tbuckley/cabot-search huggingface dataset:
Surgeons and Internists
Authors: Christine S. Hunter
Journal: Annals of Internal Medicine (1994)

Letters15 April 1994Surgeons and InternistsChristine S. Hunter, MDChristine S. Hunter, MDCommander, U.S. Navy Medical Corps; Naval Medical Center; San Diego, CA 92134Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-8-199404150-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As another medical oncologist with a special interest in breast cancer, I can empathize with Dr. Susan Rosenthal's “Parable of the Surgeon and the Internist” [1]. Patients diagnosed with breast cancer must be educated about and participate in decisions regarding treatment options during a most trying period in their lives. Surgeons, medical oncologists, and radiation oncologists must all possess outstanding communication skills and should consider themselves partners in this effort if progress against breast cancer is to be made.Unfortunately, the literature on adjuvant treatment of breast cancer is voluminous. Legitimate differences regarding the management of individual ...REFERENCE1. Rosenthal S. Parable of the surgeon and the internist. Ann Intern Med. 1993; 119:950. Google Scholar Author, Article, and Disclosure InformationAuthors: Christine S. Hunter, MDAffiliations: Commander, U.S. Navy Medical Corps; Naval Medical Center; San Diego, CA 92134 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 1994Volume 120, Issue 8Page: 696-697KeywordsBreast cancerCancer treatmentSurgeonsSurgery ePublished: 15 August 2000 Issue Published: 15 April 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Participatory approach works
Authors: Anne MacFarlane, Mary O’Reilly-de Brún, Tomas de Brún
Journal: BMJ (2008)

Fudge et al report that users were not involved in defining categories or criteria for their involvement in the stroke programme on which this published ethnography is based.1 

In our experience, user involvement, and research about user involvement, requires and benefits from a participatory approach.2 This fosters congruence …
Incidence of Cervical Squamous Intraepithelial Lesions in HIV-Infected Women
Authors: Tedd V. Ellerbrock
Journal: JAMA (2000)

ContextWomen infected with human immunodeficiency virus (HIV) are at increased risk for cervical squamous intraepithelial lesions (SILs), the precursors to invasive cervical cancer. However, little is known about the causes of this association.ObjectivesTo compare the incidence of SILs in HIV-infected vs uninfected women and to determine the role of risk factors in the pathogenesis of such lesions.DesignProspective cohort study conducted from October 1, 1991, to June 30, 1996.SettingUrban clinics for sexually transmitted diseases, HIV infection, and methadone maintenance.ParticipantsA total of 328 HIV-infected and 325 uninfected women with no evidence of SILs by Papanicolaou test or colposcopy at study entry.Main Outcome MeasureIncident SILs confirmed by biopsy, compared by HIV status and risk factors.ResultsDuring about 30 months of follow-up, 67 (20%) HIV-infected and 16 (5%) uninfected women developed a SIL (incidence of 8.3 and 1.8 cases per 100 person-years in sociodemographically similar infected and uninfected women, respectively [P<.001]). Of incident SILs, 91% were low grade in HIV-infected women vs 75% in uninfected women. No invasive cervical cancers were identified. By multivariate analysis, significant risk factors for incident SILs were HIV infection (relative risk [RR], 3.2; 95% confidence interval [CI], 1.7-6.1), transient human papillomavirus (HPV) DNA detection (RR, 5.5; 95% CI, 1.4-21.9), persistent HPV DNA types other than 16 or 18 (RR, 7.6; 95% CI, 1.9-30.3), persistent HPV DNA types 16 and 18 (RR, 11.6; 95% CI, 2.7-50.7), and younger age (<37.5 years; RR, 2.1; 95% CI, 1.3-3.4).ConclusionsIn our study, 1 in 5 HIV-infected women with no evidence of cervical disease developed biopsy-confirmed SILs within 3 years, highlighting the importance of cervical cancer screening programs in this population.
Retinoic Acid and Arsenic for Treating Acute Promyelocytic Leukemia
Authors: Guang-Biao Zhou, Wei-Li Zhao, Zhen-Yi Wang, Sai-Juan Chen, Zhu Chen
Journal: PLoS Medicine (2005)

What were the critical steps in the development of ATRA and arsenic as treatments for APL? Researchers in Shanghai tell the story and look to the future.
Hsp90-targeted miRNA-liposomal formulation for systemic antitumor effect
Authors: Subrata Kumar Pore, Ashwani Choudhary, Bhowmira Rathore, Anirban Ganguly, Pombala Sujitha, C. Ganesh Kumar, Sachin Bharat Agawane, Jerald Mahesh Kumar, Vinod Scaria, Beena Pillai, Rajkumar Banerjee
Journal: Biomaterials (2013)
Survival Patterns With In-Hospital Cardiac Arrest—Reply
Authors: Mary Ann Peberdy
Journal: JAMA (2008)

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
Neoplastic Epidural Spinal Cord Compression
Authors: Jack E. Meyer
Journal: JAMA (1979)

<h3>To the Editor.—</h3> A TOPICS IN RADIOLOGY/<i>Therapy</i>titled "Neoplastic Epidural Spinal Cord Compression: A Current Perspective" (240:2771, 1978) neglected to mention urinary retention as an additional clinical finding when metastatic carcinoma encroaches on the spinal cord. The observation of an abnormally distended urinary bladder on a radionuclide bone scan, especially when associated with a local increase in spine activity, should prompt careful neurological evaluation.<sup>1</sup>
Infusion of Intravenous Immunoglobulin (IVIg) Containing anti-Abeta Antibodies is Associated with a Decrease of Abeta in Cerebrospinal Fluid (CSF) and Increase of Abeta in Blood from 8 Patients with Mild Alzheimer's Disease (AD)
Authors: M WEKSLER, P SZABO, B ADAMIAK, T BURGUT, C MONTHE, S YOUNKIN, L YOUNKIN, N RELKIN
Journal: Journal of Allergy and Clinical Immunology (2008)

To investigate whether anti-Abeta antibodies in IVIg lead to changes in the levels of Abeta peptide (Abeta) in the CSF and blood of Alzheimer patients. Abeta and anti-Abeta antibody levels were measured by ELISA during an 18 month phase I study of IVIg therapy in AD. We and other investigators have reported that serum anti-Abeta antibodies that bind Abeta monomers are significantly lower in AD patients than in age-matched non-demented subjects. In the current studies, the infusion of IVIg (Baxter, Gammagard SD) in 8 patients led to significant increases in blood anti-Abeta antibody levels (p < 0.035) and blood Abeta levels (p < 0.01) that were reproducible and consistent over 6 months of IVIg therapy. After 6 months of IVIg therapy the levels of CSF Abeta42 had decreased significantly (p < 0.005) compared to baseline levels prior to IVIg therapy. Cessation of IVIg therapy for 3 months was associated with an increase in CSF Abeta42 to baseline levels. After 9 months of further IVIg therapy, CSF Abeta levels decreased to the same level observed after the first 6 months of IVIg therapy. Human polyclonal anti-Abeta antibodies present in serum and in IVIg include specificities for the linear N-terminal and central region epitopes on Abeta monomers as well as conformational epitopes on Abeta oligomers and fibrils. IVIg therapy of AD was associated with changes in Abeta levels in the CSF and peripheral blood consistent with the clearance of Abeta from the central nervous system.
US efforts to limit marketing of unhealthy food to children are delayed
Authors: B. Roehr
Journal: BMJ (2012)

The food industry is using delaying tactics to prevent the publication of guidance that would limit the marketing of unhealthy foods to children by 2016, an advocacy group has claimed. 

The draft guidance recommends that food marketed to children and teenagers aged 2-17 “should provide a meaningful contribution to a healthful diet” and “should be formulated to minimize the content of nutrition that could have a negative impact on health or weight.”1 It would apply to advertising, social media, and all other forms of promotion.

The guidelines were created by an intergovernmental working group of federal government agencies responsible for trade, agriculture, and health with the “goal of improving children’s diets and addressing the high rates of childhood obesity.” The starting point was an Institute of Medicine report issued in December 2005. …
Exercise-Induced Lactate Increase in Relation to Muscle Substrates in Patients with Chronic Obstructive Pulmonary Disease
Authors: MARIËLLE P. K. J. ENGELEN, ANNEMIE M. W. J. SCHOLS, JOAN D. DOES, HARRY R. GOSKER, NICOLAAS E. P. DEUTZ, EMIEL F. M. WOUTERS
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Early lactic acidosis has been suggested as negatively influencing the exercise capacity of patients with chronic obstructive pulmonary disease (COPD). We conducted a study to investigate whether the early lactate (La) response to exercise in COPD is related to alterations in exercise-related substrate levels in resting muscle, associated with physical inactivity. Twenty-seven COPD patients and 22 controls (physically inactive [PI] subjects, n = 15; and physically active [PA] subjects, n = 7) performed an incremental cycle test. Venous blood was sampled for La analyses, and the oxygen uptake at which the La level began to rise (La threshold) was calculated. Vastus lateralis biopsy specimens were obtained at rest. In the PA group, muscle glutamate (GLU) and glycogen were higher, but muscle La, pyruvate, and glucose were not different than in the PI group. Moreover, the La threshold was higher in the PA group. The COPD group had lower values for La threshold and muscle GLU, and higher values for muscle La and pyruvate levels than did the PI group. Stratification of patients into those with and without macroscopic emphysema (EMPH + , EMPH − , respectively), with comparable physical activity levels on the basis of previous observations, revealed lower values for La threshold and GLU in EMPH + patients. Diffusing capacity for carbon monoxide (Dl CO) and arterial oxygen tension (PaO2 ) in the four study groups were positively related to GLU and La threshold. Moreover, La threshold was positively related to GLU. This study illustrates that the early lactic acidosis during exercise in patients with COPD is associated with the physical inactivity-related reduction in these patient's muscle GLU. However, factors other than physical inactivity, such as PaO2 or Dl CO, play a role in the different La responses during exercise in subjects with different subtypes of COPD.
Lymphocyte antigens in systemic lupus erythematosus: studies with heterologous antisera.
Authors: R C Williams, G R Hughes, M L Snaith, H F Parry, E Diao, M F Greaves
Journal: Journal of Clinical Investigation (1980)

Rabbit antisera were produced against pooled living lymphocytes from 25 patients with active systemic lupus erythematosus (SLE). Lymphocytes collected at plasmapheresis or venipuncture were frozen in liquid nitrogen and later coated with rabbit antibody to normal human tonsils and normal thymocytes immediately before intravenous immunization of rabbits. Antisera were subsequently extensively absorbed with normal human tonsillar cells, thymocytes, peripheral blood lymphocytes, erythrocytes, and leukocytes from patients with myelogeneous and lymphatic leukemia until residual base-line immunofluorescent staining of normal human lymphocytes using F(ab)2' of whole antisera averaged less than 5%. Absorbed pepsin-digested antisera detected membrane antigens which were markedly increased (mean 32%) on lymphocytes from patients with active SLE (P less than 0.05). Membrane antigens reacting with absorbed, pepsin-digested antisera were present on both T and B cells but, in most instances, predominated on T cells. Control observations using absorbed pepsin-digested antisera to normal human lymphocytes or peripheral blood lymphocytes from patients with rheumatoid arthritis showed no similar specificity. SLE patients treated with moderate or high dose corticosteroids or immunosuppressive agents (cytoxan or azathioprine) appeared to lose lymphocyte antigens detected by these reagents. Control studies with other connective tissue disease patients, miscellaneous hospitalized subjects, or normal controls showed low levels of reactivity (2-5%). SLE lymphocyte membrane antigens uniquely increased during active disease; this may represent neoantigens or alterations associated with the disease itself.
On Raising the Epiglottis
Authors: F. Hewitt
Journal: BMJ (1889)

<b>Objective:</b> This case describes antibody-verified anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis in a previously healthy 7 month-old infant female presenting within 48 hours of receiving an influenza booster vaccination during her first influenza season. <b>Background:</b> A previously healthy 7 month old infant female presented with acute onset of altered mental status, decreased activity, roving eye movements, and opisthotonic posturing within 48 hours of receiving an influenza booster vaccination. She was initially diagnosed with acute demyelinating encephalomyelitis (ADEM) and treated with a short burst of corticosteroids followed by a taper. Symptoms subjectively improved during steroid therapy but did not persist, prompting further diagnostic evaluations. Anti-NMDA receptor encephalitis was confirmed by cerebrospinal fluid antibody titer 68 days after onset of symptoms. Treatment was then undertaken with serial courses of intravenous immunoglobulin (IVIG) and rituximab. The patient’s hospital course was protracted, and she required utilization of intensive care unit resources due to aspiration risk, surgical placement of nutritional and vascular access devices, and paroxysmal autonomic hyperactivity (PAH). Minimal improvement in her neurologic exam was observed at time of hospital discharge and may be due to delayed start of treatment, as well as the cumulative effect of unrecognized seizures early in her illness course. <b>Conclusions:</b> This case describes the youngest patient with anti-NMDA receptor encephalitis yet reported, and the first to suggest correlation with recent influenza vaccination. As higher likelihood of neurologic recovery is associated with early initiation of treatment, providers are encouraged to consider autoimmune neurologic disorders like anti-NMDA receptor encephalitis when mental status abnormalities and developmental regression persist, regardless of patient age. <b>Disclosure:</b> Dr. Cartisano has nothing to disclose. Dr. Kicker has nothing to disclose.
Mood and Anxiety Disorders as Early Manifestations of Medical Illness: A Systematic Review
Authors: Fiammetta Cosci, Giovanni A. Fava, Nicoletta Sonino
Journal: Psychotherapy and Psychosomatics (2014)

Background: Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a systematic review of the literature with qualitative data synthesis. Methods: MEDLINE, PsycINFO, EMBASE, Cochrane, and ISI Web of Science were systematically searched from inception to February 2014. Search terms were ‘prodrome/early symptom', combined using the Boolean ‘AND' operator with ‘anxiety/depression/mania/hypomania/irritability/irritable mood/hostility', combined with the Boolean ‘AND' operator with ‘medical illness/medical disorder'. PRISMA guidelines were followed. Results: A total of 21 studies met the inclusion criteria and were analyzed. Depression was found to be the most common affective prodrome of medical disorders and was consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS. Mania, anxiety and irritability were less frequent. Conclusions: Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.
Cellular distribution of phosphodiesterase isoforms in rat cardiac tissue.
Authors: D C Bode, J R Kanter, L L Brunton
Journal: Circulation Research (1991)

We have resolved multiple forms of cyclic nucleotide phosphodiesterase (PDE) in whole rat ventricle and in isolated rat ventricular myocytes by use of anion-exchange high-performance liquid chromatography. One major form, the soluble calmodulin-stimulated PDE, is apparently absent from isolated myocytes. We discern four peaks of PDE activity (designated A-D in the order of their elution) in a soluble fraction obtained from whole rat ventricle. Peak A is stimulated twofold to threefold by the addition of calcium and calmodulin (Ca2+/CalM) and preferentially hydrolyzes cGMP over cAMP (in the presence of Ca2+/CalM, KmcGMP = 1.5 microM, KmcAMP = 17 microM). Peak B has similar affinities for both cAMP and cGMP (half-maximum velocities achieved at 30 microM substrate) and demonstrates positive cooperativity with cAMP but not with cGMP. The hydrolysis of cAMP by peak B is stimulated by cGMP at substrate concentrations up to 20 microM; the maximum effect is seen at 1 microM cAMP (25-fold stimulation by 3 microM cGMP). This pattern of stimulation by cGMP results from two kinetic changes: an increase in the enzyme's apparent affinity for cAMP (apparent KmcAMP decreases from 33 to 11 microM) and the abolition of positive cooperativity. Peaks C and D selectively hydrolyze cAMP, are not stimulated by Ca2+/CalM or cGMP, and differ in their affinities for substrate (peak C, apparent KmcAMP = 7.2 microM; peak D, 0.44 microM). In addition, peak D is much more sensitive than peak C to inhibition by cGMP, cilostamide, rolipram, and milrinone. Ro20-1724 is a slightly more potent inhibitor of peak D than of peak C. Peak D appears to consist of two different enzyme activities, one inhibited by cGMP, cilostamide, and cardiotonic drugs and the other potently inhibited by rolipram. In contrast to whole ventricle, the soluble fraction of isolated rat ventricular myocytes lacks peak A. Three major peaks in myocytes are entirely analogous to peaks B, C, and D of whole ventricle in terms of the NaCl concentration at which they elute, substrate affinities, and stimulation or inhibition by various drugs and effectors. We conclude that the soluble Ca2+/CalM-stimulated PDE in whole rat ventricle is present in nonmyocyte cells.
Recent advances: Cardiac surgery
Authors: T. Treasure
Journal: BMJ (1997)

Three heart operations in the past 18 months have been featured on British radio and television programmes and made headline news in the Sunday papers. Mr Stephen Westaby announced in the Sunday Times of 29 October 1995 that the implantation of a new artificial heart was a “first” for Oxford. The Bristol group, led by Professor Gianni Angelini, reported on BBC radio's Today programme on 15 February 1996 that they had performed the world's first combined angioplasty and “key hole” coronary operation. And then came the BBC 1 QED television programme “Brave Hearts” on 22 May, heralded by that morning's Today programme and articles in the Sunday Times (19 May) and Independent (May 20), announcing a series of left ventricular reduction operations performed in Bristol.

When medical advances are announced in the popular media even the best read doctors are put in a position where their patients seem more up to date than they, and specialists are upstaged by friends and colleagues who heard the latest advance on the radio before breakfast. How is the average medical practitioner, hearing these broadcasts or reading about them in the Sunday papers, to know were to place these self proclaimed advances in the context of cardiac surgery? I will attempt to do this, but I cannot tell you whether they will lead somewhere important or if they are among the many blind alleys we enter in our search for a way ahead. The research cul-de-sac usually becomes forgotten, but at the time it might have seemed as likely a route to take as any other.

As an illustration of this uncertainty, in September 1948 a visitor to the operating theatres of Guy's Hospital would have had the opportunity to witness two pioneering operations. In one theatre was Mr Russell Brock (later Lord Brock, …
A CD31-derived peptide prevents angiotensin II-induced atherosclerosis progression and aneurysm formation
Authors: Giulia Fornasa, Marc Clement, Emilie Groyer, Anh-Thu Gaston, Jamila Khallou-Laschet, Marion Morvan, Kevin Guedj, Srini V. Kaveri, Alain Tedgui, Jean-Baptiste Michel, Antonino Nicoletti, Giuseppina Caligiuri
Journal: Cardiovascular Research (2012)

The loss of the inhibitory receptor CD31 on peripheral T lymphocytes is associated with the incidence of atherosclerotic complications such as abdominal aortic aneurysms (AAA) in patients and plaque thrombosis in mice. However, we have recently discovered that a small fragment of extracellular CD31 remains expressed on the surface of the apparently ‘CD31-negative’ T-cells and that it is possible to restore the CD31-mediated T-cell inhibition in vivo by using a synthetic CD31-derived peptide. Here, we wanted to evaluate the therapeutic potential of the peptide in an experimental model of accelerated atherosclerosis and AAA formation. The effect of the murine CD31-derived peptide (aa 551–574, 1.5 mg/kg/day, sc) was evaluated on the extent of atherosclerotic plaques and the incidence of AAA in 28-week-old apolipoprotein E knockout mice (male, n ≥ 8/group) submitted to chronic angiotensin II infusion. The therapeutic mechanisms of the peptide were assessed by evaluating its effect on immune cell functions in vivo and in vitro. The prevalence of angiotensin II-induced AAA correlated with the loss of extracellular CD31 on T-cells. CD31 peptide treatment reduced both aneurysm formation and plaque size (P < 0.05 vs. control). Protection was associated with reduced perivascular leucocyte infiltration and T-cell activation in vivo. Functional in vitro studies showed that the peptide is able to suppress both T-cell and macrophage activation. CD31 peptides could represent a new class of drugs intended to prevent the inflammatory cell processes, such as those underlying progression of atherosclerosis and development of AAA.