tbuckley/cabot-search huggingface dataset:
Internal Atrial Defibrillation in Humans
Authors: Randolph A. S. Cooper, Eric E. Johnson, J. Marcus Wharton
Journal: Circulation (1997)

Background The optimal waveform for internal atrial defibrillation (IAD) in humans is unknown. This study tested the effect of waveform duration and phase duration on the efficacy of biphasic waveforms for IAD. Methods and Results Electrodes were positioned in the right atrial appendage and coronary sinus in 13 patients. In part 1, the atrial defibrillation thresholds (ADFTs) for 5 monophasic waveforms (2, 4, 6, 10, and 20 ms) and 5 symmetrical biphasic waveforms (1/1, 2/2, 3/3, 5/5, and 10/10 ms) were compared in 6 patients. In part 2, the ADFTs for two asymmetrical biphasic waveforms (7.5/2.5 and 2.5/7.5 ms) were compared with those for a symmetrical biphasic waveform (5/5 ms) and a monophasic waveform (10 ms) in 7 patients. In part 1, biphasics with total durations of 4 to 20 ms had significantly lower ADFTs than monophasic waveforms of the same total duration. For a total duration of 2 ms, there was no significant difference in ADFTs between the biphasic and the monophasic waveforms. There was no difference between symmetrical biphasic waveforms of 4 to 20 ms. In part 2, the 7.5/2.5 ms asymmetrical biphasic had significantly lower ADFTs than the three other waveforms tested. Both the 7.5/2.5 ms asymmetrical and the 5/5 ms symmetrical biphasic waveform had significantly lower ADFTs than the 2.5/7.5 ms asymmetrical biphasic and the 10 ms monophasic waveforms. Conclusions For IAD in humans, biphasic waveforms were more efficacious than monophasic waveforms. This improved efficacy is related to the total duration of the biphasic waveform and each individual phase duration of the biphasic waveform.
Interpreters or Teachers?
Authors: Abraham M. Nussbaum
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
Permanent Paralysis of the Right Phrenic Nerve
Authors: James E. Reeves, William F. Anderson
Journal: Annals of Internal Medicine (2002)

Letters17 September 2002Permanent Paralysis of the Right Phrenic NerveJames E. Reeves Jr., MD and William F. Anderson, MD, MPHJames E. Reeves Jr., MDCancer Care Associates; Oklahoma City, OK 73120National Cancer Institute; Bethesda, MD 20892-7317Search for more papers by this author and William F. Anderson, MD, MPHCancer Care Associates; Oklahoma City, OK 73120National Cancer Institute; Bethesda, MD 20892-7317Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-6-200209170-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although right phrenic nerve paralysis is an acknowledged immediate complication of implanted venous access portals, it has only recently been recognized as a late sequela of this device. To a growing list of similar occurrences, we add this case report of a 44-year-old woman with infiltrating ductal carcinoma of the breast, treated with 5-fluorouracil, cyclophosphamide, and doxorubicin chemotherapy as a continuous 48-hour infusion through a Hickman catheter. Eighty days after successful implantation of a right subclavian venous catheter, the patient developed right shoulder pain. Plain chest radiography and venography documented a widened mediastinum, raised right hemidiaphragm, and ...References1. Aggarwal S, Hari P, Bagga A, Mehta SN. Phrenic nerve palsy: a rare complication of indwelling subclavian vein catheter. Pediatr Nephrol. 2000;14:203-4. [PMID: 10752757] CrossrefMedlineGoogle Scholar2. Leong DC, Craft PS, Prosser IW. Phrenic nerve palsy due to chemotherapy extravasation from a Hickman catheter [Letter]. Aust N Z J Med. 1996;26:112-3. [PMID: 8775539] CrossrefMedlineGoogle Scholar3. Munzone E, Nolé F, Orlando L, Mandalá M, Biffi R, Ciano C, et al . Unexpected right phrenic nerve injury during 5-fluorouracil continuous infusion plus cisplatin and vinorelbine in breast cancer patients [Letter]. J Natl Cancer Inst. 2000;92:755. [PMID: 10793114] CrossrefMedlineGoogle Scholar4. Rigg A, Hughes P, Lopez A, Filshie J, Cunningham D, Green M. Right phrenic nerve palsy as a complication of indwelling central venous catheters. Thorax. 1997;52:831-3. [PMID: 9371220] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cancer Care Associates; Oklahoma City, OK 73120National Cancer Institute; Bethesda, MD 20892-7317 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByLa commande centrale de la ventilationAcute dyspnea due to right phrenic palsy during infusional chemotherapy 17 September 2002Volume 137, Issue 6Page: 551-552KeywordsCathetersChemotherapyForecastingInflammationNervesParalysisPatient advocacyShouldersThoraxThrombosis ePublished: 17 September 2002 Issue Published: 17 September 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Action-Oriented Decisions in Ambulatory Medicine
Authors: Irwin Polk
Journal: JAMA (1982)

In this era of computerized everything, numerous attempts have been made to organize the procedures of medical diagnosis and treatment into rational patterns variously called "protocols," "rules," or "algorithms." This book summarizes a five-year effort to do this for some relatively simple outpatient practices. According to the preface, the author's original purpose was to develop rules by which a computer could audit a medical record system to detect patient conditions that needed corrective actions and to ensure that all patients received exactly the care that was intended by the physician responsible. Thus, the book is about medical decision rules and practices. In an introductory 14-page chapter and two appendices, there is discussion of decision theory as it applies to medical practice, but the other 300 pages of the book offer specific diagnostic and treatment algorithms dealing with such topics as the use of digitalis or antiarrhythmic drugs, testing for occult
High titers of antibodies inhibiting the binding of envelope to human cells correlate with natural resolution of chronic hepatitis C
Authors: Koji Ishii, Domenico Rosa, Yushiro Watanabe, Tohru Katayama, Hideharu Harada, Colby Wyatt, Kendo Kiyosawa, Hideki Aizaki, Yoshiharu Matsuura, Michael Houghton, Sergio Abrignani, Tatsuo Miyamura
Journal: Hepatology (1998)

Most cases of hepatitis C virus (HCV) infection result in chronic disease; however, a very small fraction of patients naturally clear the virus and resolve chronic hepatitis. In an attempt to correlate immune response with chronic disease resolution, we compared the antibody response in patients with different outcomes of the infection. Antibody responses to HCV structural proteins were assessed in 34 patients originally diagnosed with acute hepatitis. Five cases resolved acute infection, 22 developed chronic hepatitis, and 7 naturally resolved chronic hepatitis C. To estimate HCV neutralizing antibodies we used the neutralization of binding (NOB) assay, which evaluates inhibition of the envelope-2 protein binding to human cells. Enzyme-linked immunosorbent assay was used for the quantitative assessment of serum antibodies. The presence of HCV RNA was ascertained by reverse transcription-polymerase chain reaction. In 6 of 7 patients naturally recovered from chronic hepatitis C, the emergence and the persistence (for more than 3 months) of high serum titers (>1/600) of NOB antibodies coincided with virus clearance and clinical resolution of hepatitis. NOB antibody activity was observed in only 2 of 5 patients recovered from acute hepatitis C. Chronic patients who did not show any resolution during the course of the study developed low or no NOB antibodies. Because of the correlation between prolonged high NOB titers and natural resolution of chronic hepatitis C, vaccination or passive immunization aimed at high titers of NOB antibodies may be valuable new therapeutic approaches for chronic hepatitis C.
Preventing and treating tetanus
Authors: C L Thwaites
Journal: BMJ (2003)

One hundred and twenty years ago, the BMJ contained the following report: “Death from tetanus induced by hypodermic injection. An inquest was held by the coroner for the city of Dublin last week on the body of a governess, aged fifty-six years, [who] used to inject morphia herself subcutaneously, for the relief of neuralgia arising from bad teeth … Dr Austin Meldon was of the opinion that the cause of tetanus must have been the injury of some nerve by the needle.”1

In fact, the governess's tetanus probably resulted from chronic dental infection or using a dirty needle, not the nerve injury the doctor supposed. Six years after this report, Arthur Nicolaier showed that tetanus resulted from contamination of wounds with soil bacilli, which, he correctly deduced, produced a “strychnine-like” toxin responsible for the disease.2

More than a century later much more is known about the tetanus toxin; its deoxyribonucleic acid has been sequenced and its mechanism of action established. We are equipped with antitoxin and a vaccine to prevent the disease, yet tetanus continues to be a major public health problem throughout much of the developing world.

In 2000 only 18 833 cases of …
Cerebral Manifestations of Vitamin-B12 Deficiency
Authors: J. M. Holmes
Journal: BMJ (1956)

influences.These observations therefore call for an establishment of a suitable approach; hence the creation of a therapeutic social unit in the form of a village community which offers familial care of the mentally ill.Reactive depressions are rare, and endogenous depressions are rarely seen in hospitals or native treat- ment centres, in contrast to mania.Cultural factors seem not only to play a prominent part in the clinical manifestation of depressions but give an apparent preponderance of excitement whether in association with schizophrenic and manic depressive illnesses or with some ill-defined clinical condition.From the point of view of research, what is more urgently needed is further work towards the establish- ment of a more complete study of the complex psychological reactions of the African and more refined analysis of the cultural institutions, of the critical analysis of the clinical data obtained, of the psycho- logical implications of the changes in his cerebral structure and function, of the technical procedures involved in making these observations, and the statistical examination of the evidence so acquired, with the object of facilitating the task of comparison and, ultimately, of causal explanation.I acknowledge with thanks the advice and guidance willingly
Long-term Follow-up of Health Care Workers With Work-Site Exposure to Human Immunodeficiency Virus
Authors: Keith Henry, Scott Campbell, Brooks Jackson, Henry H Balfour, Frank Rhame, Kim Sannerud, Susan Pollack, John Sninsky, Shirley Kwok
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Recently, the issue of risk for human immunodeficiency virus (HIV) infection among health care workers has received heightened attention in both the lay and medical press, with an underlying theme of this renewed concern being a distrust of the current data (<i>Newsweek</i>. November 20, 1989:82-83).<sup>1</sup> Current Centers for Disease Control guidelines are predicated on the observed HIV seroconversion rate of 0.42% seen in studies of health care workers who suffer documented work-site exposure to HIV.<sup>2,3</sup>Health care workers with exposure to body fluids of HIV-infected persons are frequently traumatized emotionally and may be advised to begin prophylaxis with zidovudine.<sup>4</sup> Data such as those reported by Imagawa et al<sup>5</sup>and Haseltine<sup>6</sup>raise the possibility that the false-negative rate of HIV serological testing might be significant in certain populations. Since the Centers for Disease Control recommendations regarding HIV exposure of health care workers were
Cholesterol Efflux Capacity, High-Density Lipoprotein Function, and Atherosclerosis
Authors: Amit V. Khera, Marina Cuchel, Margarita de la Llera-Moya, Amrith Rodrigues, Megan F. Burke, Kashif Jafri, Benjamin C. French, Julie A. Phillips, Megan L. Mucksavage, Robert L. Wilensky, Emile R. Mohler, George H. Rothblat, Daniel J. Rader
Journal: New England Journal of Medicine (2011)

High-density lipoprotein (HDL) may provide cardiovascular protection by promoting reverse cholesterol transport from macrophages. We hypothesized that the capacity of HDL to accept cholesterol from macrophages would serve as a predictor of atherosclerotic burden.We measured cholesterol efflux capacity in 203 healthy volunteers who underwent assessment of carotid artery intima-media thickness, 442 patients with angiographically confirmed coronary artery disease, and 351 patients without such angiographically confirmed disease. We quantified efflux capacity by using a validated ex vivo system that involved incubation of macrophages with apolipoprotein B-depleted serum from the study participants.The levels of HDL cholesterol and apolipoprotein A-I were significant determinants of cholesterol efflux capacity but accounted for less than 40% of the observed variation. An inverse relationship was noted between efflux capacity and carotid intima-media thickness both before and after adjustment for the HDL cholesterol level. Furthermore, efflux capacity was a strong inverse predictor of coronary disease status (adjusted odds ratio for coronary disease per 1-SD increase in efflux capacity, 0.70; 95% confidence interval [CI], 0.59 to 0.83; P<0.001). This relationship was attenuated, but remained significant, after additional adjustment for the HDL cholesterol level (odds ratio per 1-SD increase, 0.75; 95% CI, 0.63 to 0.90; P=0.002) or apolipoprotein A-I level (odds ratio per 1-SD increase, 0.74; 95% CI, 0.61 to 0.89; P=0.002). Additional studies showed enhanced efflux capacity in patients with the metabolic syndrome and low HDL cholesterol levels who were treated with pioglitazone, but not in patients with hypercholesterolemia who were treated with statins.Cholesterol efflux capacity from macrophages, a metric of HDL function, has a strong inverse association with both carotid intima-media thickness and the likelihood of angiographic coronary artery disease, independently of the HDL cholesterol level. (Funded by the National Heart, Lung, and Blood Institute and others.).
An Introduction to Physical Anthropolgy
Authors: James G. Roney
Journal: JAMA (1961)

The third edition is a real revision of the previous edition, bringing into one volume an outstanding presentation of physical anthropology today. With succinctness and clarity he delineates the primates as a zoological group and then proceeds to their origin and evolution. History is woven carefully into these chapters and others. Viewpoints of other investigators are presented and commented on. Where the author has divergent viewpoints, these are stated clearly. Two mistaken notions are orthogenetic evolution and missing-link concepts. The new idea of evolution is that of "a labile reticulate process occurring within the varying environmental matrices of spacetime, with repeated inter-crossing between different lines, at once convergent and divergent." The chapter on time, morphology, and neoteny is a stimulating and philosophical one. The author suggests that the change of status from ape to man was a result of "retention of the growth trends of the juvenile brain and its
Nitric Oxide and VIP as Co-Transmitters of Neurogenic Relaxation of Human Airways: From the Authors
Authors: Lynette Fernandes, James Ellis, Bradley Undem
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

"Nitric Oxide and VIP as Co-Transmitters of Neurogenic Relaxation of Human Airways: From the Authors." American Journal of Respiratory and Critical Care Medicine, 151(5_pt_1), pp. 1689–1690
Effects of nonpathogenic gram-negative bacterium<i>Vitreoscilla filiformis</i>lysate on atopic dermatitis… Does this make a real difference? Authors’ reply
Authors: A.G. Gueniche, B. Knaudt, E. Schuck, T. Volz, P. Bastien, R. Martin, M. Röcken, L. Breton, T. Biedermann
Journal: British Journal of Dermatology (2009)

Conflicts of interest: none declared. Sir, The sample size calculation discussed by La Colla et al.1 in relation to our recent paper2 was determined based on results from our previous pilot study.3 Following a classical prospective power calculation based on the SCORing of Atopic Dermatitis (SCORAD) primary efficacy criterion, 40 patients per group were needed in order to detect a one‐point standardized difference in the SCORAD between treatment and control groups using a two‐sided t‐test at the significance level α = 5% and with a power 1 − β = 90%. Concerning the post‐hoc power, we did not compute any calculation because the primary efficacy criterion being significant, a post‐hoc power analysis is just irrelevant.4 Once the study is completed, power calculation does not inform us in any way as to the conclusion of the present study. The primary endpoints have been analysed using a repeated measurement analysis, which takes into account the within‐subject correlation between measurements. The confidence intervals reported in Figures 2 and 4 (of our recent paper2) are more descriptive and could not be used for inferential purpose. They are based on the unpaired raw variability of the response visual analogue scale (VAS) scores by treatment groups and visits. The P‐values reported in the text or in Figures 2 and 4 are either t‐tests or F‐tests issued from the paired repeated measurement analysis.
Endoscopic Band Ligation for Rectal Dieulafoy's Lesion: Serial Endoscopic Images
Authors: Y. Mizukami, K. Akahoshi, N. Kondoh, N. Harada, H. Nawata
Journal: Endoscopy (2002)

Figure 1 An 85-year-old Japanese woman with rectal Dieulafoy's lesion presented with fresh blood hematochezia. Colonoscopy revealed a 5 mm shallow mucosal defect with an exposed vessel in the anterior wall of the lower rectum.
Practice Guidelines for Treatment of Peptic Ulcer Disease-Reply
Authors: A. H. Soll
Journal: JAMA (1996)

<h3>In Reply.</h3> —Our practice guidelines for treatment of peptic ulcer disease were developed both to "provide firm recommendations" where data supported consensus and "reasonable suppositions" where data were not definitive. Hard choices were needed. Our experts felt obliged to offer their "best guesses" to guide clinicians, rejecting the option of limiting recommendations to points of firm consensus. It would havebeen preferable to not label these guidelines "Consensus Statement." Dr Olson is correct; the cure rate for Hpylori with omeprazole-clarithromycin therapy was 75% in FDA trials.<sup>1</sup>Unfortunately, those data were not available to us at the time of the literature search. Although many published trials are weak, numbers are large; literature summary<sup>2</sup>(Table) yielded similar cure rates. Although there are no direct comparisons, the limitations of available data probably comparably affect treatment groups. The consensus among 20 experts (reconsulted May 1996) was that adding metronidazole or amoxicillin would enhance cure rates by 10% to 20%, thereby allowing shorter treatment with lower doses of clarithromycin.
Inflammatory and Immune Responses in the Arterial Media
Authors: George Tellides, Jordan S. Pober
Journal: Circulation Research (2015)

Inflammatory arterial diseases differentially affect the compartments of the vessel wall. The intima and adventitia are commonly involved by the disease process, with luminal and microvascular endothelial cells playing a critical role in the recruitment and activation of leukocytes. In contrast, the avascular media is often spared by immune-mediated disorders. Surprisingly, vascular smooth muscle cells (VSMCs), the predominant and often exclusive cell type of the media, are capable of robust proinflammatory responses to diverse stressors. The multiple cytokines and chemokines produced within the media can profoundly affect macrophage and T cell function, thus amplifying and shaping innate and adaptive immune responses. On the other hand, VSMCs and the extracellular matrix that they produce also display significant anti-inflammatory properties. The balance between the pro- and anti-inflammatory effects of VSMCs and their extracellular matrix versus the strength of the inciting immunologic events determines the pattern of medial pathology. Limitations on the extent of medial infiltration and injury, defined as medial immunoprivilege, are typically seen in arteriosclerotic diseases, such as atherosclerosis and transplant vasculopathy. Conversely, breakdown of medial immunoprivilege that manifests as more intense leukocytic infiltrates, loss of VSMCs, and destruction of the extracellular matrix architecture is a general feature of certain aneurysmal diseases and vasculitides. In this review, we consider the inflammatory and immune functions of VSMCs and how they may lead to medial immunoprivilege or medial inflammation in arterial diseases.