represents a powerful tool to induce protective immunity in the intestine after s.c. immunization, offering what we believe to be a novel approach for vaccination against enteropathogens.
Hypertension and prolonged vasoconstrictor signaling in RGS2-deficient mice
Authors: Roy J. Soberman
Journal: Journal of Clinical Investigation (2003)

During the final stages of production, an error was introduced into the list of nonstandard abbreviations and into the text.The correct list of nonstandard abbreviations and the correct sentence appear below.Nonstandard abbreviations used: reactive oxygen species (ROS); hydrogen peroxide (H 2 O 2 ); hypoxia-inducible factor 1 (HIF-1); carboxy-terminal binding protein (CtBP); apoptosis-inducing factor (AIF); apoptosis signal-regulating kinase 1 (ASK1).Sensing nuclear oxygen tension.Since its original description, the study of the transcription factor hypoxia-inducible factor 1 (HIF-1) has demonstrated its central role in regulating the body's response to changing oxygen levels (4-6).
Safety of the Blood Supply in the United States: Opportunities and Controversies
Authors: James P. AuBuchon
Journal: Annals of Internal Medicine (1997)

The risk for viral transmission by transfusion has been reduced dramatically through improved techniques for selecting and testing blood donors.Initiatives to further improve the safety of the blood supply, including more stringent donor qualifications, additional testing for infectious disease markers, viral inactivation processes, and refinement of transfusion decisions, are possible. However, because the risk for viral transmission by allogeneic transfusion is already low, additional measures will have limited yield and poor cost-effectiveness. Furthermore, unexpected side effects of some of these "improvements" may reduce the safety of the blood supply by introducing new risks. Cost-effectiveness analyses of blood safety initiatives have highlighted such successes as the introduction of virus-specific assays for screening donated blood and have identified other interventions that have poor cost-effectiveness estimates. They have also quantitated the threshold level at which the risks of an intervention outweigh its benefits. These analyses have had little effect on decisions about blood safety, possibly because of overwhelming fear of AIDS and difficulties in applying cost-effectiveness estimates to a politically and emotionally charged issue. Future interventions for improving blood supply safety must be evaluated thoroughly and chosen carefully so that the intended goals are met. Communication with the public should be undertaken so that the public understands that some of the desired measures may result in inefficient allocation of health care resources.
Sliding Scale Insulin—Time to Stop Sliding
Authors: Irl B. Hirsch
Journal: JAMA (2009)

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
Restenosis after directional coronary atherectomy. Effects of luminal diameter and deep wall excision.
Authors: R E Kuntz, T Hinohara, R D Safian, M R Selmon, J B Simpson, D S Baim
Journal: Circulation (1992)

Deep wall excision during directional atherectomy has been reported in one study to increase the risk of subsequent restenosis. On the other hand, we have observed that the probability of late (6-month) restenosis is reduced by maximizing postprocedure luminal diameter. Although such maximal luminal enlargement by directional atherectomy has not increased procedural complications in our experience, it might well increase the incidence of subintimal (deep wall component) recovery. We performed this study to evaluate the relative influences of luminal enlargement and deep wall component excision on postatherectomy restenosis.Atherectomy resulted in a 7 +/- 15% residual stenosis with < 0.5% incidence of angiographic vessel perforation. The minimal luminal diameter of each lesion was measured before and after intervention in 413 lesions, 389 (94%) of which had histological analysis of the excised specimens. Specimens were categorized by the deepest layer retrieved: type I (recovery of intima alone, n = 141), type II (recovery of media, n = 79), and type III (recovery of adventitia, n = 65). Repeat angiographic measurement of minimal luminal diameter was available for 329 (80%) segments 6 months after atherectomy. Compared with the 32% restenosis rate for type I excision, there was no increase in restenosis (stenosis > 50%) for type II, type III, or types II+III (p = 0.86). Stratification by vessel characteristics also failed to show any association between restenosis and deep wall component recovery in any subgroup, including native coronary (p = 0.85), left anterior descending coronary artery (p = 0.70), right coronary artery (p = 0.51), saphenous graft (p = 0.78), or prior restenosis lesions (p = 0.98). Paradoxically, the recovery of adventitia (type III excision) was associated with a lower late percent stenosis (p = 0.03) and a trend toward less restenosis (p = 0.11) compared with type I excisions. A multiple logistic regression model was constructed that demonstrated immediate postprocedure luminal diameter (p = 0.02) to be an independent determinant of restenosis. In this model, the presence of deep wall components (type II+III) did not adversely affect (p = 0.86) restenosis, but the recovery of adventitia was associated with an independent trend toward reduced restenosis (p = 0.06).The immediate goal of directional atherectomy should be to safely provide the largest lumen possible in order to reduce restenosis. The recovery of deep wall components does not appear to jeopardize the beneficial effect that obtaining a large immediate postprocedure lumen diameter has on reducing the incidence of late restenosis.