tbuckley/cabot-search huggingface dataset:
Is Forced Expiratory Volume in One Second the Best Measure of Severity in Childhood Asthma?
Authors: Joseph D. Spahn, Reuben Cherniack, Keith Paull, Erwin W. Gelfand
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

This essay focuses on whether FEV1 is the best measure of asthma severity in childhood asthma. For better or worse, FEV1 has become the gold standard lung function measurement in asthma, as it can be easily and quickly measured with relatively simple equipment. The current asthma guidelines use FEV1 in addition to daytime and nighttime symptoms in judging asthma severity (1, 2). Patients with mild persistent asthma are said to have FEV1 values of more than 80% of predicted, patients with moderate persistent asthma have values of 60 to 80% of predicted, whereas those with severe persistent asthma have values of less than 60% of predicted (1, 2). Despite widespread acceptance, neither are these criteria evidence-based nor is the basis of criteria described. FEV1 is also the outcome variable favored by the U.S. Food and Drug Administration to judge efficacy of asthma-controller medications. Thus, nearly all studies evaluating response to medications in asthma require subjects to have FEV1 values of 60 to 80% of predicted as essential entry criteria. Although this approach provides objective data to evaluate efficacy, it may not be the best measure for children with asthma. This is in large part because children with asthma are likely to have FEV1 values within the normal range when clinically stable.
Billings at Gettysburg
Authors: J. A. Curran
Journal: New England Journal of Medicine (1963)

DR. John Shaw Billings was one of the outstanding young surgeons in the Union Army during the Civil War (Fig. 1). At Gettysburg he was in charge of a field hospital situated in a stone farmhouse and barn near Little Round Top during the sanguinary days of July 2 and 3, 1863. Until the present study, a century after the events, the exact location of the improvised field hospital had not been identified.In view of Billings's distinguished career as one of the leading figures in American medicine at the turn of the century it seems especially appropriate, during this . . .
Pulmonary Alveolar Proteinosis
Authors: Selim M Arcasoy, Paul N Lanken
Journal: New England Journal of Medicine (2002)

Figure 1. A 26-year-old man presented with nonproductive cough and exertional dyspnea. Physical examination disclosed acrocyanosis. Chest radiography showed patchy alveolar and interstitial disease in a perihilar “batwing” distribution (Panel A). High-resolution computed tomography of the chest (Panel B) revealed extensive bilateral air-space disease (arrows) and a “crazy paving” appearance within the affected air spaces (arrowheads). Pulse oximetry revealed oxyhemoglobin desaturation to 79 percent when the patient was walking. Pulmonary-function testing demonstrated a moderate restrictive ventilatory defect and severe reduction in lung volumes and diffusion capacity. Fiberoptic bronchoscopy with transbronchial lung biopsies showed alveolar filling with amorphous, granular eosinophilic material . . .
Abstract 4943: Visualization of endogenous melanoma initiation and progression using intravital microscopy
Authors: James E. Bear, Hailey E. Brighton, Norman E. Sharpless, David B. Darr, Kelly S. Clark
Journal: Cancer Research (2014)

Abstract The death rates for malignant metastatic melanoma continue to rise because melanoma is largely refractory to existing therapies. Loss or inactivation of the tumor suppressor PTEN (Phosphatase and Tensin Homolog on Chromosome Ten) is observed in 40-50% of melanoma, and BRAF and PTEN mutations exist coincidentally in approximately 20% of melanoma cases. In mouse GEMM models, these mutations cooperate to promote metastatic melanomagenesis. However, existing methods to activate these lesions with Tyr-CreERT2 and topical tamoxifen application yields multifocal primary tumors whose origins cannot be accurately determined. To improve this model, we combined a tdTomatoLSL allele that serves as a visual marker of Cre recombination with Tyr-CreERT2;BrafCA;Ptenlox/lox to produce an animal where we can reproducibly initiate tumorigenesis in a spatiotemporally controllable manner by transiently applying extremely low doses (&amp;lt;20 nM) of tamoxifen to the dermis of the ear. Due to melanocyte-specific expression of the fluorescent protein tdTomato, we can track tumor progression from endogenous cells using two-photon intravital imaging. Starting from a single primary tumor on the ear, we can detect distant metastases in cervical lymph nodes and lungs via macroscopic fluorescent imaging, qRT-PCR and histology. We are using this model in combination with targeted therapy to investigate the effects of selective molecular inhibitors on the growth and metastasis of endogenous BRAFV600E/PTEN-/- metastatic melanoma at the cellular level. Preliminary studies using intravital imaging and a selective MEK1/2 inhibitor, GSK212 (Trametinib, FDA approved treatment for metastatic melanoma) show that targeted therapy causes heterogeneous reorganization of the tumor cells as early as 3 days post-treatment. After several weeks of continuous treatment, the remaining, resistant tumor cells are highly correlated spatially with bundled collagen structures detected by second harmonic generation signal, suggesting that cellular milieu strongly influences drug response. In addition, GSK212 treated animals still had lung macro-metastatic tumors, indicating that despite continuous MEK1/2 inhibition, metastatic tumor growth in the lung was still possible. In summary, we have developed an inducible endogenous model of melanoma metastasis that can be used to directly investigate both heterogeneous effects of targeted therapy at the cellular level and the efficacy of targeted therapy against metastasis. Citation Format: James E. Bear, Hailey E. Brighton, Norman E. Sharpless, David B. Darr, Kelly S. Clark. Visualization of endogenous melanoma initiation and progression using intravital microscopy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4943. doi:10.1158/1538-7445.AM2014-4943
Inhibition of leukocyte adherence and transendothelial migration in cultured human liver vascular endothelial cells by prostaglandin E1
Authors: Jinning Lou, Leo Bühler, Shaoping Deng, Gilles Mentha, Roberto Montesano, Georges E. Grau, Philippe Morel
Journal: Hepatology (1998)

Primary graft dysfunction is a major complication of orthotopic liver transplantation, and hepatic ischemic reperfusion injury is considered to be its major determinant cause. Although oxygen free radicals play an important role, leukocytes, cytokines, and adhesion molecules also contribute to hepatic ischemic reperfusion injury. Prostaglandin E1 (PGE1) has been shown to protect against impairment and dysfunction of transplanted livers in various experimental models as well as in clinical liver transplantation. In this study, the role of PGE1 on leukocyte adherence and transendothelial migration was investigated in cultured human liver vascular endothelial cells (HLVEC). Our results indicated that stimulated, but not resting, leukocytes exhibited high adhesion and transmigration capacity. HLVEC incubated with tumor necrosis factor (TNF) promoted leukocyte adherence and transendothelial migration. PGE1 inhibited leukocyte adherence to HLVEC when it was preincubated with either HLVEC or leukocytes. Moreover, PGE1 also suppressed stimulated leukocyte transendothelial migration in a dose-dependent manner. The inhibitory activity of PGE1 was further investigated on both HLVEC and leukocytes with attention to adhesion molecules. On HLVEC, PGE1 down-regulated TNF-induced expression of endothelial cell leukocyte adhesion molecule 1 and vascular adhesion molecule 1, but not intercellular adhesion molecule 1. On leukocytes, PGE1 inhibited expression of CD11a/CD18 and membrane-bound TNF on PHA-stimulated leukocytes. PGE1 also suppressed TNF release from the stimulated leukocytes. These results indicated that inhibition of leukocyte adherence and transendothelial migration is one of the mechanisms by which PGE1 protects liver grafts.
Supplementing Creatinine-Based Estimates of Risk in Chronic Kidney Disease
Authors: Marcello Tonelli
Journal: JAMA (2011)

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
Ecological studies of intestinal bacteria. Relation between the specificity of fecal ABO blood group antigen-degrading enzymes from enteric bacteria and the ABO blood group of the human host
Authors: Lansing C. Hoskins
Journal: Journal of Clinical Investigation (1969)

This report presents evidence for enteric bacterial adaptation to genetically controlled environmental factors in the individual human host. Human feces contains bacterial enzymes that degrade water-soluble A, B, and H antigens, and both the presence and the specificity of ABH blood group antigens in human gut mucous secretions are genetically determined for each individual. In this study, partially purified fecal blood group antigen-degrading enzymes from 31 subjects of known blood group and secretor status were obtained and their relative specificity for A, B, and H antigen was measured.
The Neurologic Examination
Authors: Roland P. Mackay
Journal: JAMA (1967)

This ponderous book, which in size and content seems to deserve the term "unabridged," has, in its two previous editions (1950, 1958), earned an enviable popularity with the American profession. This, the third edition, follows its predecessors in presenting not just a vast compendium of clinical methods of examining the neurologic patient but an explication of the pathophysiology of the symptoms and signs of neurologic disorder in the light of current orthodox theory. Opening chapters discuss with wisdom the process of history-taking and general physical and mental examination, and are followed by sections on the examination of sensory systems, the cranial nerves in detail, including articulation, the motor system including cerebellar disorders, the reflexes, and the study of the autonomic nervous system. Special chapters follow on diseases of peripheral nerves, roots, and spinal cord, on intracranial disease including especially the vascular syndromes, disturbances of consciousness, language and cortical function, epilepsy,
HYDROPS ARTICULORUM INTERMITTENS — REPORT OF A CASE.Read before the Shelby County (Ind.) Medical Society, Oct. 8, 1894.
Authors: SAMUEL KENNEDY
Journal: JAMA (1894)

I desire to report to this Society a case of hydrops articulorum intermittens. It is a rare disease, as but thirty-three cases previous to this one have been reported, and of these but three were in America. Thus it will be seen that this is the fourth case so far reported in this country and the thirty-fourth on record. The fact of its great rarity makes it all the more interesting, and consequently I have watched this case for many months with intense interest. It is also interesting from the fact that it had been seen by several physicians and invariably pronounced rheumatism. The usual remedies, such as the salicylates, wine of colchicum and other antirheumatics, had been administered, but wholly without beneficial results. After obtaining a detailed description of the case, and making a careful examination, I concluded that it was at least<i>not</i>rheumatism. I was for some
Pauciarticular Arthritis in Children
Authors: Paul P. Griffin
Journal: JAMA (1963)

With present-day diagnostic criteria for rheumatoid arthritis, almost any swollen painful joint is labeled rheumatoid, if no other diagnosis can be established, and with this diagnosis goes a stereotyped impression of crippling disease. The authors have studied 78 patients with a limited type of chronic arthritis involving one to several large joints, with few or no systemic manifestations. Of the 54 patients who appeared to be well at the time of study, 10 had residual effects of arthritis, and in 5 of these the residuum was slight. Duration of disease activity, severity of disease, and type of treatment appeared to be the major factors influencing results.
Effect of Glycemic Control on Early Diabetic Renal Lesions
Authors: J Barbosa, M W Steffes, D E Sutherland, J E Connett, K V Rao, S M Mauer
Journal: JAMA (1994)

<h3>Objective.</h3> —To determine whether optimized glycemic control in type I diabetic recipients of renal allografts will prevent or delay diabetic renal lesions in the allograft. <h3>Design.</h3> —Prospective, controlled, and randomized trial of glycemic control in an inception cohort of type I diabetic renal allograft recipients. The experimental group underwent maximized glycemic control, and the standard group was treated in the same way as other patients in the transplant clinic. Patients underwent baseline (before transplant) and 5-year posttransplant allograft biopsies. <h3>Setting.</h3> —University of Minnesota Hospital and Clinic and the Clinical Research Center and Hennepin County Medical Center, Minneapolis. <h3>Patients.</h3> —Type I diabetics with terminal diabetic renal failure undergoing renal transplantation. Forty-eight patients randomized to maximized or standard control completed the trial. <h3>Intervention.</h3> —Subcutaneous insulin given several times a day or continuously (maximized group) and once or twice each day (standard group) was used throughout the trial. A significant difference for hemoglobin A1 level was maintained (mean±SD: standard, 0.117±0.013; maximized, 0.096±0.016;<i>P</i>&lt;.001). <h3>Main Outcome.</h3> —The primary end point of this trial was the difference between the groups in renal glomerular mesangial expansion as determined by electron microscopy. <h3>Results.</h3> —There was a more than twofold increase in the volume fraction of mesangial matrix per glomerulus in the standard group (mean±SD, 0.043±0.034) compared with the maximized group (0.019±0.038;<i>P</i>=.024). The threefold increase in arteriolar hyalinosis, the greater widening of the glomerular basement membrane, and increase of volume fraction of the total mesangium in the patients who received standard treatment all approached significance (<i>P</i>=.10 or less). The incidence of severe hypoglycemic episodes was greater in the maximized group (1.7 per patient per year) than in the standard treatment group (&lt;0.1 per patient per year;<i>P</i>&lt;.001). <h3>Conclusions.</h3> —This trial indicates a causal relationship between hyperglycemia and an important lesion of diabetic nephropathy, mesangial matrix expansion, in renal allografts transplanted into diabetic recipients. In addition, the results with other lesions central to the development of diabetic nephropathy support the major conclusion. (<i>JAMA</i>. 1994;272:600-606)
963-16 Variant Angina is not Associated with Insertion/Deletion Polymorphism of Angiotensin-I Converting Enzyme (ACE) Gene
Authors: Myoung-Mook Lee, Hyo-Soo Kim, Jong-Min Song, Young-Bae Park, Cheul-Ho Kim, Dae-Won Sohn, Byung-Hee Oh, Yun-Shik Choi, Jung-Don Seo, Young-Woo Lee
Journal: Journal of the American College of Cardiology (1995)
The Discovery of Reflexes
Authors: Stanley Cobb
Journal: JAMA (1961)

A delightful and scholarly book has been written by Professor Liddell, successor to Sir Charles Sherrington in the Chair of Physiology at Oxford. Sir Charles did not want a conventional biography, so Liddell has written about neurophysiology before Sherrington. By telling the story of the discovery of reflexes up to 1906, when<i>The Integrative Action of the Nervous System</i>was published, he has skillfully pointed out Sherrington's great contribution. Chapter I, "The Nerve Cell and the Microscope," takes the reader from Robert Hooke to Santiago Ramon y Cajal. Chapter II, "Animal Electricity," tells of the remarkable experiments of Galvani and Volta, through du Bois-Reymond and Muller to Einthoven and the recording of minute electrical potentials. Chapter III, "Experimental Approaches," deals with the great men in the field before and after Charles Bell. To Liddell it was fun to meet these giants of old, and he surprises the reader with how
Mechanical Forces Producing Pulmonary Edema in Acute Asthma
Authors: S. Alex Stalcup, Robert B. Mellins
Journal: New England Journal of Medicine (1977)

Since patients with asthma have great difficulty in emptying their lungs, it has generally been assumed that large positive intrathoracic pressures are generated in this condition. On the other hand, the clinical observation that patients with acute asthma demonstrate severe intercostal retractions on inspiration suggests that large negative intrathoracic pressures are generated. Very negative peak inspiratory pleural pressures have been reported during induced bronchospasm.1 , 2 Because fluid accumulation in the lung is enhanced by very negative mean pleural pressures3 and because edema of the airways is an important part of the pathophysiology of asthma4 we measured pleural pressures in patients with . . .
Ischemic Stroke Risk With Oral Contraceptives
Authors: Leslie Allison Gillum, Sai Kumar Mamidipudi, S. Claiborne Johnston
Journal: JAMA (2000)

The relationship between ischemic stroke and oral contraceptive (OC) use has been studied for 40 years, but disagreement about an association persists.To review available literature to determine whether OC use is associated with increased stroke risk.Studies published from January 1960 through November 1999 were identified from electronic databases (MEDLINE, BIOSIS, and Dissertation Abstracts Online), Index Medicus, bibliographies of pertinent review articles and pertinent original articles, textbooks, and expert consultation.From 804 potentially relevant references retrieved, 73 were studies investigating risk of ischemic stroke with OC use. Two reviewers independently applied the following inclusion criteria: more than 10 stroke cases sampled, clear stroke subtype differentiation, concurrent controls included, adequate data included to determine relative risks (RRs) and confidence intervals (CIs), analysis controlled for age, and no later publication of identical data. A third investigator adjudicated disagreements. Sixteen studies met all inclusion criteria and were included in the meta-analysis.Two investigators independently extracted data, with disagreements resolved through discussion.The 16 studies were analyzed using random effects modeling. Current OC use was associated with increased risk of ischemic stroke (RR, 2.75; 95% CI, 2.24-3.38). Smaller estrogen dosages were associated with lower risk (P=.01 for trend), but risk was significantly elevated for all dosages. Studies that did not control for smoking (P=.01) and those using hospital-based controls (P<.001) found higher RRs, but no other patient characteristics or elements of study design were important. The summary RR was 1.93 (95% CI, 1.35-2.74) for low-estrogen preparations in population-based studies that controlled for smoking and hypertension. This translates to an additional 4.1 ischemic strokes per 100,000 nonsmoking, normotensive women using low-estrogen OCs, or 1 additional ischemic stroke per year per 24,000 such women. The RR of stroke due to OC use was not different in women who smoked, had migraines, or had hypertension.Summary results indicate that risk of ischemic stroke is increased in current OC users, even with newer low-estrogen preparations. However, the absolute increase in stroke risk is expected to be small since incidence is very low in this population. JAMA. 2000;284:72-78
Les actions psychothérapiques des équipes soignantes des cliniques universitaires médico-psychologiques de la Fondation Santé des Etudiants de France
Authors: J.L. Auber, H. Danon-Boileau
Journal: Psychotherapy and Psychosomatics (1972)

The Medical-Psychological University Clinics of the S. E. F. (French Student Health) Foundation only treat students with mental illnesses. They have a double leaning, nursing and teaching, thanks to the collaboration of skilled technicians who must coordinate their activities through the working of a team and in an institutional body that must be permanently available. After a period of adaptation of the patient to the institution, every team member uses his own methods which are aimed at readapting the student-patient to a normal social life through his University course. To be effective, this work of readapting needs a break down of counter-transferential standing points of every member in the nursing team through a permanent dialogue.
Detoxification of hydrogen sulfide and methanethiol in the cecal mucosa
Authors: Michael D. Levitt, Julie Furne, John Springfield, Fabrizis Suarez, Eugene DeMaster
Journal: Journal of Clinical Investigation (1999)

Colonic bacteria liberate large quantities of the highly toxic gases hydrogen sulfide (H2S) and methanethiol (CH3SH). The colonic mucosa presumably has an efficient means of detoxifying these compounds, which is thought to occur through methylation of H2S to CH3SH and CH3SH to dimethylsulfide (CH3SCH3). We investigated this detoxification pathway by incubating rat cecal mucosal homogenates with gas containing H2S, CH3SH, or CH3SCH3. Neither CH3SH nor CH3SCH3 was produced during H2S catabolism, whereas catabolism of CH3SH liberated H2S but not CH3SCH3. Thus, H2S and CH3SH are not detoxified by methylation to CH3SCH3. Rather, CH3SH is demethylated to H2S, and H2S is converted to nonvolatile metabolites. HPLC analysis of the homogenate showed the metabolite to be primarily thiosulfate. Analysis of cecal venous blood obtained after intracecal instillation of H235S revealed that virtually all absorbed H2S had been oxidized to thiosulfate. The oxidation rate of H2S by colonic mucosa was 10,000 times greater than the reported methylation rate. Conversion to thiosulfate appears to be the mechanism whereby the cecal mucosa protects itself from the injurious effects of H2S and CH3SH, and defects in this detoxification possibly could play a role in colonic diseases such as ulcerative colitis.
Extensive transmission of Mycobacterium tuberculosis from 9 year old child with pulmonary tuberculosis and negative sputum smear
Authors: S Paranjothy, M Eisenhut, M Lilley, S Bracebridge, I Abubakar, R Mulla, K Lack, D Chalkley, J Howard, S Thomas, M McEvoy
Journal: BMJ (2008)

A negative sputum smear does not exclude substantial risk of infection from patients with pulmonary tuberculosis
US breast cancer mortality is consistent with European data
Authors: A. Bleyer
Journal: BMJ (2011)

According to Autier and colleagues,1 little of the decline in the breast cancer death rate in northern Europe can be attributed to screening mammography. Similar concerns in the United States led its Preventive Services Task Force to endorse the elimination of routine screening in women younger than 50 and the reduction of screening from every year to every two years in …