tbuckley/cabot-search huggingface dataset:
CELL WALL COMPOSITION AND VIRULENCE IN ESCHERICHIA COLI
Authors: Donald N. Medearis, Bruce M. Camitta, Edward C. Heath
Journal: The Journal of Experimental Medicine (1968)

Uridine diphosphate galactose 4-epimerase and phosphomannose isomerase-deficient mutants of Escherichia coli O111:B4 were studied to test the hypothesis that in E. coli a specific relationship exists between O antigenicity, virulence, and capacity to resist phagocytosis. The first mutant, designated J-5, produces a cell wall lipopolysaccharide, the side chains of which do not contain galactose, glucose, N-acetylglucosamine, or colitose. The second mutant produces a cell wall lipopolysaccharide which lacks only colitose. The capacity of these various organisms to kill mice was strikingly different. E. coli O111 was 1000 times as virulent as J-5, and 100 times as virulent as L-2. The capacity of the organisms to kill mice was correlated with their ability to resist phagocytosis and to persist in the peritoneal cavity. The parent strain of O111 resisted phagocytosis by macrophages in vivo and polymorphonuclear leukocytes in vitro. The mutants did not, and the organism most deficient in the saccharide component of its LPS was most susceptible to phagocytosis and least virulent. These results were corroborated by growing the mutants in appropriately supplemented media which permitted the synthesis of complete LPS, reversed the susceptibility to phagocytosis, and restored virulence. Finally, serological reactivity was consistent with previous observations which had demonstrated that the O antigenicity of E. coli is determined by the saccharide composition of its cell wall lipopolysaccharide. Despite the difference in the capacity of the various log-phase organisms to kill mice when injected intraperitoneally, purified lipopolysaccharides extracted from them did not differ significantly in their capacity to kill or produce fever. Thus virulence was shown to be independent of endotoxin activity which in turn seemed to be unrelated to the saccharide composition of the cell wall LPS. Collectively, these data provide at least a partial molecular definition of virulence in E. coli by demonstrating that the presence or absence of specific sugars in its cell wall lipopolysaccharide is a determinant of its antiphagocytic capacity and its virulence.
Short, Black, Baird, Himsworth, and social class differences in fetal and neonatal mortality rates.
Authors: I Chalmers
Journal: BMJ (1985)

Purified recombinant proteins and peptides, which are currently under development in various anti-cancer vaccination approaches, lack sufficient immunogenicity. Therefore, potent adjuvants are needed to induce strong and persistent anti-tumor immunity. However, currently only few adjuvants are licensed, most of which primarily enhance antibody, but not T cell responses. Here, we demonstrate that a novel, well defined, and thoroughly characterized RNA-based adjuvant mediates balanced and long-lasting humoral and cellular immune responses. Our adjuvant significantly enhances anti-tumor immunity, and even complete tumor rejection can be achieved as shown for the syngeneic TC-1 tumor model, a murine model of human HPV-induced cervical cancer. Our adjuvant acts locally, promoting strong but transient up-regulation of anti-viral and pro-inflammatory cytokines, CXCR3-ligands and cytoplasmic RNA sensors at the injection site, avoiding any systemic cytokine release. A phase I first in man clinical trial testing different doses of RNAdjuvant<sup>®</sup> alone and in combination with reduced doses of the licensed rabies vaccine Rabipur<sup>®</sup> was successfully conducted in 43 subjects. Healthy volunteers received 2 intramuscular injections of RNAdjuvant<sup>®</sup> on days 0 and 21, either alone or in combination with 1/20 or 1/10 of the licensed Rabipur<sup>®</sup> dose. Virus neutralizing antibody titers (VNTs) measured on days 14 and 28 revealed a significant increase in median VNTs in subjects with RNAdjuvant<sup>®</sup> compared to their respective control group with 1/10 dose Rabipur<sup>®</sup> alone. In summary, our data suggest that RNAdjuvant<sup>®</sup> represents a novel, highly efficacious adjuvant candidate that can enhance cellular and humoral immune responses.
Liver Biopsy and Radioisotope Scans
Authors: Robert D. Wilber
Journal: JAMA (1968)

<h3>To the Editor:—</h3> We would agree with Dr. Baum that a liver scan may in some instances be of value in demonstrating metastatic nodules. Perhaps the method can increase the positive yield from needle biopsy in metastatic hepatic disease. Recently an objective critique of the hepatic scan has been published.<sup>1</sup>When controlled studies in metastatic hepatic disease as suggested in this critique have demonstrated the value of hepatic scintillography we shall welcome the procedure as a proved adjunct to biopsy of metastatic nodules.
Reduced sexual desire in women
Authors: P S Arunakumari, S Walker
Journal: BMJ (2009)

A 44 year old woman comes to see you because she is “never in the mood.” She has been married for eight years, works as a sales assistant, and is healthy.

Define reduced sexual desire —The Diagnostic and Statistical Manual of Mental Disorders , fourth edition (DSM-IV), defines hypoactive sexual desire as a deficiency or absence of sexual desire or fantasy causing personal distress, interpersonal difficulty, or both. Explore exactly what she means by never being in the mood. Does she initiate sex? What kind of sexual contact is she having (or not)?

Causes —These can be psychological (most cases) or physical, although they often overlap. Relationship problems (unexpressed negative feelings about the partner, extramarital affairs), motivational problems (fear of loss of femininity, loss of reproductive potential), cognitive problems (low self image and self esteem), family problems (“empty nest” syndrome), and life stresses (retirement, financial worries) are common associations. Physical causes can be systemic (anaemia, …
Reverse redistribution of thallium-201: A sign of nontransmural myocardial infarction with patency of the infarct-related coronary artery
Authors: A. Teddy Weiss, Jamshid Maddahi, Allan S. Lew, P.K. Shah, William Ganz, H.J.C. Swan, Daniels. Berman
Journal: Journal of the American College of Cardiology (1986)
Points from Letters: Think Again on Salmon
Authors: J. C. Linley-Adams
Journal: BMJ (1974)

poem.I was particularly interested as there is a current neglect of medals as a source of medical history.May I make some observations on the medal itself?The object under the lancet on the reverse is a vaccine point, perhaps of ivory, on which the material, fresh or dry, would be conveyed to the scarified area.Ampoules were not used for biological material until sterilization was understood.Incidentally, the goddess has a bandage round her left arm as though she had been recently vaccinated, surely a work of supererogation. . Schonlein versus Henoch
Obesity Paradox Does Exist
Authors: Vojtech Hainer, Irena Aldhoon-Hainerová
Journal: Diabetes Care (2013)

Adipose tissue has been shown to be a pivotal organ in the aging process and in the determination of life span. Owing to the rising prevalence of obesity, especially at younger ages, a potential decline in life expectancy is expected in the U.S. in the 21st century. Obesity, and mainly its abdominal form, is considered a major risk factor not only for type 2 diabetes, lipid disorders, and hypertension but also for coronary heart disease and certain cancers. In epidemiological studies, BMI, an indicator of relative weight for height (weight in kilograms divided by the square of height in meters) is frequently used as a surrogate for assessment of excess body fat. For characterization of the relative risks (RRs) of mortality and morbidity, the rates in underweight (BMI  40 kg/m2) are compared with those in normal-weight subjects (18.5 to <25 kg/m2). A plot of the RR of mortality against BMI follows a U-shaped, or J-shaped, curve with the minimum mortality close to a BMI of 25 kg/m2. Mortality increases as BMI increases above 25 kg/m2 and as BMI decreases below 25 kg/m2 (1). During the past decade, there is increasing evidence that patients, especially elderly, with several chronic diseases and elevated BMI may demonstrate lower all-cause and cardiovascular mortality compared with patients of normal weight. This article summarizes some of these paradoxical findings known as the “obesity paradox” and discusses potential causes of its manifestation.

### Obesity paradox in overweight and obese patients with coronary heart disease

Ten years ago, Gruberg and coworkers observed better outcomes in overweight and obese patients with coronary heart disease undergoing percutaneous coronary intervention compared with their normal-weight counterparts. This unexpected …
Preemployment Drug Screening and Employment Outcome-Reply
Authors: James Ryan
Journal: JAMA (1991)

In Reply.—  We agree with Dr Sidney that our study did not control for a potential confounder, alcohol abuse. However, this does not necessarily make it highly likely that alcohol abuse was an important  in our population. For example, cigarette smoking, like alcohol abuse, is associated with both drug abuse and adverse employment outcomes, but it was not an important confounder in our data set.  Parish and Dane's suggestion to use a hierarchical approach to model fitting would succeed only in producing a P value (not a relative risk) for the significance of drug category after removing all other possible explanatory covariates. For confounding covariates, the effect would be attributed primarily to the other covariates, rather than to drug effect. We believed that hierarchical modeling would be viewed here as a ploy to minimize the apparent impact of drug testing. Instead, we used all our preidentified covariates to predict
Interleukin 3 perfusion prevents death due to acute anemia induced by monoclonal antierythrocyte autoantibody.
Authors: T Shibata, V Kindler, Y Chicheportiche, P Vassalli, S Izui
Journal: The Journal of Experimental Medicine (1990)

We have evaluated the therapeutic activity of rIL-3, in comparison with recombinant granulocyte-macrophage CSF (rGM-CSF) and recombinant erythropoietin (rEpo), on a lethal form of acute anemia induced by a single injection of a monoclonal IgG1 anti-mouse RBC (MRBC) autoantibody. Continuous perfusion of rIL-3 before the administration of anti-MRBC mAb prevented animals from the death due to anemia with a rapid recovery in greater than 90% of the cases, while only partial protection (one third of the cases) was obtained by rEpo perfusion, and no protection by rGM-CSF. Since the anti-MRBC mAb induced a marked agglutination of RBC in spleens and livers, and subsequent hemodynamic failure may be an additional contributing factor to the animals' death, the activation of Fc gamma receptor-dependent phagocytosis by rIL-3, as well as the increased number of monocytes/macrophages resulting from rIL-3 perfusion, may also facilitate rapid elimination of these agglutinated RBC, resulting in the further amelioration of the animals' survival. Our results suggest that the therapeutic effect of rIL-3 on anti-MRBC autoantibody-induced anemia is achieved by: (a) its activity to promote the growth and differentiation of erythroid progenitors responsive to Epo and of monocyte/macrophage lineage; and (b) its activity to enhance the phagocytic activity of macrophages to efficiently eliminate agglutinated RBC in spleens and livers.
Hyperreactive Platelets and Complications of Coronary Artery Disease
Authors: Jack Hirsh
Journal: New England Journal of Medicine (1987)

Several lines of evidence point to an important role for platelets in the pathogenesis of sudden death, acute myocardial infarction, and unstable angina.1 These acute coronary events usually occur on a background of advanced coronary atherosclerosis. Observations made at autopsy,2 by angiography,1 and by angioscopy3 suggest that these acute coronary events are precipitated by rupture of an atherosclerotic plaque, which exposes platelets and other blood elements to reactive components, such as collagen, in the depths of the plaque. These interactions result in the adhesion of platelets to the exposed subendothelium and the release by platelets of chemical mediators that induce . . .
Post-Hospital Syndrome — An Acquired, Transient Condition of Generalized Risk
Authors: Harlan M Krumholz
Journal: New England Journal of Medicine (2013)

Interview with Dr. Harlan Krumholz on a condition of generalized risk after patients are discharged from the hospital. (17:28)Download Patients who were recently hospitalized experience a period of generalized risk for myriad adverse health events. Their condition may be characterized as a post-hospital syndrome, an acquired condition of vulnerability not necessarily linked to the original illness.
Preoperative Chemotherapy: Updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27
Authors: Priya Rastogi, Stewart J. Anderson, Harry D. Bear, Charles E. Geyer, Morton S. Kahlenberg, André Robidoux, Richard G. Margolese, James L. Hoehn, Victor G. Vogel, Shaker R. Dakhil, Deimante Tamkus, Karen M. King, Eduardo R. Pajon, Mary Johanna Wright, Jean Robert, Soonmyung Paik, Eleftherios P. Mamounas, Norman Wolmark
Journal: Journal of Clinical Oncology (2008)

National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol B-18 was designed to determine whether four cycles of doxorubicin and cyclophosphamide (AC) administered preoperatively improved breast cancer disease-free survival (DFS) and overall survival (OS) compared with AC administered postoperatively. Protocol B-27 was designed to determine the effect of adding docetaxel (T) to preoperative AC on tumor response rates, DFS, and OS.Analyses were limited to eligible patients. In B-18, 751 patients were assigned to receive preoperative AC, and 742 patients were assigned to receive postoperative AC. In B-27, 784 patients were assigned to receive preoperative AC followed by surgery, 783 patients were assigned to AC followed by T and surgery, and 777 patients were assigned to AC followed by surgery and then T.Results from B-18 show no statistically significant differences in DFS and OS between the two groups. However, there were trends in favor of preoperative chemotherapy for DFS and OS in women less than 50 years old (hazard ratio [HR] = 0.85, P = .09 for DFS; HR = 0.81, P = .06 for OS). DFS conditional on being event free for 5 years also demonstrated a strong trend in favor of the preoperative group (HR = 0.81, P = .053). Protocol B-27 results demonstrated that the addition of T to AC did not significantly impact DFS or OS. Preoperative T added to AC significantly increased the proportion of patients having pathologic complete responses (pCRs) compared with preoperative AC alone (26% v 13%, respectively; P < .0001). In both studies, patients who achieved a pCR continue to have significantly superior DFS and OS outcomes compared with patients who did not.B-18 and B-27 demonstrate that preoperative therapy is equivalent to adjuvant therapy. B-27 also showed that the addition of preoperative taxanes to AC improves response.
Le rendezvous des chats
Authors: M. Therese Southgate
Journal: JAMA (2007)

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
Treatment of Myasthenia Gravis
Authors: Werner Flacke
Journal: New England Journal of Medicine (1973)

THE therapy of myasthenia gravis is one of the more challenging but often also one of the most rewarding forms of drug therapy encountered by the physician. Myasthenia is a chronic disease characterized by skeletal-muscle weakness that may range in severity from slight depression of maximal strength to complete motor failure. These extremes of functional impairment may be seen at different times in the same patient. Any muscle may be affected. Thus, the functional impairment ranges from slight ptosis to complete respiratory failure. The course of the disease is highly variable, and prognosis is uncertain. The goal of drug therapy . . .
Safe vaccination of patients with egg allergy with an adjuvanted pandemic H1N1 vaccine
Authors: Remi Gagnon, Marie Noel Primeau, Anne Des Roches, Chantal Lemire, Rhoda Kagan, Stuart Carr, Manale Ouakki, Mélanie Benoît, Gaston De Serres
Journal: Journal of Allergy and Clinical Immunology (2010)
Decline in Neurophysiological Function After 7 Years in an Adolescent Diabetic Cohort and the Role of Aldose Reductase Gene Polymorphisms
Authors: Keerthi Thamotharampillai, Albert K.F. Chan, Bruce Bennetts, Maria E. Craig, Janine Cusumano, Martin Silink, Peter J. Oates, Kim C. Donaghue
Journal: Diabetes Care (2006)

This 7-year longitudinal study examines the potential impact of aldose reductase gene (AKR1B1) polymorphisms on the decline of nerve function in an adolescent diabetic cohort.Patients with type 1 diabetes (n = 262) were assessed with three cardiovascular autonomic tests (heart rate variation during deep breathing, Valsalva maneuver, and during standing from a lying position) and pupillometry (resting pupil diameter, constriction velocity, and reflex amplitude), thermal, and vibration thresholds on the foot. Genotyping was performed for promoters (C-106T and C-12G), (CA)(n) dinucleotide repeats, and intragenic BamH1 polymorphism.Median time between first and last assessment was 7.0 years (interquartile range 5.1-11.1), with a median of five assessments (four to seven) per individual. At first assessment, median age was 12.7 years (11.7-13.9), median duration was 5.3 years (3.4-8.0), and median HbA(1c) was 8.5% (7.8-9.3). All tests declined over time except for two cardiovascular autonomic tests and vibration discrimination. Faster decline in maximum constriction velocity was found to associate with the Z-2 allele (P = 0.045), Z-2/Z-2 (P = 0.026). Slower decline in hot thermal threshold discrimination associated with Z+2 (P = 0.044), Z+2/Z+2 (P < 0.0005), Z+2/T (P = 0.038), and bb (P = 0.0001).Most autonomic and quantitative sensory nerve testings declined over time. AKR1B1 polymorphisms were strongly associated with the rate of decline of these complications.
Obstetric complications and schizophrenia: Authors' reply
Authors: E. O'Callaghan, T. Gibson, H. A Colohan, P. Buckley, D. G Walshe, C. Larkin
Journal: BMJ (1993)

Obstetric complications and schizophrenia EDITOR,-We are concerned that the association between obstetric complications and risk of schizophrenia, as described by Eadbhard O'Callaghan and colleagues, has been arrived at without due reference to the problems associated with a definition of fetal compromise during pregnancy and labour.'Their findings in relation to fetal distress, which was the single complication noted to occur in excess in the schizophrenic group (five patients), are worthy of mention.Fetal distress was deemed to have occurred if it had been recorded as an opinion in the case notes (by presumably the attending midwife or doctor).The authors proceed to state that "fetal distress is a leading predictor of postnatal outcome" and that "there is obstetric opinion that fetal distress generally indicates oxygen deprivation."The situation is, however, that there is no single measurement, or set of measurements, for consistently qualifying an asphyxial insult in the perinatal period and relating it to postnatal outcome.So called fetal distress is often very difficult to diagnose and even with modern tech- nological advances its classification and inter- pretation are subject to considerable interobserver variation, even among experienced obstetricians.2It has long been recommended that we should no longer accept the term fetal distress as a sufficient decription of fetal condition.'All tests of fetal wellbeing have several common characteristics.A reassuring result is a predictor of adequate fetal oxygenation but an abnormal result is a poor predictor of fetal asphyxia.Sensitivity is typically less than 50% and the false abnormal rate greater than 90%.4We appreciate the limitations of retrospective data collection of 20-40 years ago but the basis of the description fetal distress is clearly unknown.A study utilising more clearly defined tests of fetal wellbeing, which have been in use for more than 20 years now, may provide a more reliable basis for investigation.
P39 Pulmonary Hypertension (PH) associated with lung disease/ hypoxia
Authors: J. Hurdman, R. A. Condliffe, C. A. Elliot, I. Sabroe, D. G. Kiely
Journal: Thorax (2010)

Background Mild elevation in pulmonary artery pressure (PAP) is common in patients with lung disease. In COPD, 2 groups are defined; PH proportionate to degree of underlying lung disease and PH out of proportion (mPAP ≥ 40 mm Hg) occurring in a minority. Aim To characterise survival and prognostic factors in patients with PH associated with lung disease. Methods Single centre retrospective review of cardiac catheters performed 2001–2010 identified incident cases of PH associated with lung disease. Results 155 patients had a primary diagnosis of PH associated with lung disease, 96 with COPD (57 PH out of proportion to COPD, 39 PH proportionate to COPD), 31 PH in interstitial lung disease (PH-ILD) and 28 PH with sleep disordered breathing / alveolar hypoventilation. Survival is shown in [Abstract P39 Figure 1][1]. Right heart pressures were most raised in patients with PH out of proportion to COPD compared to PH-ILD and PH in proportion to COPD with mRAP 12.3, 8.5 and 8.2 mm Hg (p<0.05) and mPAP 49.4, 38.6 and 32.3 mm Hg (p<0.01) respectively. In patients with PH associated with sleep disordered breathing/alveolar hypoventilation mRAP was 11.6 and mPAP 37.8 mm Hg. Cardiac index and PVR were similar in PH out of proportion to COPD and PH-ILD but markedly reduced in both groups when compared to PH in proportion to COPD (p<0.01). Baseline shuttle walking distance was most reduced in PH out of proportion to COPD with mean 67 m compared to 133 m in PH-ILD and 156 m in PH in proportion to COPD (p<0.05). In COPD, airflow obstruction was less severe in patients with out of proportion PH than COPD with proportionate PH (FEV1 63% vs 51% respectively) but TLCO was more severely affected (26% vs 38%). ![Abstract P39 Figure 1][2]</img> Abstract P39 Figure 1 Cumulative survival from diagnosis in patients with pulmonary hypertension associated with respiratory disease. Conclusions The survival of patients with PH in association with lung disease is dependent on the underlying aetiology. Whereas patients with PH associated with sleep disordered breathing/alveolar hypoventilation have a good prognosis, patients with PH in the setting of ILD and PH out of proportion to COPD have a poor prognosis. [1]: #F1 [2]: pending:yes