tbuckley/cabot-search huggingface dataset:
Effects of Long-term Infusion of Prostacyclin (Epoprostenol) on Echocardiographic Measures of Right Ventricular Structure and Function in Primary Pulmonary Hypertension
Authors: Alan L. Hinderliter, Park W. Willis, Robyn J. Barst, Stuart Rich, Lewis J. Rubin, David B. Badesch, Bertron M. Groves, Michael D. McGoon, Victor F. Tapson, Robert C. Bourge, Bruce H. Brundage, Spencer K. Koerner, David Langleben, Cesar A. Keller, Srinivas Murali, Barry F. Uretsky, Gary Koch, Shu Li, Linda M. Clayton, Maria M. Jöbsis, Shelmer D. Blackburn, James W. Crow, Walker A. Long
Journal: Circulation (1997)

Background Right heart failure is an important cause of morbidity and mortality in primary pulmonary hypertension. In a recent prospective, randomized study of severely symptomatic patients, treatment with prostacyclin (epoprostenol) produced improvements in hemodynamics, quality of life, and survival. This article describes the echocardiographic characteristics of participants in this trial; the relationships of echocardiographic variables to hemodynamic parameters, exercise capacity, and quality of life; and the echocardiographic changes associated with prostacyclin therapy. Methods and Results The 81 patients enrolled in this multicenter trial were randomized to treatment with a long-term infusion of prostacyclin in addition to conventional therapy (n=41) or conventional therapy alone (n=40) for 12 weeks. Echocardiograms and assessments of hemodynamics, exercise capacity, and quality of life were performed before and after the treatment phase. On baseline evaluation, patients had marked right ventricular dilatation and dysfunction, abnormal septal curvature, and significant tricuspid regurgitation with a high regurgitant velocity. Pericardial effusions were common. More pronounced abnormalities in right heart structure and function were associated with higher pulmonary arterial and mean right atrial pressures, lower cardiac index, and impaired exercise capacity but had no predictable relationship to quality-of-life indicators. The 12-week infusion of prostacyclin had beneficial effects on right ventricular size, curvature of the interventricular septum, and maximal tricuspid regurgitant jet velocity. Conclusions The echocardiographic manifestations of severe primary pulmonary hypertension reflect abnormalities in hemodynamics and exercise capacity. Prostacyclin has beneficial effects on right heart structure and function that may contribute to the clinical improvement and prolonged survival observed with this drug.
The combination of ursodeoxycholic acid and methotrexate for patients with primary biliary cirrhosis: The results of a pilot study*1
Authors: K LINDOR
Journal: Hepatology (1995)

Ursodeoxycholic acid (UDCA) and methotrexate (MIX) have both been proposed as treatments for patients with primary biliary cirrhosis (PBC). It has been suggested that a combination of the two drugs may offer advantages over either used separately. In this pilot study, we sought to evaluate the safety and efficacy of this combination for patients with PBC. Thirty-two patients with antimitochondrial antibody positive PBC were prospectively entered into a pilot study and received UDCA, 13 to 15 mg/kg/d, in conjunction with MTX, 0.25 mg/kg/wk, for a period of 2 years. The results of this treatment were compared with those obtained from 180 patients with PBC studied in a placebo-controlled trial of UDCA alone conducted during the same period. Patients in the pilot study and randomized study were comparable with regard to age, gender, and liver biochemistries. The UDCA/MTX-treated patients were of earlier histologic stage and had a lower mean Mayo risk score. During this period, seven patients in the UDCA/MTX group were withdrawn, four for pulmonary toxicity (two who required hospitalization), and one each with mouth ulcer, extreme fatigue, and hair loss. The use of UDCA/ MTX was not associated with improvement in symptoms. In the patients receiving UDCA/MTX, biochemical changes were comparable to those of patients receiving UDCA alone but superior to those in the placebo group (P < .05). Histological changes were comparable in all groups at 2 years. Cessation of MTX while UDCA was continued led to no deterioration in liver biochemistries. In a 2-year study, the use of MTX in combination with UDCA was associated with substantial toxicity, but with no evidence for symptomatic, biochemical, or histologic improvement over that seen with UDCA alone. The use of MTX in patients with PBC should be confined to patients in prospective trials and not used on an empiric basis.
An Address on the Connection of the Biological Sciences with Medicine
Authors: T. H. Huxley
Journal: BMJ (1881)

THE BRITISH MEDICAL 7OTJRNAL.273 lows it is composed of two kinds of things-some of absolute value, and others of relative value, but not to be disdained.It is thus we have received from our predecessors opium, cinchona, and nearly all our best drugs, which have rendered immense services, and will still render them to us, before we shall have definitely fixed their mode of action.It is thus in our time that wve shall leav.e our descendants choloroform, chloral, carbolic acid, the salicylates, pilocarpin, and many other substances, regarding which it will be the part of the future to appre- ciate, and explain their various uses.Thus are formed what Cabanis so well termed the " practical certainties " of medicine ; thus we arrive at that kind of certainty adapted to the clinical physician which in many respects is like moral certainty, and which, without equalling scientific certainty, has none the less its parallel place and its rank.The limits which have been assigned to me do not allow me to pursue further this already somewhat long study.To close it worthily, allow me, gentlemen, to quote to you a passage which is, as it were, its summary and conclusion, and which I borrow from Claude Bernard.I cannot do better than leave you under the impression of these simple and strong words: " The sceptic", says our great physiologist, in his Intr-oduction to Experimental Medicine, " is
Sleep apnoea and post-stroke vascular events: is it only due to poor continuous positive airway pressure use?
Authors: Miguel Ángel Martínez-García
Journal: European Respiratory Journal (2012)

From the authors:

We wish to thank A.E. Mirrakhimov for his interest in our article [1] and his comments on it.

With respect to these comments, we would like to raise a few points. It is important to note that we realise that this is an observational study and, as such, subject to the methodological limitations intrinsic to this type of study. It would obviously be desirable to adjust the results for many other variables that were not included in this study: the use of statins, hypotensive treatment and changes in all the cardiovascular risk factors analysed over the course of the study; and not just these variables, but also many others related to the …
Colorectal Surgery Comes in from the Cold
Authors: Neil Mortensen, Christopher S. Garrard
Journal: New England Journal of Medicine (1996)

Mild perioperative hypothermia is common during major abdominal surgery. Its usual causes are anesthetic-induced impairment of thermoregulation, exposure to cold, and altered distribution of body heat. Measures to reduce heat loss include covering the skin, warming intravenous fluid and transfused blood, and increasing the ambient temperature. Few patients are actively warmed during surgery, however.1 Hypothermia may have both beneficial and adverse effects on patients. By reducing the consumption of oxygen, it may protect tissue from ischemia, an effect that is exploited during circulatory arrest in cardiac surgery.2,3 The adverse effects include cardiac arrhythmias, reduced cardiac output, and shifts in . . .
358 HEPATOCELLULAR CARCINOMA IS ASSOCIATED WITH AN IMPAIRED CD4 T CELL IMMUNE RESPONSE
Authors: R. Cabrera, G. Morelli, M. Ararat, C. Soldevila-Pico, R.J. Firpi, C. Levy, V. Machicao, C. Liu, D.R. Nelson
Journal: Journal of Hepatology (2008)
Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data
Authors: Paul P. Glasziou, Les Irwig
Journal: Annals of Internal Medicine (2008)

Letters16 September 2008Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful DataPaul P. Glasziou, MBBS, PhD and Les Irwig, MBBS, PhDPaul P. Glasziou, MBBS, PhDFrom University of Oxford, Oxford OX3 7LF, United Kingdom, and University of Sydney, Sydney, New South Wales 2006, Australia.Search for more papers by this author and Les Irwig, MBBS, PhDFrom University of Oxford, Oxford OX3 7LF, United Kingdom, and University of Sydney, Sydney, New South Wales 2006, Australia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-6-200809160-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Timbie for the 2 corrections. All our calculations and writing were done in mmol/L, but we added the U.S. units (mg/dL) in our revision and did this incorrectly for variances (although SDs and means are correct).Dr. Cayley points out that most of the statin trials have used a fixed dose (4S [Scandinavian Simvastatin Survival Study] is an exception) rather than monitoring-based titration or adjustment. As our work demonstrates, trials with a fixed dose allow the opportunity to assess how cholesterol values increase over time. In patients who truly have a substantial increase, a change ...Reference1. Choudhury N, Wall PM, Truswell AS. Effect of time between measurements on within-subject variability for total cholesterol and high-density lipoprotein cholesterol in women. Clin Chem. 1994;40:710-5. [PMID: 8174241] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Paul P. Glasziou, MBBS, PhD; Les Irwig, MBBS, PhDAffiliations: From University of Oxford, Oxford OX3 7LF, United Kingdom, and University of Sydney, Sydney, New South Wales 2006, Australia.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMonitoring Cholesterol Levels: Measurement Error or True Change? Paul P. Glasziou , Les Irwig , Stephane Heritier , R. John Simes , and Andrew Tonkin , for the LIPID Study InvestigatorsMonitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data Justin W. Timbie Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data William E. Cayley Monitoring Cholesterol Levels: Understanding Variance and Finding the Most Useful Data Liu Hong , Kaichun Wu , and Daiming Fan Metrics 16 September 2008Volume 149, Issue 6Page: 437KeywordsCholesterolConflicts of interestDietLipidsResearch laboratoriesStatins ePublished: 16 September 2008 Issue Published: 16 September 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
β-Adrenergic Stimulation Modulates Ryanodine Receptor Ca <sup>2+</sup> Release During Diastolic Depolarization to Accelerate Pacemaker Activity in Rabbit Sinoatrial Nodal Cells
Authors: Tatiana M. Vinogradova, Konstantin Yu. Bogdanov, Edward G. Lakatta
Journal: Circulation Research (2002)

It has long been recognized that activation of sympathetic beta-adrenoceptors (beta-ARs) increases the spontaneous beating rate of sinoatrial nodal cells (SANCs); however, the specific links between stimulation of beta-ARs and the resultant increase in firing rate remain an enigma. In the present study, we show that the positive chronotropic effect of beta-AR stimulation is critically dependent on localized subsarcolemmal ryanodine receptor (RyR) Ca(2+) releases during diastolic depolarization (CRDD). Specifically, isoproterenol (ISO; 0.1 micromol/L) induces a 3-fold increase in the number of CRDDs per cycle; a shift to higher CRDD amplitudes (from 2.00+/-0.04 to 2.17+/-0.03 F/F(0); P<0.05 [F and F(0) refer to peak and minimal fluorescence]); and an increase in spatial width (from 3.80+/-0.44 to 5.45+/-0.47 microm; P<0.05). The net effect results in an augmentation of the amplitude of the local preaction potential subsarcolemmal Ca(2+) transient that, in turn, accelerates the diastolic depolarization rate, leading to an increase in SANC firing rate. When RyRs are disabled by ryanodine, beta-AR stimulation fails to amplify subsarcolemmal Ca(2+) releases, fails to augment the diastolic depolarization rate, and fails to increase the SANC firing rate, despite preserved beta-AR stimulation-induced augmentation of L-type Ca(2+) current amplitude. Thus, the RyR Ca(2+) release acts as a switchboard to link beta-AR stimulation to an increase in SANC firing rate: recruitment of additional localized CRDDs and partial synchronization of their occurrence by beta-AR stimulation lead to an increase in the heart rate.
Patient's fight to allow doctors to end his life is taken up by his widow
Authors: C. Dyer
Journal: BMJ (2012)

The widow of Tony Nicklinson, a man with locked-in syndrome who died after failing to win a High Court ruling allowing doctors to end his life, is to carry on her husband’s legal battle.

Jane Nicklinson has applied for permission to take the landmark case, the first to argue for a right to voluntary euthanasia, to the Court of Appeal in London.

Tony Nicklinson, who was paralysed after a stroke in 2005, lost his case on 16 August, when three judges ruled that such a change in the law …
The Resource-Based Relative Value Scale: A Methodological and Policy Evaluation
Authors: William L. Roper
Journal: JAMA (1988)

The Resource-Based Relative Value Scale (RBRVS) developed by the research team at Harvard University is an important and ambitious effort. Dr Hsiao and his group are to be commended for their creative approach to this technically difficult and politically sensitive endeavor. My comments on the RBRVS study reflect my dual perspective as the administrator of the Health Care Financing Administration and as a pediatrician. First, I discuss the basic issues surrounding Medicare physician payment. Second, several of the important methodological aspects of the RBRVS study are reviewed. Finally, I discuss the likely impact of Medicare paying physicians according to fee schedules based on an RBRVS.  Physician Payment Reform  It is projected that in 1989 the Medicare program will spend more than $24 billion for physicians' services. Between 1975 and 1987, Medicare spending for physicians' services per beneficiary increased at a compound rate of 15% per year. About half of this
Microvascular Free-Flap Reconstruction in the Head and Neck
Authors: Neal D. Futran
Journal: JAMA (2000)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Augmentation of spontaneous macrophage-mediated cytolysis by eosinophil peroxidase
Authors: CF Nathan, SJ Klebanoff
Journal: The Journal of Experimental Medicine (1982)

Eosinophil peroxidase (EPO), a cationic protein purified from horse blood, adhered to four different types of tumor cells, markedly potentiating their lysis by preformed or enzymatically generated H(2)0(2) (up to 76-fold, as assayed in serum-containing tissue culture medium without supplemental halide). Similarly, compared with uncoated tumor cells, EPO-coated tumor cells were up to 32 times more sensitive to lysis when incubated with macrophages or granulocytes whose respiratory burst was triggered by PMA. However, EPO-coated tumor cells were also readily lysed by bacillus Calmette- Guerin-activated macrophages in the absence of exogenous triggering agents. This spontaneous cytolysis was rapid (50 percent at 2 h) and potent (50 percent lysis at macrophage/tumor cell ratios of 1.5 to 4.6), and was observed with both a peroxide-sensitive tumor (TLX9) and a peroxide-resistant tumor (NK lymphoma). Under the conditions used, neither EPO alone nor macrophages alone were spontaneously cytolytic. Neither EPO nor EPO-coated tumor cells triggered a detectable increment in H(2)0(2) release from macrophages. Nonetheless, spontaneous macrophage-mediated cytolysis of EPO- coated tumor cells was completely inhibitable by catalase (50 percent inhibition, 23 U/ml), although not by heated catalase, indicating a requirement for H(2)0(2). Cytolysis was also completely inhibitable by azide (50 percent inhibition, 2.6 X 10 -5 M), indicating a requirement for enzymatic activity of EPO. Thus, a cytophilic peroxidase from eosinophils and H(2)0(2) spontaneously released from activated macrophages interacted synergistically in a physiologic medium to destroy tumor cells.
The Continuing Need for Late Abortions
Authors: David A. Grimes
Journal: JAMA (1998)

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
Enhancement by pyrazole of lipopolysaccharide-induced liver injury in mice: Role of cytochrome P450 2E1 and 2A5
Authors: Yongke Lu, Arthur I. Cederbaum
Journal: Hepatology (2006)

The mechanisms by which alcohol causes liver injury are still not certain. Either LPS or CYP2E1 are considered independent risk factors involved in alcoholic liver disease, but mutual relationships or interactions between them are unknown. In the present study, the possible synergistic action of CYP2E1 and LPS in liver injury was investigated by evaluating the effects of pyrazole (inducer of CYP2E1), Chlormethiazole (CMZ), an inhibitor of CYP2E1, and CYP2E1-knockout mice. Mice were injected with pyrazole (150 mg/kg, ip) daily for 2 days, followed by LPS injection (4 mg/kg, ip). CMZ (50mg/kg, ip) was administered 15 h before and 30 min after LPS treatment, respectively. LPS-induced liver injury was enhanced by pyrazole, as indicated by pathological changes and increases in ALT and AST, and positive TUNEL staining. LPS-induced oxidative stress was also enhanced by pyrazole as indicated by increases in 4-hydroxy-2-nonenal and 3-nitrotyrosine adduct formation. CMZ protected against the pyrazole enhanced LPS liver injury and oxidative stress. CYP2E1 but also CYP2A5 were increased by the pyrazole/LPS treatment. CMZ decreased the elevated CYP2E1 activity by 90%, but CYP2A5 activity was also lowered (30%-50%). CYP2E1-knockout mice exhibited only minor liver injury after treatment with pyrazole/LPS, but wild-type mice exhibited severe liver injury. While no CYP2E1 was present in the CYP2E1 knockout mice, CYP2A5 activity was also lower. In conclusion, induction of CYP2E1 plays an important role in the enhancement of LPS liver injury by pyrazole, but some contribution by CYP2A5 cannot be excluded.
Confocal features of equivocal facial lesions on severely sun-damaged skin: Four case studies with dermatoscopic, confocal, and histopathologic correlation
Authors: Elisabeth M.T. Wurm, Claudia E.S. Curchin, Duncan Lambie, Caterina Longo, Giovanni Pellacani, H. Peter Soyer
Journal: Journal of the American Academy of Dermatology (2011)
Status of Cardiovascular Health in Chinese Adults
Authors: Yufang Bi, Yong Jiang, Jiang He, Yu Xu, Limin Wang, Min Xu, Mei Zhang, Yichong Li, Tiange Wang, Meng Dai, Jieli Lu, Mian Li, Chung-Shiuan Chen, Shenghan Lai, Weiqing Wang, Linhong Wang, Guang Ning
Journal: Journal of the American College of Cardiology (2015)
Toxic epidermal necrolysis induced by lamotrigine in a child: Rapid recovery after high dose intravenous immunoglobin treatment
Authors: JL Corzo, FJ Garcia-Martin, V Vera, C Mayorga, MJ Torres, L Gonzalez, JA Cornejo-García, A Jurado, M Blanca
Journal: Journal of Allergy and Clinical Immunology (2002)
TCT-669 Differences in Culprit Lesion Plaque Stability between Males and Females: A VH-IVUS Analysis from the ADAPT-DES Study
Authors: Lin Wang, Bruce R. Brodie, Peter L. Duffy, Akiko Maehara, Ernest L. Mazzaferri, D. Christopher Metzger, Gary S. Mintz, Michael Rinaldi, Gregg W. Stone, Thomas Stuckey, Giora Weisz, Bernhard Witzenbichler, Ke Xu
Journal: Journal of the American College of Cardiology (2013)
A germline gain-of-function mutation in Ptpn11 (Shp-2) phosphatase induces myeloproliferative disease by aberrant activation of hematopoietic stem cells
Authors: Dan Xu, Siying Wang, Wen-Mei Yu, Gordon Chan, Toshiyuki Araki, Kevin D. Bunting, Benjamin G. Neel, Cheng-Kui Qu
Journal: Blood (2010)
Relation between Quality Assessment and Utilization Review in a Functioning PSRO
Authors: Alan R. Nelson
Journal: New England Journal of Medicine (1975)

The Utah State Medical Association, through its peer-review foundation, the Utah Professional Review Organization, has implemented an integrated system of utilization reveiw and quality assessment linked to a program of continuing education. Nurse co-ordinators, employed by the Organization, screen all hospitalized patients covered by Titles XVIII, XIX and V as well as by subscribing private insurers. Approximately 10 per cent of hospitalized patients do not meet peer-generated criteria for admission review or length of stay and are screened out for peer review, The nurse co-ordinators collect data for retrospective quality assessment, identifying targets for continuing medical education. Preliminary data support the cost effectiveness of such a review program. Continuing qualtiy audit will test the effectiveness of education programs.