tbuckley/cabot-search huggingface dataset:
FINAL REPORT ON THE IDENTIFICATION OF THE ORGANISM OF THE PREVIOUSLY REPORTED CASE OF SUBACUTE ENDOCARDITIS AND SYSTEMIC MYCOSIS (MONILIA)
Authors: S. H. Polayes
Journal: JAMA (1941)

In the report of the first case of subacute endocarditis with systematic moniliasis ever to have been clinically diagnosed and published<sup>1</sup>it was not possible to state the identity of the causative organism, although it was definitely known to be a species of Candida (Monilia). Since then, however, studies of cultures which had been submitted to the Division of Infectious Diseases of the U. S. Public Health Service have led to the definite identification of the fungus as Candida (Monilia) parakrusei. Because numerous requests have been made for the final results of our studies, it was deemed advisable to publish them at this time. The following, therefore, is a brief summary of the mycologic studies of the organism, including some of the more pertinent features mentioned in the previous publication. The present report also affords us the opportunity to publish a reproduction of a photomicrograph of a typical smear
Generation of Chemotactic Activity in Serum from Patients with Erythropoietic Protoporphyria and Porphyria Cutanea Tarda
Authors: Henry W. Lim, H. Daniel Perez, Maureen Poh-Fitzpatrick, Ira M. Goldstein, Irma Gigli
Journal: New England Journal of Medicine (1981)

THE porphyrias are a group of diseases characterized clinically by photosensitivity and biochemically by elevated levels of porphyrins in erythrocytes, plasma, urine, or feces.1 , 2 Within minutes to hours after exposure to sunlight, dermal edema and erythema develop in persons with these disorders. Extensive scarring can occur after repeated attacks. The pathogenesis of these cutaneous lesions is poorly understood.We have previously reported that the addition of exogenous uroporphyrin to normal human serum, followed by irradiation with light containing the absorption spectra of porphyrin compounds (400 to 410 nm) results in activation of the classical pathway of complement and generation of . . .
Pupillary Dilation with Tropicamide 1% for Funduscopic Screening
Authors: William C. Steinmann, Michael E. Millstein, Stephen H. Sinclair
Journal: Annals of Internal Medicine (1987)

Primary care practitioners omit pupillary dilation from funduscopic examination, possibly because of time constraints, poor patient compliance, or fear of adverse reactions. Nevertheless, the omission of this procedure may lead to the inadequate visualization of the fundus for screening. We administered a topical solution of 1% tropicamide to 30 adults to determine the course of pupillary dilation over time and whether adequate dilation could be attained within a routine clinic visit. Pupil diameters were measured every 5 minutes in a 30-minute period. The initial mean pupillary diameter was 2.4 mm and the endpoint was 5.5. Dilation was significantly slower in those older than 50 years of age. However, at 15 minutes 87% of the patients, regardless of age, had achieved dilation to at least 4 mm, which should be sufficient for screening under most circumstances. We conclude that adequate pupillary dilation in adults usually can be achieved within the time frame of a routine office visit and thus should not be a deterrent to routine funduscopic screening by primary care practitioners.
Bend in the Epte River near Giverney
Authors: M. Therese Southgate
Journal: JAMA (2006)

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
Effects of Five Per Cent Dextrose-Water Infusions in Normal and Hypertensive Man
Authors: PAUL J. CANNON
Journal: Circulation (1968)

During infusions of 5% dextrose in water urinary sodium excretion and the renal tubular rejection of filtered sodium (E/F Na %) were significantly higher in hypertensive than in normotensive subjects. Increased E/F Na % did not result from alterations in plasma sodium, in filtered sodium, or from an osmotic diuresis. Fractional sodium reabsorption in proximal (isosmotic) portions of the nephron was diminished in the hypertensive patients. Free water formation (C H H2 o rose with increased "distal" sodium delivery (V) in both groups; however, fractional sodium reabsorption in the "distal" nephron was significantly impaired in the hypertensive patients and urinary osmolality was increased. Mean arterial blood pressure and E/F Na % were related in curvilinear fashion in the 31 studies, and there was a direct relation between E/F Na % and the magnitude of renal vascular resistance. The data suggested that alterations of renal arterial pressure and vascular resistance in hypertensive disease modify sodium transport in proximal and diluting segments of the nephron and determine to a major extent the increased natriuresis exhibited by hypertensive subjects during infusions that expand extracellular fluid volume.
Tissue and cell renewal in the natural aortic valve of rats: an autoradiographic study
Authors: P. J SCHNEIDER, J D. DECK
Journal: Cardiovascular Research (1981)

The present study has demonstrated that tissues of the aortic valve respond to the cyclic stresses of normal cardiac function by continual synthesis and renewal. Rats were injected with tritiated-precursors specific for proteins, ground substance components, and replicating DNA, and their sites of incorporation were identified autoradiographically. Extracellular component renewal and cell proliferation were greater in the fibrous connective tissue areas of the valve, namely the leaflet and attachment region, than in the musculoelastic sinus wall. Extracellular protein synthesis was greatest in the leaflet, whereas the highest glycosaminoglycan synthesis occurred in the attachment zone. Cellular replication, although infrequent, was equal in these fibrous regions, being higher than in the sinus wall. These observations may be explained by an analysis of the histology of the valve and consideration of the functional stresses to which the valve is subjected during the cardiac cycle. The leaflet is composed of layers of dense connective tissue oriented for maximum strength. On the other hand, the attachment zone represents a fibrous connective tissue designed for maximum flexibility; this area appears to function as a hinge. Cyclic operation of the valve causes damaging mechanical stresses in these regions, necessitating the continual regeneration of structural proteins required for strength and lubricative ground substance components required for flexibility. The sinus wall, composed of smooth muscle cells and elastic fibres, is undoubtedly better suited to cyclic tissue deformation, thereby explaining the lower synthetic levels of macromolecules. Due to the low level of cell replication, it seems reasonable to conclude that the functional stresses act to modulate the cell's secretory activity rather than to stimulate proliferation. Similar observations of stress-related tissue renewal have been reported.
Intrathecal delivery of protein therapeutics to the brain: A critical reassessment
Authors: Pericles Calias, William A. Banks, David Begley, Maurizio Scarpa, Patricia Dickson
Journal: Pharmacology & Therapeutics (2014)

Disorders of the central nervous system (CNS), including stroke, neurodegenerative diseases, and brain tumors, are the world’s leading causes of disability. Delivery of drugs to the CNS is complicated by the blood–brain barriers that protect the brain from the unregulated leakage and entry of substances, including proteins, from the blood. Yet proteins represent one of the most promising classes of therapeutics for the treatment of CNS diseases. Many strategies for overcoming these obstacles are in development, but the relatively straightforward approach of bypassing these barriers through direct intrathecal administration has been largely overlooked. Originally discounted because of its lack of usefulness for delivering small, lipid-soluble drugs to the brain, the intrathecal route has emerged as a useful, in some cases perhaps the ideal, route of administration for certain therapeutic protein and targeted disease combinations. Here, we review blood–brain barrier functions and cerebrospinal fluid dynamics and their relevance to drug delivery via the intrathecal route, discuss animal and human studies that have investigated intrathecal delivery of protein therapeutics, and outline several characteristics of protein therapeutics that can allow them to be successfully delivered intrathecally.
Research Offers Only a Limited View of Imaging’s Effect on Patient Outcomes
Authors: Mike Mitka
Journal: JAMA (2010)

CHICAGO—The tug-of-war between radiologists and other specialists over the use of diagnostic and interventional imaging is often seen as a turf battle. The disagreements typically focus on utilization patterns, with the various specialties presenting studies to support their contentions that they provide the most efficacious and appropriate imaging services. But these discussions and debates, which often come down to reimbursement issues, tend to overlook the patient’s concerns: which types of diagnostic and interventional imaging, used by which specialists and in what settings, produce the best results? The short answer is, “No one knows.” No rigorous trials have focused on the use of diagnostic and interventional imaging and patient outcomes. Steven D. Pearson, MD, president of the Institute for Clinical and Economic Review at Harvard Medical School in Boston, maintains that practitioners should set aside turf battles and instead focus on improving patient care. As for imaging, he added, radiologists need to concede that some simpler tests can be performed by nonradiologists, but nonradiology specialists must realize that other tests require more rigorous training than they can obtain in a 6-hour weekend course. “The basic issue from the patient’s perspective is, ‘How much skill does the physician have who is testing, diagnosing, and treating me?’” Pearson said. “The professional societies need to work together where possible, and they all need to take this issue much more seriously than they have.” But rigorous study into improving imaginguseremains lacking.Thedearth ofoutcomes trialswasevident at theScientific Assembly of the Radiological SocietyofNorthAmerica(RSNA)heldhere
Sagittal plane body positions influence tibial anteror shear force during single-leg landing
Authors: Y Shimokochi, E Meyer
Journal: British Journal of Sports Medicine (2011)

Background Excessive tibiofemoral compression has been shown to rupture the Anterior Cruciate Ligament (ACL) as axial tibia load may produce an anterior shear force to the proximal lateral tibial plateau. Objective To quantify and compare the amount of Tibial Anterior Shear Force (TASF) during three different landing styles. Design Controlled Crossover Design. Setting Controlled Laboratory. Participants 20 healthy volunteers (10 M, 10 F; 23.4±3.6 years, 171.0±9.4 cm, 73.3±12.7 kg) without history of lower extremity ligamentous injuries. Interventions Biomechanical data were collected from three different landings; (1) self-selected (SS), (2) leaning forward (LF), and (3) upper body upright (UR). TASF was calculated from the sagittal plane knee joint reaction force, and assuming that the posterior slope of the lateral tibial plateau was 15° and that joint reaction force occurred on the lateral knee. Main outcome measures Maximum TASFs (TASFmax) normalised by body weight (N), Sagittal plane angle of the ground reaction force (GRF) vector relative to the longitudinal axis of the tibia at TASFmax (GRF Angle , positive direction indicates GRF is inclined more anteriorly than the tibia in sagittal plane). Results LF produced the least amount of TASFmax whereas UR produced the largest amount of TASFmax (LF=0.54±0.06, SS=0.95±0.10, UR=1.30±0.11). GRF Angle in UR was the largest while no difference in GRF Angle was observed between LF and SS (LF=−3.4°±2.2°, SS=0.2°±1.2°, UR=4.2°±1.1°). Conclusions It has been reported that GRF pushes the tibia posteriorly during landing, slacking the ACL. However, our research demonstrated GRF Angle may push the tibia anteriorly and straining the ACL for certain sagittal plane body positions during landing. Based on the TASF calculations, the risk of ACL injuries may depend on the sagittal plane body positions during landing, as well as other factors which increase the lateral TASF, such as valgus knee loading and the amount of the posterior slope on the lateral tibial plateau.
Woman fights for parents' right to know abortion advice to under 16s
Authors: Clare Dyer
Journal: BMJ (2005)

A mother of two teenage daughters went to the High Court in London last week to challenge government guidance allowing doctors to provide abortion advice or contraception to young people under 16 in England without the knowledge of their parents.

Judgment is pending in the judicial review case brought by Sue Axon, 51, a divorced single mother of five children from Manchester, over Department of Health guidelines issued last year that, she says, “undermine the role of parents.”

The case has echoes of the controversy two decades ago when Victoria Gillick unsuccessfully claimed that parents should have …
Notched T Waves in Young Persons with Central Nervous System Lesions
Authors: KAY MILLAR, J. A. ABILDSKOV
Journal: Circulation (1968)

Eighty-nine abnormal electrocardiograms taken on young persons with central nervous system (CNS) lesions were reviewed. Most had S-T segment and T-wave abnormalities of a nonspecific type. A high incidence of notched T waves was also noted. In this group of patients with CNS lesions the notching may be due to asymmetrical alterations in sympathetic tone to the ventricle.
New Way to Syringe Ears
Authors: J. B. Dawson
Journal: BMJ (1964)

From the history and clinical findings of the case it was possible to say that the fungus was first inoculated into the skin.Later the organism involved the subcutaneous fatty tissue and produced nodules akin to those seen in the peritoneum.The culture studies suggested that pathogenicity of the fungus mainly depended on the presence of the periodic-acid-Schiff-positive material.-Iam, etc
Minimizing Malpractice Risks by Role Clarification
Authors: Jerry A. Green
Journal: Annals of Internal Medicine (1988)

The purposes and applications of informed consent are the subject of confusion and controversy according to a President's Commission report. The Commission suggests shared decision making as the new ideal for physician-patient relationships, but notes that such a changed ideal will not be initiated by court action. The four models of decision making are the traditional model, informed consent, collaboration, and patient choice. Misunderstandings about these and other terms arise when they are implied; therefore, they should be defined expressly. Mutual expectations should be ascertained and common misunderstandings that erode relationships and lead to litigation should be clarified. Without agreements, different models may be selected and expectations about responsibility may differ. Such agreements may be documented by notes in patients' charts, supported by intake procedures that teach patients about defining responsibility, and questionnaires that elicit values, needs, and preferences. The literature on the evolution of contract principles in health care is reviewed, with informed consent viewed as a judicial stepping stone from tort to contract. A framework for defining mutual expectations is presented. Physicians' patterns of allocating responsibility by express and implied agreements should be evaluated and changes made where needed.
Outcome of the management of hepatitis B infection in pregnancy
Authors: N. Tehami, P. Mills, S. Cameron, G. Penrice, R. Hague, A. Mathers
Journal: Gut (2011)

<h3>Introduction</h3> Many UK centres have experienced a significant increase in the prevalence of hepatitis B virus (HBV) infection, particularly in the immigrant population. The commonest method of infection is vertical transmission from mother to child. A review the outcome of HBV in pregnancy in Glasgow was undertaken. <h3>Methods</h3> City wide data for the 6 year period 2004–2009 was accessed and a comprehensive review of mothers presenting during the 3 year period 2006–2008 was undertaken to assess outcome. <h3>Results</h3> A total of 343 mothers tested positive for HBV over the 6 year period. The number of positive tests increased annually from 18, 46, 41, 74, 82 to 78. The uptake of screening for HBV was 98%. During 2006–2008, 197 mothers were screened positive for HBV, but complete data was only available for 182 mothers and 176 infants (5 mothers transferred out during pregnancy, 1 baby died aged 3 days). The mean age of the 182 mothers studied was 25.1 years (range 19–41). Of 182 HBV positive mothers, there were 3 (1.6%) cases of acute hepatitis and 179 (98.4%) of chronic hepatitis, of which 146 (81.5%) were anti-HBe positive and 33 (18.5%) HBeAg positive. Viral coinfection was detected in 5 patients (2 HIV, 2 HCV, 1 HDV). None of the 182 patients were on any treatment prior to pregnancy. Only 97 (53%) mothers had HBV viral load and 113 (62%) had LFTs checked at any point. None of the mothers had viral load checked during the third trimester and none received nucleoside analogues. No mothers were monitored during the puerperium for HBV flare and only 53 (29.1%) mothers were referred for specialist hepatology advice after pregnancy. All babies born to HBV mothers were given HBV vaccination and 43 babies also received HBIg. Over 90% of these babies completed the full course of four HBV vaccinations. Only 31 out of 176 children were tested for anti-HBs after the successful completion of vaccination and all had a positive response. None had HBsAg measured. <h3>Conclusion</h3> The number of mothers testing HBV positive in Glasgow is steadily increasing. However, the assessment of liver disease during pregnancy and monitoring for HBV flare in the puerperium remains inadequate. There is a robust system in place for HBV vaccination in the infants born to these mothers but the assessment of outcome of vaccination is not satisfactory. The subsequent management of HBV infected mothers after delivery requires improvement.
Reprogramming of antiviral T cells prevents inactivation and restores T cell activity during persistent viral infection
Authors: David G Brooks, Dorian B McGavern, Michael B A Oldstone
Journal: Journal of Clinical Investigation (2006)

Failure to clear persistent viral infections results from the early loss of T cell activity. A pertinent question is whether the immune response is programmed to fail or if nonresponsive T cells can specifically be fixed to eliminate infection. Although evidence indicates that T cell expansion is permanently programmed during the initial priming events, the mechanisms that determine the acquisition of T cell function are less clear. Herein we show that in contrast to expansion, the functional programming of T cell effector and memory responses in vivo in mice is not hardwired during priming but is alterable and responsive to continuous instruction from the antigenic environment. As a direct consequence, dysfunctional T cells can be functionally reactivated during persistent infection even after an initial program of inactivation has been instituted. We also show that early therapeutic reductions in viral replication facilitate the preservation of antiviral CD4+ T cell activity, enabling the long-term control of viral replication. Thus, dysfunctional antiviral T cells can regain activity, providing a basis for future therapeutic strategies to treat persistent viral infections.
Infections Associated With Prosthetic Devices
Authors: Jerry D. Smilack
Journal: JAMA (1985)

Nearly every physician in the mid 1980s has at least one patient with a prosthetic<i>something</i>. Prosthetic hip and knee replacement has revolutionized the practice of orthopedics; at least 150,000 prosthetic joint implantations are performed annually in the United States. Ocular lens implants, pacemakers, prosthetic heart valves, vascular grafts, and peritoneal dialysis catheters are commonplace. But for every advance in medicine a price must be paid. This book reminds us of the occasional infection that develops in association with prostheses. Infections involving almost every type of prosthesis (except totally artificial hearts) are discussed in this compact volume. Particularly illuminating are those chapters devoted to cerebrospinal fluid shunts, prosthetic heart valves, dialysis shunts and catheters, and orthopedic devices. A discussion of infections associated with urinary tract catheters (indwelling and intermittent) is extremely thorough, yet admirably lucid. Somewhat less helpful are those sections that deal more with the surgical than the infectious aspects
Metabolic Characterization of Obesity
Authors: RUDOLPH L. LEIBEL
Journal: Annals of Internal Medicine (1985)

Body composition (adiposity) is a regulated characteristic with multicomponent controls having redundant and interconnecting loops. The nature of the relevant control processes and of their interactions is poorly understood. Components of the system include complex mechanisms controlling food intake; energy expenditure; and the production, location, and filling of adipocytes. Recent studies in humans have implicated three systems in this overall control process: systemic energy homeostasis, adipocyte-related substrate flux, and adrenoreceptor function in adipocytes. These studies indicate that the formerly obese state is characterized by changes in systemic energy expenditure and adipocyte metabolism that may favor regaining weight. The anatomic distribution of adipose tissue, influencing risk of metabolic complications at any absolute level of adiposity, may be partially controlled by the status of adrenergic receptors in the adipocytes of the relevant anatomic sites.
Recurrent thymoma with myasthenia gravis.
Authors: W H Allum, D C Watson
Journal: BMJ (1983)

asymmetrical distension with a tender tympanitic mass occupying the right lower quadrant.Bowel sounds were absent.Plain abdominal radiographs showed the features of acute caecal volvulus.At laparotomy a 180' anticlockwise rotation of the caecum was found with a gangrenous anterior wall.Diverticular disease of the colon was confirmed, and there was a paracolic abscess around the lower descending and upper sigmoid colon.Subtotal colectomy was carried out with a primary end to end ileorectal anastomosis.Uneventful recovery followed until 37 days post- operatively, when a small faecal fistula developed.This closed over the next 14 days, and she was discharged 55 days postoperatively.'Namba T, Brunner NG, Grob D. Myasthenia gravis in patients with thymoma, with particular reference to onset after thymectomy.