tbuckley/cabot-search huggingface dataset:
Potts Shunt in Patients with Pulmonary Hypertension
Authors: Julie Blanc, Pascal Vouhé, Damien Bonnet
Journal: New England Journal of Medicine (2004)

Potts Shunt in Patients with Pulmonary Hypertensionto the editor: Pulmonary hypertension is a rare complication of transposition of the great arteries. 1 As in other forms of primary pulmonary hypertension, the prognosis is poor, particularly in children who have symptoms. 2Converting normal cardiac physiological features to features typical of Eisenmenger's syndrome by means of blade atrial septostomy has already been proposed for patients with this condition. 3But patients with severe right heart failure and markedly elevated pulmonary vascular resistance do not tolerate atrial septostomy, because massive right-to-left shunting may result in insufficient pulmonary blood flow and severe hypoxemia.Therefore, in the cases of two boys who had suprasystemic pulmonary hypertension and right ventricular failure 4 years and 14 years after an arterial switch performed for transposition of the great arteries, we decided to create an anastomosis between the descending aorta and the left pulmonary artery (Potts shunt) (Fig. 1).The ratio of pulmonary blood flow to systemic blood flow was 1, as there was no intracardiac shunt in either boy.The aim of this intervention was to decrease right ventricular afterload so as to improve right ventricular function and potentially prevent syncope and sudden death.The procedures were uneventful.The patients' condition improved rapidly, and both are now in New York Heart Association functional class II.Right ventricular function was restored.Right-to-left shunting through the Potts shunt was responsible for cyanosis of the lower limbs, and consequently, polycythemia developed in both patients (the hematocrit values were 51 percent and 55 percent at the last follow-up).The patients did not have any further episodes of syncope after a follow-up of 18 and 6 months, respectively.Hemodynamic evaluation confirmed that the pulmonaryartery pressure and aortic pressure were equal.Leftheart output was preserved.The advantages of the Potts procedure are the immediate decrease in the right ventricular afterload and the absence of cyanosis of the upper part of the body in the absence of intracardiac shunting.The chief concern remains the operative risk in patients with pulmonary hypertension.Without treatment, the mean survival of children is less than one year after diagnosis. 2For adults with pulmonary hypertension who are treated with prostacyclin analogues, the survival rate is estimated to be about 55 percent at five years, 4 but comparable studies in
ETIOLOGY OF THROMBO-ANGIITIS OBLITERANS (BUERGER)
Authors: WILLY MEYER
Journal: JAMA (1918)

On the basis of extensive clinical observation and a variety of laboratory examinations of patients suffering from the so-called thrombo-angiitis obliterans (Buerger), some points that may prove of interest are presented herein as tentative conclusions. They may have to be revised from time to time as our knowledge of the disease deepens. Chemical analysis of the blood of these patients has shown that: There is no retention of waste nitrogenous constituents. There is no marked decrease in the alkaline reserve of the blood, as demonstrated by the carbon dioxid combining power of the blood plasma (method of Van Slyke). In all the cases thus far studied, the ingestion of 100 gm. of glucose, after a brief fasting period, has produced hyperglycemia. This observation shifts the whole question of the etiology of the disease to new ground, and the old designations appear no longer appropriate. For the present I would propose
HIV and Youth
Authors: Joan Stephenson
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
Depression and Survival Following Myocardial Infarction-Reply
Authors: Nancy Frasure-Smith
Journal: JAMA (1994)

<h3>In Reply.</h3> —We acknowledge that an error was made in calculating CIs for our article. (A Correction with corrected tables appears at the end of the Letters section.) This correction does not change the HRs originally reported. The data still support the conclusion that major depression in hospitalized patients following MI is associated with a significant increase in risk of mortality. In reply to Drs Wei and Hornung and Dr Thompson, as discussed in the original article, with a modest sample size such as ours, the number of variables that can be controlled for is limited. We believe that with our sample the best approach is adjustment for those variables that are at the same time imbalanced between the depressed and nondepressed groups and predictive of outcome,<sup>1</sup>ie, the prescription of warfarin sodium. Control for warfarin resulted in an adjusted HR ratio of 4.81 (95% CI, 1.49 to 15.53;
OPHTHALMIA MYIASIS EXTERNA, DUE TO LARVAE OF OESTRUS OVIS
Authors: H. H. STARK
Journal: JAMA (1923)

During the day's work of ophthalmology, one becomes so accustomed to common diseases of the eye that diagnosis of any of the usual cases is a simple procedure and it is only the rare cases that are difficult. Therefore, anything adding to our knowledge of rare cases should be of value, especially when it widens the geographic field in which they are found. I would hesitate to report a single case did it not seem to have an exclusive place in American literature, evidenced by the fact that I have found none like it so far recorded. <h3>REPORT OF CASE</h3> F. D., a girl, aged 16, reported to her local physician, L. H. Dunham of Las Cruces, N. M., in July, 1921, that for two days she had had a burning itching of the right eye and lid, with something passing in front of her sight, and that several small
Assessment of Heart Rate Turbulence and T Wave Alternans in Ventricular Hypertrabeculation/Noncompaction Patients by Using 24-hour ECG Ambulatory Holter Electrocardiogram
Authors: Hatice Betül Erer, Nurten Sayar, Elif İclal Çekirdekçi, Tolga Sinan Güvenç, Servet Altay, Nazmiye Özbilgin, Dilaver Öz, Ahmet Ekmekçi, Aycan Zencirci, Gönül Zeren, Mehmet Eren
Journal: Journal of the American College of Cardiology (2013)
Risk factors and angiographic coronary artery disease: a report from the coronary artery surgery study (CASS).
Authors: R E Vlietstra, R L Frye, R A Kronmal, D A Sim, F E Tristani, T Killip
Journal: Circulation (1980)

The findings for 14 risk variables were correlated with the results of coronary arteriography in 8807 patients registered in the interinstitutional Coronary Artery Surgery Study (CASS). Discriminant-function analysis revealed that age, sex, cigarette smoking and the level of blood cholesterol best distinguished between the groups with (6688 patients) and without (2119 patients) coronary artery disease. A family history of coronary artery disease and the presence of hypertension or diabetes were of addition, but less, discriminating value. The relative risk for coronary artery disease in patients with the combination of cigarette smoking and an elevated cholesterol level was high (> 4) in females age 55 years or younger and in males age 35 years or younger. Few females age 45 years or younger (seven of 97) had coronary artery disease when both of these risk factors were absent. In spite of these correlations, only limited gains accrued from the use of discriminant-function analysis in correctly allocating patients into disease and nondisease groups. This indicates that, while certain factors are significantly correlated with coronary arteriographic findings, their value for predicting the presence of coronary artery disease is limited.
Accidental Drowning of Toddlers in Buckets
Authors: Robin A. Helmuth
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The recent Brief Report by Jumbelic and Chambliss<sup>1</sup>provided some alarming statistics concerning drowning deaths in toddlers. However, my attention was caught by the photograph in Fig 2, labeled "Infant with head down in an empty 5-gallon plastic industrial bucket." I could not help but notice the presence of livor mortis on the midback and the legs as well as the prominent blanching of the presacral area, buttocks, and both heels. Livor mortis is "the reddish-purple discoloration found in dependent areas of the body due to accumulation of blood in the small vessels of the dependent areas secondary to gravity."<sup>2</sup>Blanching is due to external pressure on dependent areas during this process. The external pressure compresses the soft tissue, which prevents the accumulation of blood, thus producing the pale or blanched areas. With these facts in mind, one could postulate at least two different scenarios.
Codeine and Propoxyphene in Postepisiotomy Pain
Authors: Charles M. Gruber
Journal: JAMA (1977)

In a double-blind control study, oral doses of placebo, propoxyphene napsylate (50 or 100 mg), or codeine sulfate (30 or 60 mg) were administered to 46 postepisiotomy patients, grouped by severity of pain reported at first-dose drug administration. Eight hourly observations by a trained observer provided estimates of analgesia. The analgesia scores for placebo treatments were significantly lower than for the lesser doses of either drug (<i>P</i>&lt;.05) as well as for the greater doses (<i>P</i>&lt;.01). At both dose levels, the analgesia scores for both drugs were almost identical. Analgesia with the higher doses was greater than with the lower, but not to a statistically significant extent. The difference in patient responses increased following the second dose. No serious adverse reactions occurred; the elicited and volunteered reports of minor side effects were similar for all five treatments. (<i>JAMA</i>237:2734-2735, 1977)
Illinois State Board of Health vs. Northwestern University Woman's Medical Society.
Authors: I. N. Danforth
Journal: JAMA (1895)

<h3>To the Editor:</h3> —In the July issue of various prominent medical journals appeared a letter from the Illinois State Board of Health accompanied by a set of resolutions adopted by said Board. The undersigned, the Executive Committee of the Faculty of the Northwestern University Woman's Medical School, having carefully investigated this matter desire to make the following report, in order that no injustice may be done to the State Board. The resolutions adopted by the State Board are as follows: Whereas, The Faculty of the Northwestern University Woman's Medical School adopted a set of resolutions, criticising the Illinois State Board of Health for having issued to three non-graduate students of said college the State certificate entitling them to practice medicine, whom they claim were not entitled to receive them, and charging the Board with having adopted a lax policy in numerous other instances, thereby seriously detracting from the usefulness of
Extravasation of Epirubicin
Authors: Sergio Vano-Galvan, Pedro Jaen
Journal: New England Journal of Medicine (2009)

A 63-year-old woman with a diagnosis of infiltrative ductal carcinoma of the breast (stage T2N1M0[IIB], according to the tumor–node–metastasis staging system) that was estrogen receptor–negative and HER2-negative was referred for adjuvant chemotherapy after undergoing modified radical mastectomy and axillary lymph-node dissection. Epirubicin, at a dose of 90 mg per square meter of body-surface area, was infused at 21-day intervals, along with fluorouracil and cyclophosphamide. During the third period of administration, the patient reported having excruciating pain in the left wrist, near the intravenous-catheter site (arrow). The infusion was stopped, and a diagnosis of extravasation of epirubicin was made. Physical examination . . .
Hepatic immunohistochemical staining with a monoclonal antibody against HCV-E2 to evaluate antiviral therapy and reinfection of liver grafts in hepatitis C viral infection
Authors: Chris Verslype, Frederik Nevens, Nicoletta Sinelli, Carine Clarysse, Jacques Pirenne, Eric Depla, Geert Maertens, Jos van Pelt, Valeer Desmet, Johan Fevery, Tania Roskams
Journal: Journal of Hepatology (2003)
Analysis of health effects resulting from population exposures to acid precipitation precursors.
Authors: H Ozkaynak, J D Spengler
Journal: Environmental Health Perspectives (1985)

Types of available studies relevant to the quantification of air pollution health effects and their principal limitations are discussed. Assessments are provided based on review and re-analysis of previously reported data bases, synthesis of published findings, and original analysis of health data sets using new methods or recent size-specific particle mass measurements. Interim results from ongoing research activities on airborne particle health effects are presented. It is shown that preliminary results obtained from cross-sectional and time-series mortality studies appear to be consistent, indicating that particulate air pollution, even at current levels, could be of concern for public health. Throughout the paper, methodological deficiencies and remaining gaps in knowledge are identified. In particular, uncertainties associated with the reported exposure-response coefficients are assessed. Finally, by characterizing the limitations of analysis we propose various recommendations for future studies and research that will serve to further define the nature, magnitude, and uncertainties of air pollution health risks.
Hemodialysis increases apparent diffusion coefficient of brain water in nephrectomized rats measured by isotropic diffusion-weighted magnetic resonance imaging.
Authors: J P Galons, T Trouard, A F Gmitro, Y H Lien
Journal: Journal of Clinical Investigation (1996)

The nature of brain edema in dialysis disequilibrium syndrome (DDS) was investigated by diffusion-weighted magnetic resonance imaging (DWI). DWI was performed on normal or bilaterally nephrectomized rats before, and immediately after, hemodialysis. Hemodialysis was performed with a custom-made dialyzer (surface area 150 cm2) against a bicarbonate-buffered bath for 90 min with or without 70 mM urea. Hemodialysis with non-urea bath decreased plasma urea by 21 mM, and plasma osmolality by 22 mosmol/kg H2O, and increased brain water content by 8.0% (all < 0.05), while hemodialysis with urea bath did not affect plasma urea, osmolality, or brain water content. Three sets of axial DWI images of the brain were obtained at different gradient weighing factors with an in-plane resolution of 0.39 mm2. The apparent diffusion coefficient (Dapp) of the brain water was not affected by bilateral nephrectomy, or by hemodialysis in normal rats. In nephrectomized rats, brain Dapp was significantly increased after dialysis with non-urea bath (1.15 +/- 0.08 vs 0.89 +/- 0.07 x 10(-9)m2/sec, P < 0.01). No significant changes of brain water Dapp could be observed after dialysis with urea bath. The increased Dapp associated with DDS indicates that brain extracellular water increases and/or intracellular water decreases after hemodialysis. Our results strongly suggest that the brain edema induced by hemodialysis in uremic rats is due to interstitial edema rather than cytotoxic edema. Furthermore, our results support a primary role for the "reverse urea effect" in the pathogenesis of brain edema in DDS.DWI may be a useful diagnostic tool for DDS in patients with end-stage renal disease.
Massive Jejunal Diverticulosis with Steatorrhoea and Megaloblastic Anaemia Improved by Excision of Diverticula
Authors: G. Watkinson, D. B. Feather, F. G. W. Marson, J. A. Dossett
Journal: BMJ (1959)

tis 58 Medical loumnal angina; but triac may be the best thyroid hormone for treating subjects with myxoedema coma who do not give a history of angina An E.C.G. may be taken eight hours after a dose ot trial to confirm the diagnosis of hypothyroidism in young subjectsWe have pleasure in acknowledging the considerable help of the sister and staff of the metabolic ward.Our thanks are due also to our colleagues who referred patients; to Miss M. Matthew, who performed some of the cholesterol determinations; and to the hospital technicians who made many of the B.M.
Effect of a Garlic Oil Preparation on Serum Lipoproteins and Cholesterol Metabolism
Authors: Heiner K. Berthold, Thomas Sudhop, Klaus von Bergmann
Journal: JAMA (1998)

Context.—Garlic-containing drugs have been used in the treatment of hypercholesterolemia even though their efficacy is not generally established. Little is known about the mechanisms of action of the possible effects on cholesterol in humans.Objective.—To estimate the hypocholesterolemic effect of garlic oil and to investigate the possible mechanism of action.Design.—Double-blind, randomized, placebo-controlled trial.Setting.—Outpatient lipid clinic.Patients.—We investigated 25 patients (mean age, 58 years) with moderate hypercholesterolemia.Intervention.—Steam-distilled garlic oil preparation (5 mg twice a day) vs placebo each for 12 weeks with wash-out periods of 4 weeks.Main Outcome Measures.—Serum lipoprotein concentrations, cholesterol absorption, and cholesterol synthesis.Results.—Baseline lipoprotein profiles were (mean [SD]): total cholesterol, 7.53 (0.75) mmol/L (291 [29] mg/dL); low-density lipoprotein cholesterol (LDL-C), 5.35 (0.78) mmol/L (207 [30] mg/dL); high-density lipoprotein cholesterol (HDL-C), 1.50 (0.41) mmol/L (58 [16] mg/dL); and triglycerides, 1.45 (0.73) mmol/L (127 [64] mg/dL). Lipoprotein levels were virtually unchanged at the end of both treatment periods (mean difference [95% confidence interval]): total cholesterol, 0.085 (−0.201 to 0.372) mmol/L (3.3 [−7.8 to 14.4] mg/dL), P=.54; LDL-C, 0.001 (−0.242 to 0.245) mmol/L (0.04 [−9.4 to 9.5] mg/dL), P=.99; HDL-C, 0.050 (−0.028 to 0.128) mmol/L (1.9 [−1.1 to 4.9] mg/dL), P=.20; triclycerides, 0.047 (−0.229 to 0.135) mmol/L (4.2 [−20.3 to 12.0]) mg/dL, P=.60. Cholesterol absorption (37.5% [10.5%] vs 38.3% [10.7%], P=.58), cholesterol synthesis (12.7 [6.5] vs 13.4 [6.6] mg/kg of body weight per day, P=.64), mevalonic acid excretion (192 [66] vs 187 [66] µg/d, P=.78), and changes in the ratio of lathosterol to cholesterol in serum (4.4% [24.3%] vs 10.6% [21.1%], P=.62) were not different in garlic and placebo treatment.Conclusions.—The commercial garlic oil preparation investigated had no influence on serum lipoproteins, cholesterol absorption, or cholesterol synthesis. Garlic therapy for treatment of hypercholesterolemia cannot be recommended on the basis of this study.
Empirical Therapy for Community-Acquired Pneumonia
Authors: Michael S. Niederman
Journal: Annals of Internal Medicine (1998)

Letters15 September 1998Empirical Therapy for Community-Acquired PneumoniaMichael S. Niederman, MDMichael S. Niederman, MDWinthrop-University Hospital; Mineola, NY 11501Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-6-199809150-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Community-acquired pneumonia (CAP) continues to be a topic of great interest to physicians, but one that remains filled with controversy because of the limitations of current diagnostic testing and therapeutic options. Unfortunately, Brown and Lerner's letter serves only to emphasize the emotion and misunderstanding in this field. Their letter is unnecessarily critical and inaccurate and is typical of the controversy in this area. It certainly does not accurately reflect the content of our Update or the ATS guidelines on CAP [1].Brown and Lerner ask how Bartlett and Mundy's review could be interpreted to mean that the ATS ...References1. Niederman MS, Bass JB, Campbell GD, Fein AM, Grossman RF, Mandell LA, et al. Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. Am Rev Respir Dis. 1993; 148:1418-26. Google Scholar2. Bartlett JG, Mundy LM. Community-acquired pneumonia. N Engl J Med. 1995; 333:1618-24. Google Scholar3. Mundy LM, Auwaerter PG, Oldach D, Warner ML, Burton A, Vance E, et al. Community-acquired pneumonia: impact of immune status. Am J Respir Crit Care Med. 1995; 152:1309-15. Google Scholar4. Gordon G, Throop D, Berberian L, Niederman M, Bass J, Alemayehu D, Mellis S. Validation of the therapeutic recommendations of the American Thoracic Society Guidelines for community acquired pneumonia in hospitalized patients [Abstract]. Chest. 1996; 110:55S. Google Scholar Author, Article, and Disclosure InformationAffiliations: Winthrop-University Hospital; Mineola, NY 11501 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1998Volume 129, Issue 6Page: 510KeywordsAntibioticsAntimicrobial resistanceBacteriologyEmotionsPathogensPatient advocacyPneumoniaTreatment guidelines Issue Published: 15 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Autologous Endothelialized Vein Allograft
Authors: Peter Lamm, Gerd Juchem, Stefan Milz, Matthias Schuffenhauer, Bruno Reichart
Journal: Circulation (2001)

Early graft failure after the use of less satisfactory autologous grafts (30% of all vein grafts) is caused primarily by the following problems: (1) suitable autologous transplants are limited; (2) biotechnology has not yet been able to produce reliable graft substitutes that are legally and ethically approved; and (3) current prosthetic materials are prothrombotic. To overcome these problems, we developed an easily accessible, quality-controlled graft.Human autologous venous endothelial cells (HAVECs) were isolated from short segments of peripheral veins unsuitable for bypass grafting. After mechanical deendothelialization of cryopreserved allograft veins (CAVs) and precoating with recipient autologous serum, these homologous cells were seeded by use of a rotating device. Growth of a confluent HAVEC layer within 1 week in a special incubator was observed. After histological and mechanical tests, 12 patients received 15 grafts in total. Bypass operation was followed by clinical and angiographic follow-up. Production period was 22+/-8 days. HAVEC-coated CAVs showed normal connective tissue wall structure and a tight endothelial monolayer (burst pressure >2000 mm Hg). To date, 12 CABG patients lacking suitable autologous graft material have been treated. One patient died of a cause unrelated to the grafts, which were found morphologically normal and patent during autopsy. Of 15 grafts, 2 were occluded at the first angiographic follow-up. The oldest graft has now been in place for approximately 3 years. Immune suppression was not administered.At present, autologous endothelialized CAVs present good alternative small-caliber grafts for patients lacking suitable autologous vessels.