tbuckley/cabot-search huggingface dataset:
Sympatholytic Action of Intravenous Amiodarone in the Rat Heart
Authors: Xiao-Jun Du, Murray D. Esler, Anthony M. Dart
Journal: Circulation (1995)

Background Amiodarone is a commonly used antiarrhythmic agent with complex pharmacological effects. Although ventricular arrhythmias can be suppressed soon after intravenous amiodarone, the mechanisms responsible for this action are unclear. We studied the effects of acute treatment with amiodarone on the metabolism and release of norepinephrine (NE) in intact rats and in perfused rat hearts. Methods and Results Experiments were performed in anesthetized rats and in perfused, innervated hearts with amiodarone administered intravascularly. NE release was induced by electrical stimulation of the sympathetic ganglion. Concentrations of NE and its intraneuronal metabolite dihydroxyphenylglycol (DHPG) in hearts, plasma, and coronary venous effluent were measured by high-performance liquid chromatography. Acute administration of amiodarone induced dose-dependent increases in DHPG concentrations in plasma (5 mg/kg, +48%; 15 mg/kg, +84%; and 50 mg/kg, +467%) and in coronary venous effluent (1 μmol/L, +37%; 3 μmol/L, +510%; and 10 μmol/L, +1100%) together with an unchanged basal overflow of NE. In perfused hearts, NE release evoked by nerve stimulation was inhibited by infusion of amiodarone (1 μmol/L, −16%; 3 μmol/L, −24%; and 10 μmol/L, −64%) or by intravenous amiodarone (50 mg/kg) given 1 hour before heart perfusion (−70%), and the extent of this suppression correlated well with levels of DHPG overflow present immediately before nerve stimulation. When given in vitro and in vivo, amiodarone also significantly reduced NE and increased DHPG content in the heart, leading to a raised DHPG/NE ratio. All these effects of amiodarone were similar to those found with reserpine but less potent. In contrast, oral amiodarone produced none of these effects. Conclusions Acute administration of amiodarone in perfused hearts or intact rats induces partial NE depletion in the heart by interfering with vesicular NE storage and enhancing intraneuronal NE metabolism, effects associated with an impaired NE release during sympathetic activation. Oral dosing with amiodarone has no such effect. Further study is required to test whether this novel sympatholytic effect of amiodarone contributes to its antiarrhythmic action after intravenous administration.
Stress Thallium-201/Rest Technetium-99m Sequential Dual Isotope High-Speed Myocardial Perfusion Imaging
Authors: Daniel S. Berman, Xingping Kang, Balaji Tamarappoo, Arik Wolak, Sean W. Hayes, Ryo Nakazato, Louise E.J. Thomson, Faith Kite, Ishac Cohen, Piotr J. Slomka, Andrew J. Einstein, John D. Friedman
Journal: JACC. Cardiovascular imaging (2009)
Novel drug candidates for blast phase chronic myeloid leukemia from high-throughput drug sensitivity and resistance testing
Authors: P O Pietarinen, T Pemovska, M Kontro, B Yadav, J P Mpindi, E I Andersson, M M Majumder, H Kuusanmäki, P Koskenvesa, O Kallioniemi, K Wennerberg, C A Heckman, S Mustjoki, K Porkka
Journal: Blood Cancer Journal (2015)

Abstract Chronic myeloid leukemia in blast crisis (CML BC) remains a challenging disease to treat despite the introduction and advances in tyrosine kinase inhibitor (TKI) therapy. In this study we set out to identify novel candidate drugs for CML BC by using an unbiased high-throughput drug testing platform. We used three CML cell lines representing different types of CML blast phases (K562, EM-2 and MOLM-1) and primary leukemic cells from three CML BC patients. Profiling of drug responses was performed with a drug sensitivity and resistance testing platform comprising 295 anticancer agents. Overall, drug sensitivity scores and the drug response profiles of cell line and primary cell samples correlated well and were distinct from other types of leukemia samples. The cell lines were highly sensitive to TKIs and the clinically TKI-resistant patient samples were also resistant ex vivo . Comparison of cell line and patient sample data identified new candidate drugs for CML BC, such as vascular endothelial growth factor receptor and nicotinamide phosphoribosyltransferase inhibitors. Our results indicate that these drugs in particular warrant further evaluation by analyzing a larger set of primary patient samples. The results also pave way for designing rational combination therapies.
Lesson of the week: Digital examination for oral cancer
Authors: R. Gupta, M. Perry
Journal: BMJ (1999)

All medical students are taught the importance of rectal examinations especially in patients with gastrointestinal and genitourinary symptoms. Digital palpation is an essential aspect of clinical examination as tumours are often not seen but can be felt by an examining finger.

Although inspection of the mouth can provide many clues to underlying disease this may not always be the case with local disorders.

Many cancers of the mouth, particularly in the early stages, manifest few symptoms many of which may be mistakenly attributed to benign causes. A high index of suspicion is therefore essential if malignant tumours are to be identified at a potentially curable stage. We describe three cases that emphasise the importance of performing a digital examination in all patients presenting with symptoms suggestive of oropharyngeal disease.

Case 1 —A 62 year old woman presented with a 3 week history of a “lump in [her] throat,” which she localised to the back of her tongue on the left side. No lesion was evident on inspection, especially mucosal ulceration or swelling, and the tongue moved freely. Palpation, however, indicated a large infiltrating indurated mass arising deep within the left posterolateral border …
Evaluation of Biopsy Classification for Rejection: Relation to Detection of Myocardial Damage by Monoclonal Antimyosin Antibody Imaging
Authors: Manel Ballester, Ramón Bordes, Henry D. Tazelaar, Ignasi Carrió, Jaume Marrugat, Jagat Narula, Margaret E. Billingham
Journal: Journal of the American College of Cardiology (1998)
Association of Childhood Pertussis With Receipt of 5 Doses of Pertussis Vaccine by Time Since Last Vaccine Dose, California, 2010
Authors: Lara K. Misegades, Kathleen Winter, Kathleen Harriman, John Talarico, Nancy E. Messonnier, Thomas A. Clark, Stacey W. Martin
Journal: JAMA (2012)

A POORLY controlled vaccine-preventable disease in the United States, despite a well-established childhood vaccination program and high coverage. 1Although infants have substantially higher rates of pertussis compared with other age groups, data from the National Notifiable Diseases Surveillance System reflect a recent increase in the number of reported pertussis cases among children aged 7 to 10 years.In 2010, this age group had the second highest incidence of pertussis in the United States. 2 The changing epidemiology raises important questions about possible waning protection from the childhood acellular pertussis vaccine series.After the diphtheria, tetanus, and whole-cell pertussis (DTwP) vaccine was introduced in the late 1940s, a dramatic decline occurred in the number of reported pertussis cases.However, whole-cell vaccine was commonly associated with local adverse events (eg, redness, swelling, and pain at the injection site) and less commonly with more serious adverse events. 3,4These safety concerns prompted development and licensure of diphtheria, tetanus, and acellular pertussis (DTaP) vaccines, which were recommended by the
Predicting Mortality in Cirrhosis — Serum Sodium Helps
Authors: Andrés Cárdenas, Pere Ginès
Journal: New England Journal of Medicine (2008)

Liver transplantation is widely accepted as a standard method of treatment for many patients with advanced cirrhosis, and survival rates among patients who have undergone liver transplantation approach 80% at 3 years.1 These success rates, together with a high prevalence of chronic liver diseases and a shortage of donors, have led to a steady increase in the number of patients awaiting liver transplantation. More than 16,000 patients in the United States are on the waiting list, and approximately 6000 liver transplantations are performed each year.2 With this striking imbalance, the rate of death among patients on the waiting list has . . .
Fibroma of the Labium Majus Complicating Pregnancy
Authors: W. R. Billington
Journal: BMJ (1948)

For these reasons, then, I regard all cases of phantom pain as being similar in origin and mechanism of production, whether they have burning pain or not.It is, however, possibly not altogether desirable for the word " causalgia " to be used to describe all these cases, with their varying painful sensations, or even for the term "minor causalgia " to be used for the less severe examples.As pointed out by Dr. Bowden and Dr. Napier, Weir Mitchell originally coined the word " causalgia," meaning literally " fire pain," to describe only the single symptom of burning pain; and it might still be desirable to use it only in this sense, or at least only for cases with this type of pain, without of course implying that there is any difference in pathogenesis between this " causalgic ' pain and lesser degrees of pain following nerve trauma.-Iam, etc., Belfast.
Abstract P5-20-08: Phase II trial of ixabepilone (Ixa) and dasatinib (D) for treatment of metastatic breast cancer (MBC)
Authors: LS Schwartzberg, KW Tauer, FM Schnell, R Hermann, P Rubin, D Christianson, P Weinstein, A Epperson, M Walker
Journal: Cancer Research (2012)

Abstract Background: Ixa is a novel semi-synthetic epothilone microtubule blocking agent with activity in taxane and anthracycline-resistant MBC. D is a potent small molecule tyrosine kinase inhibitor with substantial activity against SRC family non-receptor kinases, known to play multiple roles in promoting tumor growth and metastases. D inhibits cellular SRC autophosphorylation in cell lines that highly express SRC and inhibits in vivo activation in a broad array of tumors in nude mice. Ixa and D have synergistic effects in preclinical models suggesting this strategy would be of clinical benefit as combination therapy. A phase I trial of the combination determined the maximally tolerated doses of ixabepilone at 20 mg/m2 weekly and dasatinib 100 mg po daily with objective responses seen. Neutropenia was the dose limiting toxicity. Methods: Multicenter single arm phase II trial. Eligibility: Measurable or evaluable disease by RECIST 1.0, ECOG PS 0–2, HER2− or HER2 refractory, no CYP 3A4 inducers or inhibitors, no H2 blockers or PPIs, no pleural/pericardial effusion, exposure to 1 or 2 prior lines of chemotherapy in the metastatic setting, peripheral neuropathy ≤ grade 1. The primary endpoint was progression-free survival (PFS). Assessment for response was performed every 8 weeks. The treatment schedule was D at 100 mg po daily starting day 1, and Ixa 20 mg/m2 Day 1, 8, 15 every 28 days (1 cycle). Results: The study met its accrual goal with 50 patients (pts) enrolled on the phase II dosing, including six from the phase I portion. As of May 21, 2012, 47 pts are evaluable. The median age was 55 (range, 34–70), 19 African-American, 46 ECOG PS 0–1, median number of metastatic sites, three. Forty pts had prior taxanes, 24 prior anthracyclines. Median PFS was 6.0 months (95% CI, 2.9–8.0), achieving pre-specified value of interest for further study of the combination. The overall unconfirmed response rate was 14.9% with a clinical benefit rate (CR+PR + stable at 24 weeks) of 25.5%. Six pts continued D monotherapy after eight cycles of Ixa + D. All-grade adverse events (AEs) occurring in &amp;gt;15% of pts included anemia (45%), neutropenia (32%), nausea (51%), vomiting (32%) diarrhea (51%), fatigue (53%), anorexia (25%) dysgeusia (32%), headache (28%), peripheral neuropathy (34%) cough (28%) alopecia (21%) and hypokalemia (19%). Grade 3/4 adverse events occurred in 30 patients, with only four experiencing grade 4 AEs, three neutropenia and one chest pain. No grade 3/4 febrile neutropenia occurred. Grade 3 AEs of interest included two pts with peripheral neuropathy and 1 with pleural effusion. Conclusions: The combination of Ixabepilone weekly + Dasatinib orally daily is an active and well tolerated regimen in pretreated MBC with manageable toxicity. Updated results will be reported. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-20-08.
The Need for Rigorous Evidence on Medication Use in Preterm Infants
Authors: Jonathan M. Davis, Edward M. Connor, Alastair J. J. Wood
Journal: JAMA (2012)

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
The Pathology and Treatment of Suppurative Diseases of the Ear: Being an abstract of the Harveian Lectures delivered before the Harveian Society of London
Authors: G. P. Field
Journal: BMJ (1892)

rw1 iov 1329 about 3 ounces of blood-stained urine, and complained of a good deal of pain.During the night he suffered from a desire to micturate about every half hour.
Stent-Based Local Delivery of Nuclear Factor-κB Decoy Attenuates In-Stent Restenosis in Hypercholesterolemic Rabbits
Authors: Kisho Ohtani, Kensuke Egashira, Kaku Nakano, Gang Zhao, Kouta Funakoshi, Yoshiko Ihara, Satoshi Kimura, Ryuji Tominaga, Ryuichi Morishita, Kenji Sunagawa
Journal: Circulation (2006)

Nuclear factor-kappaB (NF-kappaB) plays a critical role in the vascular response to injury. However, the role of NF-kappaB in the mechanism of in-stent restenosis remains unclear. We therefore tested the hypothesis that blockade of NF-kappaB by stent-based delivery of a cis-element "decoy" of NF-kappaB reduces in-stent neointimal formation.Stents were coated with a polymer containing or not containing NF-kappaB decoy, which represented a fast-release formulation (<7 days). Bare, polymer-coated, and NF-kappaB decoy-eluting stents were implanted in iliac arteries of hypercholesterolemic rabbits. Increased NF-kappaB activity was noted at early stages after stenting, which was suppressed by stent-based delivery of NF-kappaB decoy. NF-kappaB decoy-eluting stents also reduced monocyte infiltration and monocyte chemoattractant protein-1 expression and suppressed CD14 activation on circulating leukocytes. Importantly, NF-kappaB decoy-eluting stents attenuated neointimal formation on day 28. There was no evidence of an incomplete healing process (persistent inflammation, hemorrhage, fibrin deposition, impaired endothelial regeneration) at the site of NF-kappaB decoy-eluting stents. Transfection of NF-kappaB decoy suppressed proliferation of human coronary artery smooth muscle cells in vitro. No systemic adverse effects of NF-kappaB decoy were detected.Stent-based local delivery of NF-kappaB decoy reduced in-stent neointimal formation with no evidence of incomplete healing. These data suggest that this strategy may be a practical and promising means for prevention of in-stent restenosis in humans.
Quinolones and False-Positive Urine Screening for Opiates by Immunoassay Technology
Authors: Lindsey R. Baden
Journal: JAMA (2001)

Millions of assays are performed each year to monitor for substance abuse in various settings. When common medications cross-react with frequently used testing assays, false-positive results can lead to invalid conclusions.To evaluate cross-reactivity of quinolone antimicrobials in common opiate screening assays and to assess the in vivo implications of this phenomenon.The reactivity of 13 quinolones (levofloxacin, ofloxacin, pefloxacin, enoxacin, moxifloxacin, gatifloxacin, trovafloxacin, sparfloxacin, lomefloxacin, ciprofloxacin, clinafloxacin, norfloxacin, and nalidixic acid) was tested in 5 commercial opiate screening assays from September 1998 to March 1999. In 6 healthy volunteers, we confirmed the cross-reactivity of levofloxacin or ofloxacin with these opiate screening assays.Opiate assay activity (threshold for positive result, 300 ng/mL of morphine).Nine of the quinolones caused assay results above the threshold for a positive result in at least 1 of the assays. Four of the assay systems caused false-positive results for at least 1 quinolone. Eleven of the 13 compounds caused some opiate activity by at least 1 assay system. At least 1 compound caused opiate assay activity in all 5 assay systems. Levofloxacin, oflaxacin, and perfloxacin were most likely to lead to a false-positive opiate result. Positive results were obtained in urine from all 6 volunteers.Greater attention to the cross-reactivity of quinolones with immunoassays for opiates is needed to minimize the potential for invalid test interpretation.
Stent-Supported Reconstruction of the Aortoiliac Bifurcation With the Kissing Balloon Technique
Authors: D. Scheinert, M. Schroder, J. O. Balzer, H. Steinkamp, G. Biamino
Journal: Circulation (1999)

Bilateral iliac artery obstructions involving the aortic bifurcation or high-grade stenosis of the abdominal aorta are not usually considered an indication for percutaneous treatment. The purpose of the present study was to evaluate the initial and long-term results of primary stent implantation for reconstruction of the aortic bifurcation.In 48 patients with obstructions of the aortoiliac segment, primary stent implantation was performed with the "kissing balloon technique." Preinterventional angiography showed bilateral stenoses (>85%) of the proximal common iliac arteries in 25 patients, unilateral occlusions and contralateral stenosis in 22 patients, and bilateral occlusion in 1 patient. In 7 cases, stents were placed for the treatment of high-grade infrarenal aortic stenoses. After excimer laser-assisted recanalization of the common iliac artery obstructions, the aortic bifurcation was reconstructed with the bilateral simultaneous implantation of Palmaz stents (diameter, 7 to 8 mm). Stents used for the treatment of aortic stenoses (Palmaz, n=6; Gianturco, n=1) had a diameter ranging from 20 to 25 mm. In all patients, stents were placed successfully (residual stenosis <30%) and without complications. A clinical improvement of +2 to +3 according to American Heart Association criteria was observed in 41 and 7 patients, respectively. Follow-up was performed clinically (standardized treadmill testing and color-coded Doppler ultrasound) and angiographically. The primary angiographic patency rate (24-month follow-up) was 86.8%. In 3 patients, angiography revealed significant restenoses, which were successfully treated with percutaneous transluminal angioplasty.Primary stent implantation with the kissing balloon technique is safe and effective for the treatment of aortoiliac obstructions involving the aortic bifurcation and represents a true endovascular alternative to surgery.
Vocal cord dysfunction in a child
Authors: Jc Juliá, A Martorell, Jc Cerdá, V Alvarez, Ma Armengot, R Lluch, Cf Boluda
Journal: Allergy (1999)

Vocal cord dysfunction (VCD) involves paradoxical adduction of the vocal cord during the respiratory cycle. This usually occurs during inspiration, but can also be seen in expiration. Vocal cord appositioning produces airflow obstruction sufficient to cause wheezing, shortness of breath, chest tightness, and coughing. These symptoms often imitate the respiratory alterations of asthma, thus leading to inappropriate treatment; intubation or tracheotomy may prove necessary. An 11‐year‐old girl was admitted with intractable dyspnea. She had been diagnosed with atopic asthma, although she failed to respond to an increase in antiasthma medication, including high‐dose oral steroids. Flow‐volume loops were abnormal, with evidence of variable extrathoracic airway obstruction, manifested as a flat inspiratory loop. No structural abnormalities were seen with either computed tomography (CT) or magnetic resonance imaging (MRI). Fibroscopy revealed paradoxical adduction of the vocal cords during the respiratory cycle, no obstructive disorder being observed. After the diagnosis of VCD, the clinical manifestations resolved with psychiatric treatment. Adduction was not demonstrable at repeat fibroscopy after treatment. VCD may simulate bronchial asthma; it may also be associated with that disorder, thus masking the diagnosis. It should be suspected in patients with recurrent wheezing who fail to respond to usual asthma treament. An early diagnosis avoids unnecessary aggressive management. Treatment should consist of respiratory and phonatory exercises; psychotherapy may be useful.
Papilloedema in patients taking perhexiline maleate.
Authors: W P Stephens, J D Eddy, S P Singh, L M Parsons
Journal: BMJ (1978)

that some strain differences in long-term persistence of antibody may be expected.It is possible that some of the vaccinees who apparently lose circulating antibody after vaccination may be protected against infection by low levels not detected by the test pro- cedures used.On the other hand second attacks of rubella are documented,'4 15 as is fetal damage from reinfection.'6In the United States and Great Britain peak child-bearing is at the age of 24 years, and since the duration of protection induced by vaccination is not yet assured the policy of vaccinating girls between their eleventh and fourteenth birth- days still seems to have merit in comparison with the American system of vaccinating children before school entry.
Continuity of Outpatient Care in Elderly Men-Reply
Authors: J. H. Wasson, A. E. Sauvigne, R. P. Mogielnicki, W. G. Frey
Journal: JAMA (1985)

<h3>In Reply.—</h3> We share the curiosity expressed by Drs Flynn and Kiel about how provider continuity accounts for significant differences in duration of hospitalization in our study. However, we do not share their concern that the finding was an artifact caused by some unrecognized difference in the two large groups of prospectively randomized patients that made up our study population. Table 2, which demonstrated comparability of patients prior to the analysisperiod of the study, was shortened prior to publication. An appended Table 2 is published in this letter. In a separate manuscript, currently in preparation, we demonstrate that broad descriptions that profile patient health status forecast subsequent use of service better than disease diagnoses. Table 2 demonstrated that health status measures, as well as diagnoses, were comparable in both groups prior to the analysis period of the study.