tbuckley/cabot-search huggingface dataset:
Cyclosporin A in the treatment of severe aplastic anemia: Description of a case complicated by the development of tubercular pericarditis during treatment
Authors: E. M. Pogliani, M. Cortellaro, P. Foa, A. Lurlo, E. E. Polli
Journal: American Journal of Hematology (1989)

Abstract We report on a 62 year‐old woman who developed a severe aplastic anemia requiring frequent packed red cell and platelet transfusions. Since conventional pharmacological therapy was ineffective, treatment with Cyclosporin A was started, resulting in a significant increase of leukocyte, platelet, and red cell counts. However, 5 months after the beginning of Cyclosporin A treatment, despite a past medical history not significant for clinical tuberculosis, the patient developed tubercular pericarditis. This report underlines the need for a careful follow‐up of Cyclosporin A‐treated patients aimed at a prompt diagnosis of possible infectious complications.
Relationship Between Time of Day, Day of Week, Timeliness of Reperfusion, and In-Hospital Mortality for Patients With Acute ST-Segment Elevation Myocardial Infarction
Authors: David J. Magid
Journal: JAMA (2005)

Understanding how door-to-drug and door-to-balloon times vary by time of day and day of week can inform the design of interventions to improve the timeliness of reperfusion therapy.To determine the pattern of door-to-drug and door-to-balloon times by time of day and day of week and whether this pattern may affect mortality.Cohort study of 68,439 patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolytic therapy and 33,647 treated with percutaneous coronary intervention (PCI) from 1999 through 2002. We classified patient hospital arrival period into regular hours (weekdays, 7 am-5 pm) and off-hours (weekdays 5 pm-7 am and weekends).Geometric mean door-to-drug time for fibrinolytic therapy and door-to-balloon time for PCI and all-cause in-hospital mortality. All outcomes were adjusted for patient and hospital characteristics.Most fibrinolytic therapy (67.9%) and PCI patients (54.2%) were treated during off-hours. Door-to-drug times were slightly longer during off-hours (34.3 minutes) than regular hours (33.2 minutes; difference, 1.0 minute; 95% confidence interval [CI], 0.7-1.4; P<.001). In contrast, door-to-balloon times were substantially longer during off-hours (116.1 minutes) than regular hours (94.8 minutes; difference, 21.3 minutes; 95% CI, 20.5-22.2; P<.001). A lower percentage of patients met guideline recommended times for door-to-balloon during off-hours (25.7%) than regular hours (47%; P<.001). Door-to-balloon times exceeding 120 minutes occurred much more commonly during off-hours (41.5%) than regular hours (27.7%; P<.001). Longer off-hours door-to-balloon times were primarily due to a longer interval between obtaining the electrocardiogram and patient arrival at the catheterization laboratory (off-hours, 69.8 minutes vs regular hours, 49.1 minutes; P<.001). This pattern was consistent across all hospital subgroups examined. Furthermore, patients presenting during off-hours had significantly higher adjusted in-hospital mortality than patients presenting during regular hours (odds ratio, 1.07; 95% CI, 1.01-1.14; P = .02).Presentation during off-hours was common and was associated with substantially longer times to treatment for PCI but not for fibrinolytic therapy. To achieve the best outcomes, hospitals providing PCI during off-hours should commit to doing so in a timely manner.
Acute kidney injury: summary of NICE guidance
Authors: S. Ftouh, M. Thomas
Journal: BMJ (2013)

Acute kidney injury is seen in about 15% of adults admitted to hospital in developed countries,1 with elderly people being particularly affected. The definition of acute kidney injury is based on monitoring serum creatinine levels, with or without urine output (see tables 1⇓ and 2⇓ for examples of definitions for adults and children (the "Further information" box on bmj.com discusses controversies in the definition)). In a recent large NHS audit of severe (stage 3) acute kidney injury, mortality across hospitals was consistent at about 30-40% (personal communication, James Medcalf). As acute kidney injury often occurs in people under the care of healthcare professionals other than nephrologists, awareness of the condition needs to be raised among all healthcare professionals, especially those seeing sick or older patients. It is estimated that raising awareness and delivery of optimal care could save about 12 000 lives and £150m in England each year.4 This article summarises the most recent recommendations on acute kidney injury for adults, young people, and children from the National Institute for Health and Care Excellence (NICE).5 View this table: Table 1 Initial detection and staging of acute kidney injury in adults according to Kidney Disease: Improving Global Outcomes (KDIGO) Group2 View this table: Table 2 Initial detection and staging of acute kidney injury in children according to pRIFLE (paediatric RIFLE) definition3 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Identifying acute kidney injury in adults with acute illness
External Cephalic Version With Anesthesia
Authors: John Bonnar
Journal: JAMA (1968)

From 1962 to 1966, external cephalic version, with the patient under anesthesia, was performed after 34 weeks gestation in 500 patients, and the deliveries over this period were 38,831. Successful version was achieved in approximately 50%. The perinatal mortality attributable to the procedure was 1.6%, and after correction for gross fetal abnormality, the subsequent perinatal mortality after successful version was 0.4% and after failed version 1.8%. The cesarean section rate after successful version was 12%, and that after failed version was 22%. The risk of this procedure should be compared with the overall risk of breech delivery, and the incidence of cesarean section with breech presentation. Except where breech mortality is between 1% and 2%, version with anesthesia is justifiable to reduce the incidence of the malpresentation with its attendant hazards. The procedure will also reduce the cesarean section rate.
An Overview of State Medical Discipline
Authors: Richard P. Kusserow
Journal: JAMA (1987)

The Office of Inspector General's responsibility for financially penalizing and excluding health care professionals from Medicare and Medicaid participation led to an interest in examining the state medical boards' licensure and discipline processes. This article discusses the results of the subsequent study and focuses only on medical discipline issues. We found that the rate of disciplinary actions taken by boards has been increasing. However, revocations and suspensions, the most serious category of actions, have remained relatively constant. Additionally, consumers and law enforcement agencies are the most active sources of possible violations. Individual health care professionals, hospitals, peer review organizations, and medical societies provide strikingly few reports. To rectify these problems, we encourage states to increase physician license renewal fees to fund expansion and improvement of boards' enforcement activities and to consider ways to limit the legal liability of those making goodfaith referrals. (<i>JAMA</i>1987;257:820-824)
Child resistant containers
Authors: R W Odd
Journal: BMJ (1994)

of couple therapy, whether analytically or behaviourally based, focused on the couple's inter- action and mutual projections are totally different from the psychodynamics of one to one examination of an individual's personal anxieties.Nigel Mather and colleagues' paper attempted only to assess how far achievement of this brief technique is possible by seminar training with leaders who are not psychoanalysts.3It is good to know that the multidisciplinary British Association of Sexual and Marital Therapists has now begun to offer training and is using the seminar method.I look forward to its assessment of results.
Impedance spirometry in clinical monitoring.
Authors: J V Farman, D A Juett
Journal: BMJ (1967)

There are certain places, such as the operating-theatre and the intensive therapy unit, where it is impossible to keep a finger always on a patient's pulse or a constant watch on his breathing. In these circumstances it is customary to employ various types of monitor. Ideally, by using such a machine, one should be able to tell at a glance that the patient is breathing and his heart is beating, even if he cannot be directly observed. Most of the apparatus in common use falls short of this ideal. We have therefore been examining changes in the electrical impedance across the chest as a method of monitoring patients.
Reflected pressure waves in the ascending aorta: effect of glyceryl trinitrate
Authors: D. H FITCHETT, G. J SIMKUS, J. P. BEAUDRY, D. G F MARPOLE
Journal: Cardiovascular Research (1988)

Journal Article Reflected pressure waves in the ascending aorta: effect of glyceryl trinitrate Get access DAVID H FITCHETT, DAVID H FITCHETT From the Cardiology Division, Royal Victoria Hospital, Montreal, Quebec, Canada Search for other works by this author on: Oxford Academic PubMed Google Scholar GERALD J SIMKUS, GERALD J SIMKUS From the Cardiology Division, Royal Victoria Hospital, Montreal, Quebec, Canada Search for other works by this author on: Oxford Academic PubMed Google Scholar JEAN PIERRE BEAUDRY, JEAN PIERRE BEAUDRY From the Cardiology Division, Royal Victoria Hospital, Montreal, Quebec, Canada Search for other works by this author on: Oxford Academic PubMed Google Scholar DEREK G F MARPOLE DEREK G F MARPOLE From the Cardiology Division, Royal Victoria Hospital, Montreal, Quebec, Canada Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 22, Issue 7, July 1988, Pages 494–500, https://doi.org/10.1093/cvr/22.7.494 Published: 01 July 1988 Article history Received: 30 September 1987 Accepted: 17 February 1988 Published: 01 July 1988
Aerosolized Soluble Nitric Oxide Donor Improves Oxygenation and Pulmonary Hypertension in Acute Lung Injury
Authors: BRIAN R. JACOBS, RICHARD J. BRILLI, EDGAR T. BALLARD, DANIEL J. PASSERINI, DANIEL J. SMITH
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Acute respiratory distress syndrome (ARDS) is a major cause of morbidity and mortality in critically ill patients. The associated ventilation/perfusion mismatch and pulmonary hypertension are amenable to treatment with inhaled nitric oxide (NO) gas. Compounds formed by reacting NO with various nucleophiles (NONOates) release NO spontaneously and induce vasodilation. Intratracheally administered NONOates result in selective reduction in pulmonary hypertension. We hypothesized that a nebulized NONOate would improve oxygenation and reduce pulmonary vascular resistance in oleic acid-induced acute lung injury and pulmonary hypertension. Pigs underwent catheterization of the pulmonary artery, left atrium, and right atrium, and a flow probe was positioned around the pulmonary artery. Acute lung injury and pulmonary hypertension were induced with intravenous oleic acid. Animals were randomly assigned to receive either nebulized saline or the NONOate 2-(dimethylamino)ethylputreanine/NO (DMAEP/NO). Hemodynamic, gas exchange, pulmonary function, methemoglobin, and nitrite/nitrate measurements were obtained for 60 min. Animals in the DMAEP/NO group had improvement in PaO2 as compared with control animals (from 139 +/- 19 mm Hg to 180 +/- 19 mm Hg in the DMAEP/NO group [n = 6]; and from 144 +/- 6 mm Hg to 150 +/- 9 mm Hg in the saline group [n = 6], p < 0.05). After aerosol treatment, animals in the DMAEP/NO group had a greater reduction in pulmonary vascular resistance index (PVRI) than did control animals (from 81 +/- 17 dyne. s/cm5/kg to 34 +/- 8 dyne. s/cm5/kg; and from 104 +/- 16 dyne. s/cm5/kg to 64 +/- 11 dyne. sec/cm5/ kg in the saline group at 60 min, p < 0.05). There were no differences between the groups in systemic vascular resistance index (SVRI), cardiac index (CI), methemoglobin, nitrite/nitrate, or lung pathology scores. We conclude that DMAEP/NO improves oxygenation and has selective pulmonary vasodilating properties without causing significant systemic toxicity in this porcine model of acute lung injury.
Doctor who fabricated claims she had been raped is suspended for 12 months
Authors: C. Dyer
Journal: BMJ (2013)

A junior doctor who falsely claimed to have been raped twice on hospital grounds has been suspended for 12 months by a panel of the Medical Practitioners Tribunal Service.

Hannah Farnsworth, 26, told the hearing in Manchester that she “embellished” details of two real attacks that occurred while she was a foundation year 1 doctor at Bassetlaw District General Hospital in Worksop, Nottinghamshire.

She told colleagues at the hospital that she had been tied up, beaten, and raped by two men on 1 April 2011. The attackers cut her with a …
Rho proteins play a critical role in cell migration during the early phase of mucosal restitution.
Authors: M F Santos, S A McCormack, Z Guo, J Okolicany, Y Zheng, L R Johnson, G Tigyi
Journal: Journal of Clinical Investigation (1997)

In the intestine, several growth factors stimulate migration of epithelial cells, contributing to the maintenance of tissue integrity. The Ras-like GTPase Rho regulates a signal transduction pathway linking growth factor receptors to the formation of actin stress fibers and focal adhesions, presumed to be important for motility. Using an in vitro wound-induced migration assay, we have examined the role of Rho GTPases in the migration of IEC-6 and Caco-2 cells, and provide evidence that the Rho GTPases play an essential role in the initial phase of mucosal wound healing. Treatment of the cells with Clostridium difficile toxins A and B, inhibitors of the Rho family GTPases inhibited migration in a dose-dependent fashion. Microinjection of the inhibitory exchange factor Rho-guanine nucleotide dissociation inhibitor (GDI), or Clostridium botulinum C3 ADP-ribosyl transferase (C3) toxin, a Rho-ADP-ribosylating exoenzyme, potently inhibited migration. Microinjection of RhoT19N, a dominant negative form of RhoA, or in vitro ADP-ribosylated RhoA impaired the ability of cells to migrate. Rho-GDI and C3 exoenzyme also inhibited EGF-induced migration of IEC-6 cells. These results demonstrate that Rho is required for endogenous and EGF-induced migration of small intestinal crypt cells, and that Rho proteins are essential elements of a mechanism by which growth factors induce cell migration to restitute mucosal integrity.
PODs Associated With Increased Use of Spinal Devices and Surgeries
Authors: Mike Mitka
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
Treatment of Cardiac Arrest and Slow Ventricular Rates in Complete A-V Heart Block
Authors: SAMUEL BELLET, FRED WASSERMAN, JEROME I. BRODY
Journal: Circulation (1955)

Molar and half-molar sodium lactate was efficacious (a) in restoring the heart beat following episodes of cardiac arrest, (b) ventricular standstill occurring during repeated Stokes-Adams seizures and (c) in increasing the idioventricular rate in the presence of complete A-V heart block. The increase in rate was related to the rapidity and amount of injection. These effects were associated with an increase in blood pressure and other evidences of improvement in the clinical state. No ventricular extrasystoles or other dangerous types of ectopic rhythms were observed in these subjects. The possible mechanisms by which the sodium lactate produces these effects are discussed.
Abstract 3530: Lipid accumulation inhibits DC ability for cross-presentation of antigens in tumor-bearing mice
Authors: Wei Cao, John M. Koomen, Dmitry I. Gabrilovich, Vladimir A. Tyurin, Valerian E. Kagan
Journal: Cancer Research (2012)

Abstract Professional antigen presenting cells dendritic cells (DCs) play an important role in the initiation and maintenance of immune responses. Numerous studies have demonstrated defective function of DCs in cancer. However, the mechanisms of those defects remain not clear. Previously, we have demonstrated that DCs in tumor-bearing hosts accumulate lipids via up-regulation of the expression of scavenger receptor A (CD204). This resulted in inability of DCs to effectively process exogenous antigens. In this study we found that the DCs exposed to tumor-derived factors (TDF) in vitro or isolated from tumor-bearing (TB) mice had increased uptake of soluble protein ovalbumin (OVA). No defect in the activity of lysosomal and endosomal proteases was detected. Using mass-spectrometry we determined that TDF did not affect processing of OVA by DCs. At the same time, DCs exposed to TDF or isolated from TB mice expressed lower levels of OVA-derived peptide-MHC class I (pMHC) complexes and decreased ability to stimulate OVA peptide specific CD8+ T cells (OT1). Using lipid mass-spectrometry we found substantial accumulation of oxidized lipids in DCs obtained from TB mice or generated in vitro in the presence of TDF. To mimic accumulation of oxidized lipids in vitro, we treated bone marrow derived DCs with linoleic fatty acid (LA) and oxidized agent azobis-(2,4-dimethylvaleronitrile) (AMVN). DCs easily picked LA and form lipid bodies similar to the process observed in the presence of TDF. However, accumulation of LA did not result in defective processing of OVA-derived epitope as was determined by measuring the level of pMHC on DC surface and by stimulation of OT1 cells. AMVN at selected concentration also did not affect OVA processing and presentation. In contrast, combination of LA and AMVN significantly reduced the ability of DCs to process antigens associated with OVA. No changes in the expression of MHC class I and co-stimulatory molecules were observed. These data indicate that oxidized lipids accumulated in DCs in tumor-bearing hosts prevent cross-presentation of antigens, which may have important implications for DC ability to induce tumor-specific immune responses. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3530. doi:1538-7445.AM2012-3530
Factitious HIV Infection: The Importance of Documenting Infection
Authors: Donald E. Craven
Journal: Annals of Internal Medicine (1994)

Objective: To examine possible causes for factitious human immunodeficiency virus (HIV) infection among patients in an HIV clinic. Design: Retrospective chart review, a case–control study, and a survey of local hospital practices for documenting HIV infection. Setting: Clinical acquired immunodeficiency syndrome (AIDS) program at a municipal hospital. Results: Seven patients with self-reported, undocumented HIV infection were identified as HIV seronegative after a mean of 9.2 months of care in our clinical AIDS program. The median CD4 count for these patients was 740 cells/mm3; 6 patients had a history of illicit narcotic use and clinical symptoms consistent with HIV disease. Compared with 70 randomly selected controls from HIV clinics, patients with factitious HIV infection had higher CD4 counts (difference, 519 cells/mm3; P < 0.001) and were more likely to have an HIV-infected sexual partner (odds ratio, 15.0; P = 0.005) and a history of a suicide attempt (odds ratio, 9.8; P = 0.02). Known cases of alleged HIV infection have occurred at 8 of the 10 other local hospitals surveyed. However, only 1 of the 10 hospitals routinely documented HIV infection in patients before initiating care. Conclusions: Limitations of the current serologic tests for HIV, the use of anonymous HIV testing, and recent reports of factitious HIV disease or immune deficiency syndromes that may mimic AIDS underscore the need for clear documentation of HIV infection before medical care is started.
Thromboangiitis Obliterans — An Autoimmune Disorder?
Authors: John A. Spittell
Journal: New England Journal of Medicine (1983)

Since Leo Buerger reported his classic studies in 1908,1 clinicians and investigators have been interested in thromboangiitis obliterans (Buerger's disease), which has several characteristic features. No other occlusive peripheral arterial disease has the same predisposition for young men, affects the small and medium-sized arteries of the wrist and hand with almost the same frequency as those of the leg and foot, and is accompanied so often (in about 40 per cent of cases) by superficial thrombophlebitis.Thromboangiitis obliterans is a segmental inflammatory panarteritis or panphlebitis (or both) of the small and medium-sized arteries and veins, involving chiefly vessels of the . . .
Impact of genetic variation on perioperative bleeding
Authors: Jochen D. Muehlschlegel, Simon C. Body
Journal: American Journal of Hematology (2008)

Variation in bleeding in the perioperative period is a complex and multifactorial event associated with immediate and delayed consequences for the patient and health care resources. Little is known about the complex genetic influences on perioperative bleeding. With the discovery of multiple variations in the human genome and ever-growing databases of well-phenotyped surgical patients, better identification of patients at risk of bleeding is becoming a reality. In this review, polymorphisms in the platelet receptor genes, plasminogen activator inhibitor, and angiotensin genes among others will be discussed. We will explore the nature, effects, and implications of the genetics that influence perioperative bleeding above and beyond surgical bleeding, particularly in cardiac surgery.
RESECTION AND ANASTOMOSIS OF THE DIVIDED URETER.
Authors: HOWARD A. KELLY
Journal: JAMA (1900)

Case 1.-Cancer of the cervix, involving the ureter on the right side ; vaginal operation.The anterior portion of the ureter was deliberately sacrificed with the uterus and the upper end anastomosed at once into the bladder.Recovery; anastomosis perfect, Case 2.-Ureter involved in a cancerous ovary in a woman 72 years old.Deliberate sacrifice of the ureter from the pelvic brim forward.Ureter stitched into bladder.Recovery; no leakage.Case 3.-Cancer of the cervix
A comparison of left atrial volume measured by magnetic endocardial catheter mapping versus two-dimensional transthoracic echocardiography
Authors: Vickas V. Patel, Jian-Fang Ren, Dusan Z. Kocovic, David J. Callans, Erica S. Zado, Francis E. Marchlinski
Journal: Journal of the American College of Cardiology (2002)