tbuckley/cabot-search huggingface dataset:
In rheumatoid arthritis highly expanded B cell clones can be found in the early synovitis stage
Authors: M. E. Doorenspleet, M. J. de Hair, M. M. Herenius, P. L. Klarenbeek, C. A. Wijbrandts, M. G. van de Sande, B. D. van Schaik, R. E. Esveldt, J. K. Singh, A. H. van Kampen, D. M. Gerlag, F. Baas, P. P. Tak, N. de Vries
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Background</h3> B cells are thought to play an important role in the pathogenesis of rheumatoid arthritis (RA). We previously observed that highly expanded B-cell clones (HECs) were specifically present in inflamed synovial tissue (ST) compared to peripheral blood (PB) in a patient with established RA (ESRA). These findings suggest involvement of B cells via their B cell receptor (BCR), and local retention and/or proliferation of B cell clones in ST. Here we extend our patient group and include patients with early synovitis (ERA). <h3>Objective</h3> To analyse the presence of expanded B-cell clones in paired samples from PB and ST during different stages of disease using a newly developed High-Throughput Sequencing (HTS) protocol. <h3>Methods</h3> Six ACPA+ patients with active RA were included. Three patients were disease-modifying antirheumatic drug naïve and had synovitis for less than 1 year (ERA). Three patients had active disease despite methotrexate treatment and had a disease duration of more than 10 years (ESRA). mRNA was isolated from paired samples (PB and ST biopsies from arthritic ankle/knee), and linear amplification of the B-cell receptor heavy chain was performed with primers for all V-gene families. The amplified products encode the CDR3 of all analysed B cells, used as a 'fingerprint' for each clone. The samples were analysed using a Genome Sequencer (454). The frequency of clones was determined by custom bioinformatics algorithms identifying the CDR3 of each receptor (up to 10.000 receptors per sample). Clones with a frequency of ≤1% were arbitrarily considered as HECs. <h3>Results</h3> HECs were detected in ST of both ERA and ESRA patients, with comparable frequencies in both stages (9 vs 11 clones resp.). Frequencies of HECs were as high as 53% in ERA, while this was 34% in ESRA. These HECs were either absent, or present in very low frequency in PB-samples. Surprisingly, HECs were also found in PB-samples of both groups (up to 30% in both groups), but the HECs recovered in PB were not found in ST. <h3>Conclusion</h3> This is the first analysis of B cell clones in ST- and PB-samples comparing RA patients with different disease duration, using novel HTS technology. Our data suggests that ST-specific HECs can already be detected in early stages of synovial inflammation, and that the number of HECs does not change during disease. These findings suggest that specific BCRs are involved in the early phase of RA and provide a rationale for early anti-B cell therapy.
Radioxenon Retention in the Early Diagnosis of Respiratory Burns
Authors: N ADISESHAN, S P PEGG, V M HINCKLEY
Journal: Clinical Nuclear Medicine (1977)

A simple scintigraphic technique is described to detect regional pulmonary retention of 133Xe 90 seconds after an intravenous injection. Regional retention accurately reflected distal airway damage due to thermal inhalation injury. In the early diagnosis of respiratory burns, this procedure supplements fiberoptic bronchoscopy which primarily detects proximal airway injury. Simultaneous pulmonary perfusion scintigraphy may assist in the diagnosis of pulmonary embolism which has a reported high incidence in respiratory burns.
Clinical Utility and Cost-effectiveness of an Air Suspension Bed in the Prevention of Pressure Ulcers
Authors: Kevin J. Inman
Journal: JAMA (1993)

To determine, in critically ill patients at risk, both the clinical utility and cost-effectiveness of using an air suspension bed in the prevention of pressure ulcers.Randomized, parallel group, controlled clinical trial with accompanying cost-effectiveness analysis.30-bed multidisciplinary intensive care unit.100 consecutive patients at risk for the development of pressure ulcers randomly assigned to receive treatment on either an air suspension bed or a standard intensive care unit bed. Patients considered at risk were those at least 17 years of age with an Acute Physiology and Chronic Health Evaluation II (APACHE II) score greater than 15 who had an expected intensive care unit stay of at least 3 days.The development of pressure ulcers by site and severity and the costs associated with each of the two programs.The air suspension bed was associated with fewer patients developing single, multiple, or severe pressure ulcers. In patients at risk, the use of an air suspension bed in the prevention of pressure ulcers was a cost-effective therapy.Despite intense nursing care, pressure ulcers are more prevalent in the critically ill patient population than in the general hospital population. Air suspension therapy provides a clinically effective means of preventing pressure ulcers in these patients. In patients at risk, air suspension therapy was a cost-effective means of managing pressure ulcers compared with the standard hospital bed.
SPECT Imaging of Intense Bone Tracer Uptake by an Extensive Extraosseous Hemangioma
Authors: HADYN T. WILLIAMS, OLIVER A. SORSDAHL
Journal: Clinical Nuclear Medicine (1993)

Extraskeletal radiophosphate accumulation may be seen with soft tissue ossification; altered cell membrane or capillary permeability; mitochondrial binding; or complexing to calcium, iron, protein, or other phosphate compounds. Uptake of bone tracer is often more intense and more extensive than would be anticipated from the degree of calcification visible radiographically. Presented is a case of cutaneous hemangioma involving the right thigh, with dramatic contiguous involvement encompassing the entire ascending colon.
Systolic thickening increases from subepicardium to subendocardium
Authors: J. A Gascho, G. L Copenhaver, D. F Heitjan
Journal: Cardiovascular Research (1990)

Journal Article Systolic thickening increases from subepicardium to subendocardium Get access Joseph A Gascho, Joseph A Gascho Correspondence to: Dr Gascho Search for other works by this author on: Oxford Academic PubMed Google Scholar Gary L Copenhaver, Gary L Copenhaver Search for other works by this author on: Oxford Academic PubMed Google Scholar Daniel F Heitjan Daniel F Heitjan Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 24, Issue 10, October 1990, Pages 777–780, https://doi.org/10.1093/cvr/24.10.777 Published: 01 October 1990 Article history Received: 27 February 1990 Accepted: 25 April 1990 Published: 01 October 1990
Organic Causes of Minimal Brain Dysfunction
Authors: Abraham Towbin
Journal: JAMA (1971)

The fetus and newborn incur cerebral hypoxic lesions which result in minimal brain dysfunction. The lesions are basically of a venous infarctional nature. In the premature, the damage affects primarily periventricular deposits of germinal tissue. At term, the loss is mainly in the cortex. Subacute lesions defined provide a transitional link between the acute patterns of neonatal cerebral damage and the chronic lesions in minimal brain dysfunction. This syndrome, estimated to affect over 3 million in this country, is responsible for nervous system disability not only in infants and children, but also in adults.
Work Study on Junior Anaesthetic Staff
Authors: D. A. Nightingale, T. H. Taylor
Journal: BMJ (1966)

A major revision of the duties of the junior anaesthetic staff of the London Hospital became necessary with the impending opening of an intensive care unit. As a first step it was essential to know how the existing staff spent their working time, and so an intensive work study was carried out for a period of 10 weeks. We could find no published information about the actual working week of junior anaesthetists or other junior hospital staff. As this working week has never been established by contract (unlike that of part-time hospital consultants), we feel that the data presented in this study will be of general interest whenever staffing and terms and conditions of service of junior staff are discussed. The training of junior anaesthetists in this hospital is largely by example from their senior colleagues, and because of this the consultants are nearly always accompanied by a junior for training purposes. Thus the total hours of work of the junior staff approximate in duration to the total work load of the department.
Pharmacogenomics and Clopidogrel
Authors: Steven E. Nissen
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 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
Celecoxib reduced GI events more than diclofenac plus omeprazole in patients with osteoarthritis or rheumatoid arthritis
Authors: Emilio B. Gonzalez
Journal: Annals of Internal Medicine (2011)

Source Citation Chan FK, Lanas A, Scheiman J, et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet. 2010;376:173-9. 20638563
Cross-Validation of the A/B Typology in The Netherlands
Authors: F. Verhagen, C. Nass, A. Appels, A. van Bastelaer, J. Winnubst
Journal: Psychotherapy and Psychosomatics (1980)

In a retrospective patient-control study in The Netherlands, relationships were established between the coronary-prone behavior pattern, as measured with the Structured Interview (SI) and the Jenkins Activity Survey (JAS), and selected Dutch questionnaires, i.e. The Maastricht Questionnaire (MQ) on vital exhaustion as a prodrome for myocardial infarction, the Western Time Attitude Scale (WTAS), and the Achievement Motivation Test (AMT), among others. The SI and the MQ discriminated best between patients (n = 58) and controls (n = 58); negative fear of failure (AMT subscale) was significantly associated with patients but not so with controls, as was time anxiety (WTAS subscale).
Mischievous Odds Ratios
Authors: William Steinsmith
Journal: PLoS Medicine (2006)

Pieter Reitsma and colleagues have explored—in a population of patients anticoagulated with coumarin congeners—the connection between the presence of mutant alleles of a single gene and the risk of haemorrhage [ 1]. 

Using as their denominator the odds for bleeding in a patient without mutant alleles, and using as their numerator the odds for patients with each of the two mutant alleles, the authors propose the resulting odds ratios as surrogates for the relative risk of haemorrhage.

It should be noted, however, that the conflation of an odds ratio with a relative risk is not generally justified [ 2, 3]. The relative risk is the ratio of two probabilities (p2/p1), whereas the corresponding odds ratio is [p1/(1-p1)]/[p2/(1-p2)]. Equating these two ratios requires that p1 = p2, i.e., that the risk ratio be unity. 

In Reitsma and colleagues' paper, none of the eight odds ratios presented in Table 2 turn out identical with the corresponding calculated risk ratio, and the most discordant pair of values diverge by a factor of about 1.4, i.e., the odds ratio of 2.6 corresponding to a relative risk of 1.9.

Mischievous conflation of odds ratios with probability ratios is widespread in the literature dealing with laboratory testing, with the odds ratio (confusingly termed the “likelihood ratio”) typically presented as surrogate for the corresponding ratio of probabilities.

The power of a positive laboratory test to enhance the likelihood of disease presence in a given patient (properly termed the “positive probability-based likelihood ratio”) is the ratio of two probabilities: the probability that the patient who tested positive is truly diseased (termed the “positive predictive value”) divided by the probability of disease in the pre-test population (termed the “disease prevalence”).

Expressed explicitly in terms of the subcategories of the test population, the positive predictive value is the ratio represented by (True Positives)/(True Positives + False Positives), and the prevalence is the ratio represented by (True Positives + False Negatives)/(True Positives + False Negatives + True Negatives + False Positives).

The calculus is easily adapted to compute the probability-based likelihood ratio for the absence of disease in a given patient. In this case, the post-negative-test probability of disease absence (termed the “negative predictive value”) is the ratio represented by (True Negatives)/(True Negatives + False Negatives), and the pre-test probability is one minus the disease prevalence. The negative probability-based likelihood ratio is, then, the ratio represented by the post-test probability divided by the pre-test probability.

A more descriptive term for the probability-based likelihood ratio would be the “probability magnifying power,” since it leads to the expanded probability of the presence (or absence) of disease yielded by a positive (or negative) test result.
Myocardial and cerebral hemodynamics during tachyarrhythmia-induced hypotension in the rat.
Authors: A Hagendorff, C Dettmers, P Danos, L Pizzulli, H Omran, M Manz, A Hartmann, B Lüderitz
Journal: Circulation (1994)

The different vulnerabilities of heart and brain to hypotension and hypoxia have been discussed. Hemorrhagic or cardiogenic hypotension appears to cause greater cerebral lesions than drug-induced hypotension. The present model was established to evaluate myocardial blood flow (MBF) and function of the heart and cerebral blood flow (CBF) during tachyarrhythmias and to characterize the capacity of blood flow regulation in the heart and brain during tachycardia-induced borderline hypotension.MBF and CBF were determined with radiolabeled microspheres. Coronary and central venous oxygen tensions were measured to estimate myocardial and cerebral oxygen consumption (MVO2 and CVO2). Measurements were performed in 62 Sprague-Dawley rats during sinus rhythm and high-rate left ventricular pacing and after hemorrhage. In control rats, MBF and CBF were 5.08 +/- 1.07 and 1.09 +/- 0.29 mL.g-1.min-1. MBF increased (7.21 +/- 1.98 mL.g-1.min-1, P < .05), whereas CBF decreased (0.99 +/- 0.29 mL.g-1.min-1, P = NS) during normotensive high-rate pacing. MBF and CBF dropped to 4.27 +/- 2.24 mL.g-1.min-1 (P = NS) and 0.68 +/- 0.29 mL.g-1.min-1 (P < .05) during pacing-induced borderline hypotension and decreased further during severe hypotension (1.77 +/- 0.81 mL.g-1.min-1, P < .01; 0.45 +/- 0.18 mL.g-1.min-1, P < .01). During borderline hypotension due to hemorrhage, MBF and CBF were 4.05 +/- 0.95 mL.g-1.min-1 (P = NS) and 0.71 +/- 0.23 mL.g-1.min-1 (P < .05). MVO2 and CVO2 were 72.7 +/- 15.4 and 12.7 +/- 3.3 mL.100 g-1.min-1 in control rats. MVO2 increased during normotensive pacing (100.3 +/- 27.4 mL.100 g-1.min-1, P = NS). Mean MVO2 was reduced during pacing-induced borderline hypotension (64.1 +/- 35.6 mL.100 g-1.min-1, P = NS) and severe hypotension (29.8 +/- 15.4 mL.100 g-1.min-1, P < .05). CVO2 decreased in correlation to CBF. Coronary and cerebrovascular resistance and autoregulation indexes indicated a maintenance of MBF regulation and a failure of CBF regulation during borderline hypotensive tachycardias. These results show a dissociation of MBF and CBF after onset of hypotensive tachycardias. Thus, brain tissue appears to be jeopardized at an earlier stage than myocardial muscle during tachyarrhythmias.The proposed hypotension model is suitable to analyze tachyarrhythmia-induced hemodynamic changes and end-organ perfusion in the presence of myocardial dysfunction. It has the potential to test therapeutic strategies in the treatment of tachycardias.
CONGENITAL DEFORMITIES OF THE HANDS.
Authors: FRANCIS R. SHERWOOD
Journal: JAMA (1899)

Anomalies of the hand are not an infrequent occurrence. The variety of the deviations from the normal are very great, from that of a double hand, as reported by Geraldes and others, or one with supernumerary digits, or cleft hand, as operated on and reported by C. N. Dowd,<sup>1</sup>or with suppression of digits, and so on down to congenital absence of hand. Perhaps the most frequent congenital deformity of the hand is that of supernumerary digits. The writer attended school with a family in which there were supernumerary digits of the hands and feet in both males and females in two generations. Some of the children were normal. The father of one of the families had a cleft palate without any deformity of the hands. These cases have never been recorded. Those who possess the deformities, as well as the parents, are always more or less sensitive about
Internet access is a socioeconomic issue
Authors: Geoff Wong
Journal: BMJ (2004)

National Programme for Information Technology (NPfIT), has highlighted the lack of clinicians' engagement with this £6bn project.The advisory board represents a much needed injection of resources to NHS information technology systems, which could bring many benefits to care for patients and clinicians' working practices.The Wanless reports have emphasised the importance of information technology in the future of healthcare in the United Kingdom. 1 A national programme could avoid the problems around interoperability associated with past failures in NHS information technology systems.However, the secrecy surrounding the procurement phase of the programme has led to an increasing feeling of unease among clinician end users.Anxieties prevail about changes in working practices, usability of systems, training needs, and the possibility that political expediency will overshadow clinical needs.Aidan Halligan, the deputy chief medical officer, has been charged with ensuring clinical engagement with the programme. 2 The good news for the Department of Health comes from its survey, carried out by Medix, which shows that many doctors are enthusiastic about the potential of the national programme, with three quarters of respondents endorsing it as an important NHS priority. 3 Only 4% of respondents thought, however, that they had been adequately consulted.The recently announced new Front Line Support Academy aims to correct omissions at the leadership level.
Neurogenic inflammation and sensitivity to environmental chemicals.
Authors: W J Meggs
Journal: Environmental Health Perspectives (1993)

Neurogenic inflammation as a pathway distinct from antigen-driven, immune-mediated inflammation may play a pivotal role in understanding a broad class of environmental health problems resulting from chemical exposures. Recent progress in understanding the mediators, triggers, and regulation of neurogenic inflammation is reviewed. Evidence for and speculations about a role for neurogenic inflammation in established disorders such as asthma, rhinitis, contact dermatitis, migraine headache, and rheumatoid arthritis are presented. The sick building syndrome and multiple chemical sensitivity syndrome have been defined as clinical entities in which exposure to chemical inhalants gives rise to disease. Current data on the existence of chemical irritant receptors in the airway and skin are discussed; neurogenic inflammation arising from stimulation of chemical irritant receptors is a possible model to explain many of the aspects of chemical sensitivities.
Coronary Intervention for Persistent Occlusion after Myocardial Infarction
Authors: Judith S. Hochman, Gervasio A. Lamas, Christopher E. Buller, Vladimir Dzavik, Harmony R. Reynolds, Staci J. Abramsky, Sandra Forman, Witold Ruzyllo, Aldo P. Maggioni, Harvey White, Zygmunt Sadowski, Antonio C. Carvalho, Jamie M. Rankin, Jean P. Renkin, P. Gabriel Steg, Alice M. Mascette, George Sopko, Matthias E. Pfisterer, Jonathan Leor, Viliam Fridrich, Daniel B. Mark, Genell L. Knatterud
Journal: New England Journal of Medicine (2006)

It is unclear whether stable, high-risk patients with persistent total occlusion of the infarct-related coronary artery identified after the currently accepted period for myocardial salvage has passed should undergo percutaneous coronary intervention (PCI) in addition to receiving optimal medical therapy to reduce the risk of subsequent events.We conducted a randomized study involving 2166 stable patients who had total occlusion of the infarct-related artery 3 to 28 days after myocardial infarction and who met a high-risk criterion (an ejection fraction of <50% or proximal occlusion). Of these patients, 1082 were assigned to routine PCI and stenting with optimal medical therapy, and 1084 were assigned to optimal medical therapy alone. The primary end point was a composite of death, myocardial reinfarction, or New York Heart Association (NYHA) class IV heart failure.The 4-year cumulative primary event rate was 17.2% in the PCI group and 15.6% in the medical therapy group (hazard ratio for death, reinfarction, or heart failure in the PCI group as compared with the medical therapy group, 1.16; 95% confidence interval [CI], 0.92 to 1.45; P=0.20). Rates of myocardial reinfarction (fatal and nonfatal) were 7.0% and 5.3% in the two groups, respectively (hazard ratio, 1.36; 95% CI, 0.92 to 2.00; P=0.13). Rates of nonfatal reinfarction were 6.9% and 5.0%, respectively (hazard ratio, 1.44; 95% CI, 0.96 to 2.16; P=0.08); only six reinfarctions (0.6%) were related to assigned PCI procedures. Rates of NYHA class IV heart failure (4.4% vs. 4.5%) and death (9.1% vs. 9.4%) were similar. There was no interaction between treatment effect and any subgroup variable (age, sex, race or ethnic group, infarct-related artery, ejection fraction, diabetes, Killip class, and the time from myocardial infarction to randomization).PCI did not reduce the occurrence of death, reinfarction, or heart failure, and there was a trend toward excess reinfarction during 4 years of follow-up in stable patients with occlusion of the infarct-related artery 3 to 28 days after myocardial infarction. (ClinicalTrials.gov number, NCT00004562 [ClinicalTrials.gov].).
Medically unexplained symptoms
Authors: M C T Morrison
Journal: Journal of the Royal Society of Medicine (2003)

The data presented by Dr Fontaine and his colleagues (August 2003 JRSM 1 ) suggest that perforation of an enterocystoplasty is often associated with an overfilled bladder which, in turn, can be produced by poor compliance with a strict intermittent catheterization regimen.It would be interesting to know how many of the total patients involved had diminished pain sensibility in their bladders, and what proportion of these were in the perforation group.Even the most fastidious patients may let their catheterization routine slip and this is a particular temptation when delay in performing catheterization does not result in pain.It could be that such patients need an efficient 'pain substitute'. 2Perhaps urological surgeons should reconsider the plastic surgeon's technique (when repairing pressure ulcers) of using normally innervated autografts?Such a graft, using perhaps expanded skin, might one day be incorporated into reconstructed bladders that would otherwise have absent or diminished pain sensibility.I appreciate that this would not be an easy operation, and skin might not be the best tissue to use.