tbuckley/cabot-search huggingface dataset:
Decontamination of the Digestive Tract and Oropharynx in ICU Patients
Authors: A.M.G.A. de Smet, J.A.J.W. Kluytmans, B.S. Cooper, E.M. Mascini, R.F.J. Benus, T.S. van der Werf, J.G. van der Hoeven, P. Pickkers, D. Bogaers-Hofman, N.J.M. van der Meer, A.T. Bernards, E.J. Kuijper, J.C.A. Joore, M.A. Leverstein-van Hall, A.J.G.H. Bindels, A.R. Jansz, R.M.J. Wesselink, B.M. de Jongh, P.J.W. Dennesen, G.J. van Asselt, L.F. te Velde, I.H.M.E. Frenay, K. Kaasjager, F.H. Bosch, M. van Iterson, S.F.T. Thijsen, G.H. Kluge, W. Pauw, J.W. de Vries, J.A. Kaan, J.P. Arends, L.P.H.J. Aarts, P.D.J. Sturm, H.I.J. Harinck, A. Voss, E.V. Uijtendaal, H.E.M. Blok, E.S. Thieme Groen, M.E. Pouw, C.J. Kalkman, M.J.M. Bonten
Journal: New England Journal of Medicine (2008)

Selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) are infection-prevention measures used in the treatment of some patients in intensive care, but reported effects on patient outcome are conflicting.
Sutureless Anastomoses: Secrets for Success
Authors: Richard M. Stillman
Journal: JAMA (2007)

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
Regulation of insulin-like growth factor I gene expression in the human macrophage-like cell line U937.
Authors: I Nagaoka, B C Trapnell, R G Crystal
Journal: Journal of Clinical Investigation (1990)

Activated macrophages release tissue forms of insulin-like growth factor I (IGF-I), 20-25-kD products of the IGF-I gene, thus providing an extracellular growth and differentiation signal at sites of inflammation. To examine the control of IGF-I gene expression in mononuclear phagocytes, the human macrophage-like cell line U937 was evaluated at rest and after surface activation with phorbol myristate acetate (PMA) or Ca2+ ionophore. Northern analysis and RNAse protection analysis with 32P-labeled IGF-I-specific probes demonstrated that the IGF-I mRNA transcripts of resting U937 cells were similar in size and amount to those of resting human alveolar macrophages, mononuclear phagocytes known to express the IGF-I gene. Nuclear run-off assays demonstrated that surface activation of U937 cells increased the transcription rate of the IGF-I gene four- to fivefold, a process that was inhibited by cycloheximide, suggesting that active protein synthesis was involved in the activation pathway. Despite this, cytoplasmic IGF-I mRNA levels after surface activation declined markedly, a process blocked by a protein kinase C inhibitor (for PMA activation) or a calmodulin antagonist (for Ca2+ ionophore activation). Like the increased transcription of the IGF-I gene, modulation of IGF-I mRNA transcript levels required active protein synthesis; in the presence of cycloheximide constitutive IGF-I mRNA levels increased and surface activation no longer caused a decrease in transcript number. Interestingly, surface activation caused a rapid release of IGF-I, even in the presence of a protein synthesis inhibitor, suggesting that mononuclear phagocytes have a preformed, stored, releasable pool of IGF-I. Together these observations demonstrate that IGF-I gene expression is complex and probably involves control of transcription rate, cytoplasmic mRNA levels possibly mediated through protein kinase C, calcium influx and calmodulin, and finally, release of preformed IGF-I from a storage pool.
Diagnosis of Pulmonary Embolism. A Correlative Study of the Clinical, Scan, and Angiographic Findings
Authors: K. P. Poulose, R. C. Reba, D. L. Gilday, F. H. Deland, H. N. Wagner
Journal: BMJ (1970)

Seventy-one patients with suspected pulmonary embolism had both pulmonary scans and angiograms. Clinically it was impossible to predict the absence or presence of subsequent angiographic evidence of pulmonary embolism in the individual patient. In 24 patients the scans showed defects that were believed to indicate a high probability of pulmonary embolism—namely, perfusion defects that corresponded to specific anatomical segments of the lung together with normal chest radiographs or radiographs suggestive of pulmonary embolism. Specific angiographic evidence of pulmonary embolism was found in 18 (75%) of these patients. Diffuse, patchy, and non-segmental perfusion defects were seen in 28 patients. Only seven (25%) of this group had angiographic abnormalities specific for embolism. In 12 patients with normal lung scans none showed subsequent evidence of embolism by angiography. It is concluded firstly that lung scanning is a sensitive screening procedure for pulmonary embolism and, secondly, that segmental perfusion defects are highly suggestive of pulmonary embolism.
Herpes Simplex Virus Resistant to Acyclovir
Authors: Janet A. Englund
Journal: Annals of Internal Medicine (1990)

Study Objective: To determine the sensitivity of herpes simplex virus isolates to acyclovir and the importance of resistant isolates in hospitalized patients. Design: Retrospective incidence cohort study. Setting: All herpes simplex virus isolates cultured over 1 year from patients followed at a tertiary care center. Patients: Consecutive herpes simplex virus isolates were collected from 207 patients, including immunocompetent patients, patients with malignancy, neonates, bone marrow and organ transplant recipients, and patients seropositive for human immunodeficiency virus. Measurements and Main Results: A rapid nucleic acid hybridization method was used to assess susceptibility to acyclovir. Acyclovir-resistant herpes simplex viruses were recovered from 7 of 148 immunocompromised patients (4.7%) but from none of 59 immunocompetent hosts. Clinical disease was found in all 7 patients with resistant herpes simplex virus and was more severe in pediatric patients. All resistant isolates were from acyclovir-treated patients and had absent or altered thymidine kinase activity by plaque autoradiography. Conclusion: Herpes simplex virus resistant to acyclovir arises relatively frequently in immunocompromised patients and may cause serious disease. Rapid detection of resistance permits antiviral therapy to be individualized. Antiviral susceptibility testing to monitor viral resistance should be encouraged, especially in tertiary care settings.
The Natural History of Quackery.
Authors: Lester S. King
Journal: JAMA (1963)

A whole book devoted to quacks and quackery has a great opportunity to deal with social history, to furnish insight into contemporary cultures, to provide a background into which so-called quacks can fit—in other words, to make a genuine historical contribution. On the other hand, there is the much easier approach of recounting a few facts, pointing to absurdities, talking down in condescending fashion without presenting any real picture of the times or any sense of historical development. Unfortunately, Eric Jameson chose the latter way. He has produced a book which in places will entertain, but whose<i>raison d'être</i>is not entirely clear. The author displays only a shallow knowledge of medicine as a discipline, and no sense of medicine as a developing science. Jumping back and forth in time, the book presents the stories of numerous individuals who could properly be called quacks, and remedies of clearly fraudulent nature.
Amyotrophy Due to Hypoglycaemia
Authors: C. J. Williams
Journal: BMJ (1955)

A relatively high number of this resistant group had radiation of pain initially, and this may be an important symptom in predicting response to treatment in either group. ConclusionIn the patient with acute low back pain in whom the probable lesiol is derangement of an intervertebral joint, including minor protrusion of a disk, and in whom irritation or pressure on adjacent structures occurs, then treatment by manipulation, without anaesthesia, seems a logical method of gaining relief from signs and symptoms. SummaryA group of 152 patients suffering from acute low back pain were selected at random and treated either by manipulation or by bed rest and analgesics.Full clinical and radiological examination was carried out in every case, and progress, whether improvement or deterioration, was noted at weekly intervals.Of the patients manipulated, 50% were symptom-free and discharged within one week and 87% were dis- charged within three weeks.Of the patients treated by rest in bed and analgesics, 27 % were symptom-free and discharged within one week and 60% within three weeks.After six weeks, 12% of the patients treated by mani- pulation, and 28% of the patients treated by rest in bed and analgesics still suffered pain and disability.
A unique receptor-independent mechanism by which insulinlike growth factor I regulates the availability of insulinlike growth factor binding proteins in normal and transformed human fibroblasts.
Authors: C A Conover
Journal: Journal of Clinical Investigation (1991)

Insulin-like growth factor I and II (IGF-I and IGF-II) associate with specific IGF binding proteins (IGFBPs) present in plasma and extracellular fluids that can modulate the anabolic effects of these peptides. IGF-I has been shown to increase IGFBP concentrations in vivo and in vitro, but the mechanism and significance of this action are unknown. We examined these issues using normal and simian virus 40-transformed adult human fibroblasts (SV40-HF) in culture. Treatment with IGF-I markedly stimulated the appearance of IGFBP-3 (42/38 kD doublet), a 36 kD IGFBP, and 28-32 kD IGFBPs in the medium of these cells, as assessed by Western ligand blotting; IGF-I decreased levels of 24 kD IGFBP in normal HF cultures. The IGF-I-induced change in IGFBP levels was not a type I IGF receptor-mediated effect on IGFBP synthesis because (a) high concentrations of insulin did not mimic IGF-I's effect; (b) IGF-II and IGF-I analogues having reduced affinity for the IGF-I receptor were equipotent with IGF-I in increasing medium IGFBPs; (c) [QAYL]IGF-I, and IGF-I analogue having normal receptor affinity and decreased affinity for IGFBPs, had no effect; and (d) alpha IR-3, a monoclonal antibody specific for the type I IGF receptor, did not block IGF-I-stimulated increases in IGFBPs. In physiological studies, preincubation with 1 nM IGF-I had no effect on type I IGF receptor binding in normal HF and SV40-HF. In contrast, preincubation of cells with an equivalent concentration of [QAYL]IGF-I downregulated the receptors 40-50%. Changes in cell surface receptor number were reflected in cell responsiveness to IGF-I-stimulated [3H]thymidine incorporation and [3H]aminoisobutyric acid uptake. In conclusion, IGF-I regulates the availability of specific IGFBPs in cultured human fibroblasts by a novel receptor-independent mechanism. Rapid changes in levels of soluble IGFBPs as a direct response to extracellular IGF-I, in turn, modulate IGF-I peptide and receptor interaction, and may constitute an important level of control in IGF cellular physiology.
The Ha Ha
Authors: K. Robertson
Journal: BMJ (2012)

The Ha Ha captures both the joy and horror of psychosis. It has previously been held up as an indictment of the treatments and morality of psychiatry of the time and admittedly it is sometimes dated, with the references to the “new mental health act” of 1959, the narrator held in hospital under “certificate,” and patients (“schizies” one patient calls them) treated with insulin, with ECT, and with lobotomies. 

But this book’s depiction of the lonely estrangement of severe mental illness has rarely been bettered. The strange and shocking treatments are not heartless, and are documented without conspicuous outrage. The staff are all quite human, and there is no sense that treatments …
Clinical responsibility: II. Where does the patient stand? When did you last see your psychiatrist?
Authors: A W Clare
Journal: BMJ (1977)

I published a book recently which, among other things, expressed several mild criticisms of psychiatric practice.Subsequently, I received a positive barrage of unsolicited support from all sorts of disgruntled and dissatisfied customers of the finest Health Service in the world.Leaving aside those authors who wondered why the NHS failed to provide acupuncture or courses in Zen Buddhism for recurrent reactive depression, most of the rest were preoccupied with the apparent difficulty encountered by many patients in actually seeing let alone talking to their doctors.
Rectal prolapse after anorectal dilatation in the elderly.
Authors: T Bates
Journal: BMJ (1972)

was a wrapping of cotton-wool 4 in (0-6 cm) thick.A small temperature rise was noted in the first minute, but from the fifth to the eighth minute the rise was rapid-a maximum temperature of 84'C was reached 10 minutes after starting the test. (2)The heat generation test was repeated with Chlorhexidine (Hibitane) in spirit.No temperature rise resulted. Conclusion and RecommendationIt is believed that the lesion suffered by the patient was a bum produced by heat generated by the action of thiomersal on
Building towards a consensus for the use of tumour necrosis factor blocking agents
Authors: D E FURST, F C BREEDVELD, J R KALDEN, J S SMOLEN
Journal: Annals of the Rheumatic Diseases (1999)

Over the past 10 to 15 years, scientific advances have ushered in a new era in the treatment of rheumatoid arthritis. The aetiopathogenesis of rheumatoid arthritis is slowly being dissected and an increased understanding of the mechanisms by which tissue damage occurs in this disease is appearing.1 2 This knowledge, combined with the use of molecular technology, have begun to allow medical research to pinpoint potential targets for treatment of rheumatoid arthritis. Among such targets, you could include T cells, macrophages, synoviocytes, the interaction between antigen presenting cells and T cells, the MHC and its sub-units, and numerous cytokines (for example, IL1, IL1ra, IL10, IL12, TNFα, etc).

This knowledge and technology have introduced a number of potential new therapeutic agents. Earlier efforts using IL2 fusion proteins were unfortunately unsuccessful.3 Various anti-CD4 monoclonal antibodies have been tried to treat rheumatoid arthritis and some may still be in development.4 Likewise, early trials of IL4, IL6, IL10 and IL11 are all underway.5 

TNFα plays a very significant part in inflammation as it promotes IL1 production and augments GM-CSF, IL6 and IL8. Furthermore, it promotes the expression of adhesion molecules, which facilitate leucocyte traffic to sites of inflammation.6 Increased levels of TNFα were found in rheumatoid arthritis and this finding was followed by early experiments showing that anti-TNFα antibodies were effective in both in vitro and in animal models of rheumatoid arthritis.5-10 Later, chimeric monoclonal antibodies, recombinant TNF receptor fusion proteins and …
The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia
Authors: Silvana Galderisi, Alessandro Rossi, Paola Rocca, Alessandro Bertolino, Armida Mucci, Paola Bucci, Paola Rucci, Dino Gibertoni, Eugenio Aguglia, Mario Amore, Antonello Bellomo, Massimo Biondi, Roberto Brugnoli, Liliana Dell'Osso, Diana De Ronchi, Gabriella Di Emidio, Massimo Di Giannantonio, Andrea Fagiolini, Carlo Marchesi, Palmiero Monteleone, Lucio Oldani, Federica Pinna, Rita Roncone, Emilio Sacchetti, Paolo Santonastaso, Alberto Siracusano, Antonio Vita, Patrizia Zeppegno, Mario Maj
Journal: World Psychiatry (2014)

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia.
Radioimmunoassay follow-up of hydatidiform mole.
Authors: K D Bagshawe
Journal: BMJ (1973)

jouRNAL 28 APR1 1973 241 was based on a significant rise in the titres of complement-fixation and metabolism- inhibiting antibodies to the organism.Cold agglutinins were present in all cases.In two of them agglutination also occurred in blood samples kept at room temperature.All the patients had high serum levels of IgM (330-500 mg/ 100 ml), while the concentra- tions of IgG and IgA were normal.Such a selective increase in IgM is known to occur in infections caused by mycoplasmas.34All the patients had raised serum and urine concentrations of amylase.Analysis of isoenzymes of amylase in serum suggested that the increase in this enzyme in the serum originated from the pancreas.None of the patients had a history of gall stone disease and none took alcohol.No virus was isolated from throat washings and faeces and serological tests for coxsackie B, cytomegalo, and mumps virus were also negative.Three of the four patients had a severely depressed respiratory exchange and two of them had to be treated with a respirator.One patient had E.C.G. changes of the type seen in pericarditis.One of them developed a hyperosmnolar diabetic coma one week before she died.She had a high titre of cold agglutinins and multiple thromboses were found at necropsy.The three patients who survived had an increased concentration of serum amylase for several weeks after the clinical symptoms of pancreatitis had dis- appeared.Two of them had a transient rise in the blood glucose level.A relationship between infectious pan- creatitis, such as in mumps5 and coxsackie B infections,68 and diabetes mellitus has been suggested.In this respect pancreatitis in M. pneumoniae infections requires further in- vestigation.-Weare, etc.,
The "Primary Physician"
Authors: Samuel E. Paul
Journal: JAMA (1967)

To the Editor:—  My sympathy goes out to the Ad Hoc Committee ( 197 : 985, 1966) trying to solve the lowly everyday common problems of family practice (which a real general practitioner does routinely) from their disadvantage point of the medical center.  Dr. R. N. Braun of Austria calls it  Cases Distribution Law of Nature. I call it  Pattern of General Practice. 1-3   My figure of 96% of my practice handled without hospital admissions (and 98% without consultation) checked against local and national figures for morbidity and mortality and was found to be representative. The report of White et al 4 is in rather close agreement with my figures.  Thus, the subject matter content is known. The function of the family practitioner is inextricably related to this content in spite of the italicized statement of the Ad Hoc Committee which puts things in reverse when it characterizes family practice
Opposing Effects of Particle Pollution, Ozone, and Ambient Temperature on Arterial Blood Pressure
Authors: Barbara Hoffmann, Heike Luttmann-Gibson, Allison Cohen, Antonella Zanobetti, Celine de Souza, Christopher Foley, Helen H. Suh, Brent A. Coull, Joel Schwartz, Murray Mittleman, Peter Stone, Edward Horton, Diane R. Gold
Journal: Environmental Health Perspectives (2011)

Diabetes increases the risk of hypertension and orthostatic hypotension and raises the risk of cardiovascular death during heat waves and high pollution episodes.We examined whether short-term exposures to air pollution (fine particles, ozone) and heat resulted in perturbation of arterial blood pressure (BP) in persons with type 2 diabetes mellitus (T2DM).We conducted a panel study in 70 subjects with T2DM, measuring BP by automated oscillometric sphygmomanometer and pulse wave analysis every 2 weeks on up to five occasions (355 repeated measures). Hourly central site measurements of fine particles, ozone, and meteorology were conducted. We applied linear mixed models with random participant intercepts to investigate the association of fine particles, ozone, and ambient temperature with systolic, diastolic, and mean arterial BP in a multipollutant model, controlling for season, meteorological variables, and subject characteristics.An interquartile increase in ambient fine particle mass [particulate matter (PM) with an aerodynamic diameter of ≤ 2.5 μm (PM2.5)] and in the traffic component black carbon in the previous 5 days (3.54 and 0.25 μg/m3, respectively) predicted increases of 1.4 mmHg [95% confidence interval (CI): 0.0, 2.9 mmHg] and 2.2 mmHg (95% CI: 0.4, 4.0 mmHg) in systolic BP (SBP) at the population geometric mean, respectively. In contrast, an interquartile increase in the 5-day mean of ozone (13.3 ppb) was associated with a 5.2 mmHg (95% CI: -8.6, -1.8 mmHg) decrease in SBP. Higher temperatures were associated with a marginal decrease in BP.In subjects with T2DM, PM was associated with increased BP, and ozone was associated with decreased BP. These effects may be clinically important in patients with already compromised autoregulatory function.