tbuckley/cabot-search huggingface dataset:
Role of streptokinase in the treatment of acute loculated parapneumonic pleural effusions and empyema.
Authors: D Bouros, S Schiza, P Panagou, J Drositis, N Siafakas
Journal: Thorax (1994)

BACKGROUND--Intrapleural administration of streptokinase has been shown in a few small series to be effective treatment for complicated parapneumonic effusions and pleural empyemas, but techniques of instillation of streptokinase differ. The role of streptokinase in promoting drainage was investigated prospectively in a larger series of patients with complicated parapneumonic effusions and pleural empyemas. METHODS--Twenty consecutive patients with parapneumonic effusions, 15 with complicated parapneumonic effusions and five with pleural empyemas, drawn from 160 patients presenting with pleural effusions were studied. The age of the patients ranged from 15 to 92 years. Initial thoracocentesis showed mean (SD) values of pH 7.1 (0.15), glucose 45.9 (17.5) mg/dl, white blood cell count 12,000 (6627)/mm3. Streptokinase was administered intrapleurally in a single daily dose of 250,000 units in 100 ml normal saline via the chest tube once the drainage was &lt; 100 ml/24 hours. Patients were treated for 3-10 (mean 6) days. RESULTS--Following administration of streptokinase a clinical and radiological improvement was noted in all but one patient who died on the fourth day of hospitalisation due to widespread adenocarcinoma. Another patient with clinical but minimal radiological improvement underwent thoracotomy, but a clear pleural space with only fibrotic changes was found. The mean (SD) volume of fluid drained 24 hours before streptokinase was 42.5 (39) ml, which increased in the first 24 hours after streptokinase to 334 (130) ml. Radiological evaluation showed an excellent improvement in 14 of the 20 patients, a moderate improvement in three, and minimal improvement in the remaining three patients. One patient developed a high fever as an adverse reaction to streptokinase. All 19 patients who completed the treatment were well at follow up 6-30 months (mean 15 months) later. CONCLUSIONS--Intrapleural instillation of streptokinase is an effective and safe mode of treatment for complicated parapneumonic effusions and pleural empyemas and alleviates the need for thoracotomy.
NICE recommends screening patients for malnutrition
Authors: Lisa Hitchen
Journal: BMJ (2006)

Hospital teams, care home staff, and GPs will be expected to screen patients for malnutrition or risk of malnourishment, under new clinical guidelines for England.

The guideline on nutrition support in adults, from the National Institute for Health and Clinical Excellence (NICE), says that all patients should be screened on admission to hospital or entry to care homes or on registration with a GP.

For inpatients screening should be repeated weekly or where there is clinical concern. Staff in primary care should use opportunistic health checks, such as flu vaccination appointments, to …
A Multisite Physician's Office Laboratory Evaluation of an Immunological Method for the Measurement of HbA1c
Authors: Richard Guthrie, Richard Hellman, Charles Kilo, Charles E Hiar, Lawrence E Crowley, Belinda Childs, Robin Fisher, Mary Beth Pinson, Audrey Suttner, Christine Vittori
Journal: Diabetes Care (1992)

OBJECTIVE To evaluate the clinical performance of a new immunological HbA1c method in physicians' office laboratories. RESEARCH DESIGN AND METHODS Three physicians' offices participated in the evaluations. The clinicians routinely use HbA1c test results to monitor their patients' long-term blood glucose control. Precision and interlaboratory variability were assessed using three levels of lyophilized controls. Correlation of the method's results to currently available laboratory methods was made. Comparison of finger-stick (capillary) results to venous EDTA whole blood results was made on 134 patients. Physician and laboratory personnel input was evaluated with regard to the clinical utility of the system. RESULTS The CVW and CVB were a maximum of 4.5 and 4.4% for the immunoassay system on three levels of control materials at the three sites. Interlaboratory variability among the control means was found to be 4.9–5.4, 8.0–8.3, and 11.7–12.0% HbA1c. Correlation coefficients (r) ranged from 0.95 to 0.99. There was a positive bias by the DCA 2000 compared with the in-house method at site 1. Minimal negative biases were seen by the DCA 2000 with comparative methods used at sites 2 and 3. Median percentage differences with the comparative methods were 12, −1.4, and −5.6%. Comparison of capillary to venous sample results, from the DCA 2000, showed no clinically significant differences. Operator and physician feedback were positive with respect to technical ease in performance of the test and accuracy of results. CONCLUSIONS Precision was acceptable and interlaboratory variability was low. The immunological method correlated well with manual ion-exchange and automated HPLC methods. The small sample size and good comparison between capillary and venous sample results make fingerstick sampling acceptable. The method provided immediate test results (within 9 min) to the clinicians.
Altered blood pressure responses and normal cardiac phenotype in ACE2-null mice
Authors: Susan B. Gurley, Alicia Allred, Thu H. Le, Robert Griffiths, Lan Mao, Nisha Philip, Timothy A. Haystead, Mary Donoghue, Roger E. Breitbart, Susan L. Acton, Howard A. Rockman, Thomas M. Coffman
Journal: Journal of Clinical Investigation (2006)

The carboxypeptidase ACE2 is a homologue of angiotensin-converting enzyme (ACE). To clarify the physiological roles of ACE2, we generated mice with targeted disruption of the Ace2 gene. ACE2-deficient mice were viable, fertile, and lacked any gross structural abnormalities. We found normal cardiac dimensions and function in ACE2-deficient animals with mixed or inbred genetic backgrounds. On the C57BL/6 background, ACE2 deficiency was associated with a modest increase in blood pressure, whereas the absence of ACE2 had no effect on baseline blood pressures in 129/SvEv mice. After acute Ang II infusion, plasma concentrations of Ang II increased almost 3-fold higher in ACE2-deficient mice than in controls. In a model of Ang II–dependent hypertension, blood pressures were substantially higher in the ACE2-deficient mice than in WT. Severe hypertension in ACE2-deficient mice was associated with exaggerated accumulation of Ang II in the kidney, as determined by MALDI-TOF mass spectrometry. Although the absence of functional ACE2 causes enhanced susceptibility to Ang II–induced hypertension, we found no evidence for a role of ACE2 in the regulation of cardiac structure or function. Our data suggest that ACE2 is a functional component of the renin-angiotensin system, metabolizing Ang II and thereby contributing to regulation of blood pressure.
Mechanisms of acute lumen gain and recurrent restenosis after rotational atherectomy of diffuse in-stent restenosis
Authors: Peter W Radke, Heinrich G Klues, Philipp K Haager, Rainer Hoffmann, Frank Kastrau, Thorsten Reffelmann, Uwe Janssens, Juergen vom Dahl, Peter Hanrath
Journal: Journal of the American College of Cardiology (1999)
Endoscopic Polypectomy of Large Pedunculated Gastric Polyps Using a New, Safe, and Effective Technique
Authors: A. Tursi, G. Brandimarte
Journal: Endoscopy (2002)

We have recently developed a new technique to treat endoscopically large colorectal polyps, which combines excellent results with absence of complications [1]. Since the management of large gastric polyps is still debated, we tried to also apply our technique to the treatment of large gastric polyps.
Common and rare von Willebrand factor (VWF) coding variants, VWF levels, and factor VIII levels in African Americans: the NHLBI Exome Sequencing Project
Authors: Jill M. Johnsen, Paul L. Auer, Alanna C. Morrison, Shuo Jiao, Peng Wei, Jeffrey Haessler, Keolu Fox, Sean R. McGee, Joshua D. Smith, Christopher S. Carlson, Nicholas Smith, Eric Boerwinkle, Charles Kooperberg, Deborah A. Nickerson, Stephen S. Rich, David Green, Ulrike Peters, Mary Cushman, Alex P. Reiner
Journal: Blood (2013)
491 COMPARISON OF MELD SCORE TO THREE MODEL FOR END-STAGE LIVER DISEASE INCLUDING SERUM SODIUM IN PREDICTING MORTALITY IN PATIENTS WITH CIRRHOSIS
Authors: A.R. Schmal, R.D.M. Perez, R.R. Luiz, S.T. Basto, F.L. Calcado, A.L.M. Torres, L.B. Victor, A.B. Pinto, J. Ribeiro, H.S.M. Coelho, C.A. Villela-Nogueira
Journal: Journal of Hepatology (2010)
Increasing empathy between medical students and nurses
Authors: H. G Sheth, R. Mallipedi
Journal: BMJ (1997)

Editor–As senior medical students we were most interested to read the recent letter from Siklos and Kennedy1 discussing the relationship between doctors and nursing staff and the need for a two day nursing placement for medical students, and also J Hughes' letter of a similar nature.2

The authors are keen to extol the …
Prostaglandin E <sub>2</sub> Inhibits Elastogenesis in the Ductus Arteriosus via EP4 Signaling
Authors: Utako Yokoyama, Susumu Minamisawa, Aki Shioda, Ryo Ishiwata, Mei-Hua Jin, Munetaka Masuda, Toshihide Asou, Yukihiko Sugimoto, Hiroki Aoki, Tomoyuki Nakamura, Yoshihiro Ishikawa
Journal: Circulation (2013)

Background— Elastic fiber formation begins in mid-gestation and increases dramatically during the last trimester in the great arteries, providing elasticity and thus preventing vascular wall structure collapse. However, the ductus arteriosus (DA), a fetal bypass artery between the aorta and pulmonary artery, exhibits lower levels of elastic fiber formation, which promotes vascular collapse and subsequent closure of the DA after birth. The molecular mechanisms for this inhibited elastogenesis in the DA, which is necessary for the establishment of adult circulation, remain largely unknown. Methods and Results— Stimulation of the prostaglandin E 2 (PGE 2 ) receptor EP4 significantly inhibited elastogenesis and decreased lysyl oxidase (LOX) protein, which catalyzes elastin cross-links in DA smooth muscle cells (SMCs), but not in aortic SMCs. Aortic SMCs expressed much less EP4 than DASMCs. Adenovirus-mediated overexpression of LOX restored the EP4-mediated inhibition of elastogenesis in DASMCs. In EP4-knockout mice, electron microscopic examination showed that the DA acquired an elastic phenotype that was similar to the neighboring aorta. More importantly, human DA and aorta tissues from 7 patients showed a negative correlation between elastic fiber formation and EP4 expression, as well as between EP4 and LOX expression. The PGE 2 -EP4-c-Src-phospholipase C (PLC)γ–signaling pathway most likely promoted the lysosomal degradation of LOX. Conclusions— Our data suggest that PGE 2 signaling inhibits elastogenesis in the DA, but not in the aorta, through degrading LOX protein. Elastogenesis is spatially regulated by PGE 2 -EP4 signaling in the DA.
Chronic Users of LSD: The "Acidheads"
Authors: K. H. BLACKER, REESE T. JONES, GEORGE C. STONE, DOLF PFEFFERBAUM
Journal: American Journal of Psychiatry (1968)

Twenty-one paid volunteers who were chronic users of LSD were interviewed and participated in a series of cognitive and perceptual tests and EEG studies. Among other observations derived from both interviews and testing, the authors noted that the group shared a set of magical-mystical beliefs and profound nonaggressive attitudes, as well as a unique sensitivity to certain types of sensory stimulation. The authors suggest that the beliefs and attitudes of the group may have arisen as learned consequences of frequent, intense LSD experiences in susceptible individuals.
Macroglobulins Provoking Haemagglutination in Rheumatoid Arthritis and Other Diseases
Authors: John H. Talbott
Journal: JAMA (1971)

Nanna Svartz, internationally known rheumatologist, recently retired from the King Gustaf V Research Institute in Stockholm, has prepared a monograph that summarizes her studies that have been in progress during the past decade, together with an extensive review of the world literature. The interest of the globulins in rheumatoid arthritis (RA) began with the sheep-cell test in the diagnosis of RA and continued on with the recognition that the rheumatoid factor (RF) could be classified among the γ1-globulins or heavy γ-globulins. Later these were further identified as macroglobulins, which includes all high molecular globulins. The investigations of the RF by Svartz and many others have included measurements of the molecular weight, the carbohydrate content, the amino acid content, and N-terminal acids, metabolic studies after labelling with iodine 125, immunoelectrophoresis, and use of the RF as an antigen as well as an antibody.  It seems especially appropriate that a
Crossing the Omic Chasm
Authors: Justin Starren, Marc S. Williams, Erwin P. Bottinger
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
Effects of pioglitazone on serum fetuin-A levels in patients with type 2 diabetes mellitus
Authors: Katsuhito Mori, Masanori Emoto, Takahiro Araki, Hisayo Yokoyama, Eiko Lee, Megumi Teramura, Hidenori Koyama, Tetsuo Shoji, Masaaki Inaba, Yoshiki Nishizawa
Journal: Metabolism (2008)
Non-heart beating donors as a source of kidneys
Authors: A J Wing, R W S Chang
Journal: BMJ (1994)

In 1981, 814 cadaveric renal grafts were given to patients in the United Kingdom, a rate of 14.2 per million population. By 1989 the rate had more than doubled to 30.1 per million population, or 1728 cadaveric grafts. However, no further increase was recorded in the next three years, in which 1735, 1628, and 1640 cadaveric renal grafts were reported to the United Kingdom Transplant Support Service Authority. At the end of each of these three years the numbers of patients on the authority's waiting list for the United Kingdom were 3666, 3960, and 4361 - an average annual growth approaching 10%.1 For these patients who are waiting and for the transplant teams eager to help them the mood is approaching desperation.

Most organ donations come from patients on ventilatory support in intensive care units and in whom the criteria of brainstem death have been confirmed according to the rules laid down by the royal colleges.2 Such patients are the best source of cadaveric organs for transplantation, which are associated with a graft survival at one year of over …
Randomised trial of artesunate and mefloquine alone and in sequence for acute uncomplicated falciparum malaria
Authors: S. Looareesuwan, C. Viravan, S. Vanijanonta, P. Wilairatana, P. Suntharasamai, P. Charoenlarp, K. Arnold, D. Kyle, K. Webster, C. Canfield
Journal: The Lancet (1992)
Serum Type IV Collagen in Diabetic Patients at Risk for Nephropathy
Authors: Margo P. Cohen, Clyde W. Shearman, Gregory T. Lautenslager
Journal: Diabetes Care (2001)

OBJECTIVE—Whereas increased urinary excretion of type IV collagen, which is believed to reflect renal overproduction of this extracellular matrix protein in early diabetic nephropathy, has been confirmed in several studies, examination of serum concentrations of this analyte has yielded conflicting results. We sought to clarify the relationship between early renal dysfunction in diabetes and circulating type IV collagen concentrations. RESEARCH DESIGN AND METHODS—We measured serum (human) collagen IV concentrations by immunoassay in 109 patients with type 1 or type 2 diabetes and various amounts of albuminuria extending from the normo- to the macroalbuminuric range, and we examined its relationship to albumin excretion and to serum creatinine levels. RESULTS—Serum collagen IV concentrations (mean ± SEM) were not significantly different in normoalbuminuric (219 ± 10 ng/ml), microalbuminuric (209 ± 6 ng/ml), or macroalbuminuric (206 ± 7 ng/ml) diabetic subjects or in nondiabetic normal volunteers (206 ± 10 ng/ml). Collagen IV concentrations showed no significant correlation (P &amp;gt; 0.25) with albumin excretion (r = −0.001), HbA1c (r = 0.030), or serum creatinine (r = −0.161) and were unrelated to urinary excretion of collagen IV in the subset of subjects in whom these data were available. CONCLUSIONS—The results of this cross-sectional analysis discount the utility of measurement of the serum concentration of collagen IV as an indicator of early renal dysfunction in diabetes. Increased urine excretion of collagen IV without a significant change in the serum concentration is consistent with a renal origin of this analyte in early diabetic nephropathy.
Association of Helicobacter pyloriinfection with systemic inflammation and endothelial dysfunction in healthy male subjects
Authors: Tetsuya Oshima, Ryoji Ozono, Yoko Yano, Yoshihiko Oishi, Hiroki Teragawa, Yukihito Higashi, Masao Yoshizumi, Masayuki Kambe
Journal: Journal of the American College of Cardiology (2005)
Thyroid Irradiation — One View
Authors: Charles H. Emerson, Lewis E. Braverman
Journal: New England Journal of Medicine (1980)

Thyroid irradiation is of clinical importance in several circumstances: after administration of 131I for treatment of hyperthyroidism, after external irradiation of the head and neck for benign nonthyroid disease, after exposure of the thyroid to fallout, which contains isotopes of iodine (especially 131I), and after high-dose external irradiation to the neck for nonthyroid malignant disease. In the last situation the major complication is the late development of hypothyroidism and, far less commonly, Graves' ophthalmopathy. In 1949 Quimby and Werner were concerned that 131I therapy for hyperthyroidism might be carcinogenic.1 They used questionnaires to determine the incidence of thyroid tumors in . . .
Breast Cancer
Authors: Susan M. Love
Journal: JAMA (1993)

HOW IN the world did the Department of Defense (DOD) end up with $210 million for breast cancer research? In January 1991, women across the United States organized the National Breast Cancer Coalition, one of the most effective medical lobbying groups ever. By the spring of 1992, approximately 600 000 letters urging federal attention to the breast cancer epidemic flooded Capitol Hill. Scientific hearings established the need for additional research dollars, and the DOD became the incidental recipient of "earmarked" or "reprogrammed" money, more than doubling the previous federal funding for breast cancer research. This is just the beginning of the battle. The women and men who care about breast cancer across the country and who fought so hard for this money are very concerned that it be well spent.<sup>1</sup> Last year, the DOD was appropriated $25 million for breast cancer research. Funds were quickly expended for high-technology stereotaxic
Does testing for circulating autoantibodies against disease-relevant citrullinated antigens add value to the CCP2 assay in diagnosing RA among early undifferentiated arthritis patients?
Authors: A. G. Pratt, P. J. Charles, M. Choudhury, G. Wilson, P. J. Venables, J. D. Isaacs
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Background</h3> The antigen substrates employed in the widely-used CCP2 assay do not correspond to in vivo-generated citrullinated proteins so far implicated in the potential pathogenesis of rheumatoid arthritis (RA). We assessed the diagnostic utility of circulating autoantibodies to a panel of such peptides among undifferentiated arthritis (UA) patients, and whether permutations thereof might improve upon the diagnostic utility of CCP2 testing alone. <h3>Materials and methods</h3> UA patients presenting to the Newcastle Early Arthritis Clinic who were naïve to immunomodulatory treatment were recruited. In addition to routine testing using the CCP2 assay, baseline sera were tested for reactivity to citrullinated forms of fibrinogen (cFbg), vimentin (cVim), cyclic α enolase peptides 1 and 11 (CEP-1 and CEP-11), linear filaggrin (Fil-LC), and a panel of six citrullinated pro-filaggrin-derived peptides. Corresponding native forms of the same peptides were used as negative controls where possible, and testing for IgA and IgM rheumatoid factor (RF) was also undertaken, with assay cut-offs being determined based on healthy control populations. Clinicians were blinded to all but the CCP2 results, and follow-up was for &gt;1 year (median 28 months) Individuals for whom definitive outcome diagnosis was not reached within the study period were excluded from analysis. The 1987 American College of Rheumatology classification criteria were used for the diagnosis of RA. <h3>Results</h3> Assays were carried out for 75 newly presenting UA patients, of whom 29 (39%) developed RA.The specificity, sensitivity, positive and negative predictive values (PPV and NPV) of CCP2 with respect to an RA outcome in this cohort (95% CIs) were 0.98 (0.87-1.0), 0.48 (0.30-0.67), 0.93 (0.66-1.0) and 0.75 (0.62-0.85) respectively. No single assay evaluated displayed superior NPV over CCP2 without compromising the PPV afforded by that test. Neither did combinations of assays, considered in permutations with or without CCP2, add value to CCP2-testing alone in predicting RA. Hierarchical clustering of all assay profiles revealed cFbg reactivity to correlate most closely with CCP2 test positivity among these sera (PPV and NPV 0.80 (0.51–0.95) and 0.70 (0.56–0.81)) respectively. In general, IgM RF positivity had a NPV equivalent to that of the CCP2 test, but an inferior PPV (0.65 (0.44–0.82)), and, after the CCP test, the best assay with regards PPV for RA was found to be CEP-1 (0.83 (0.36–0.99)). <h3>Conclusions</h3> The CCP2 test remains an invaluable diagnostic tool in the assessment of UA because of its impressive PPV, but the identification of biomarkers for the diagnosis of autoantibody negative RA must remain a priority.
Role of plasma vasopressin in the impairment of water excretion in nephrotic syndrome
Authors: Mario Usberti, Stefano Federico, Sergio Meccariello, Bruno Cianciaruso, Mario Balletta, Carmine Pecoraro, Luigi Sacca, Biagio Ungaro, Nicola Pisanti, Vittorio E. Andreucci
Journal: Kidney International (1984)
Therapeutic management of DRESS: A retrospective study of 38 cases
Authors: Elisa Funck-Brentano, Tu-Anh Duong, Sophie Bouvresse, Martine Bagot, Pierre Wolkenstein, Jean-Claude Roujeau, Olivier Chosidow, Laurence Valeyrie-Allanore
Journal: Journal of the American Academy of Dermatology (2015)