tbuckley/cabot-search huggingface dataset:
Hypothermia After Chlorpromazine in Myxoedematous Psychosis
Authors: J. R. A. Mitchell, D. H. C. Surridge, R. G. Willison
Journal: BMJ (1959)

We report here the case of a patient who developed myxoedematous psychosis and then lapsed into hypothermic coma after an injection of chlorpromazine. Case ReportThe patient, a housewife aged 54, was born in Italy, and came to England at the age of 21.In 1943 she developed thyrotoxicosis and was found to have a nodular goitre, so a partial thyroidectomy was done.She was well thereafter until a year ago, when she began to complain of feeling cold.Two weeks before admission she told her family that the neighbours had turned against her, and that people she met in the street would not look at her or speak to her.Three days before admission she took to her bed, saying that she had split into two pieces, and was living in the left half only.Next day her mental state was worse, and on the day before admission she said that she was now the Queen of Heaven, and that her subjects were telling her to scratch herself.When her family doctor saw her she screamed at him and told him that he was a thief.She was admitted to a mental hospital that night.When examined there she was found to be maniacal and violent, and was screaming persistently.She was given 100 mg. of chlorpromazine by intramuscular injection; next morning she was quiet but was unable to answer questions, and kept mumbling that she was cold.Methedrine was given (30 mg.intramuscularly) and she became a little more alert, but later in the day she could not be roused.As she was thought to have had a cerebral vascular accident one of us (R. G. W.) was asked to see her, and she was then transferred to the Radcliffe Infirmary.On examination she was fat and pale, with a cold dry skin.The rectal temperature was 92°F.(33.2°C.).Her hair was coarse and sparse, but the body hair was normal.No peripheral pulses could be felt and the blood pressure was unrecordable, but heart sounds could be heard, the rate being 40/minute.She would respond to questions by making a croaking, unintelligible noise.The pupils were widely dilated and did not react to light.The limbs were flaccid, the tendon reflexes were just present, and there was a very slow relaxation phase.The plantar responses were extensor.Initial Investigations.-Bloodsugar, 118 mg./100 ml.Serum cholesterol, 400 mg./100 ml.Electrolytes (mEq/l.),Cl, 100; HCO3, 17; Na, 130; K, 3.5.Chest and skull x-rays normal.Blood urea, 65 mg./100 ml.E.C.G.-sinus bradycardia; low-voltage complexes and flat T waves.E.E.G.-sleep pattern.Blood count: Hb, 80%; W.B.C., 10,000/c.mm.W.R. negative.Management She was given 40 pg. of triiodothyronine intravenously, and was then immersed up to the neck in a bath of water at 98°F.(36.7°C.).Four hours later her rectal temperature was 1000 F. (37.80 C), so she was taken out
Sickle-Cell Programming — An Imperiled Promise
Authors: Charles F. Whitten
Journal: New England Journal of Medicine (1973)

IT has taken some 60 years for sickle-cell anemia to command a level of interest, financing and programming commensurate with the magnitude of the problem. Unfortunately, undesirable features have accompanied most program implementation. Although a few isolated problems have been identified,1 2 3 there is a need to consider the negative aspects comprehensively because if they persist the current activity in the sickle-cell field may become more harmful than beneficial.The areas of concern are several. The first involves the identification of prevention as the goal of genetic counseling. The prevention approach is based on the unproved assumptions that sickle-cell anemia . . .
Prostaglandin I2 half-life regulated by high density lipoprotein is decreased in acute myocardial infarction and unstable angina pectoris.
Authors: T Aoyama, Y Yui, H Morishita, C Kawai
Journal: Circulation (1990)

To investigate the prostaglandin I2 (PGI2) half-life regulated by high density lipoprotein (HDL) in patients with coronary artery disease (CAD), we determined the stability of PGI2 and serum apolipoprotein A-I (Apo A-I) and apolipoprotein A-II (Apo A-II) levels in four age-matched groups of patients: controls (n = 17), angina pectoris (n = 18), unstable angina pectoris (n = 17), myocardial infarction (n = 19) (acute phase, 3.6 +/- 1.7 hours from onset; subacute phase, 75 +/- 15 hours from onset in the same patients). Serum PGI2 half-life and total serum Apo A-I levels were lower in the CAD group than in the control group. PGI2 was least stable in patients with unstable angina and the acute phase of myocardial infarction. In these patients, the molar ratio of Apo A-I to Apo A-II and HDL-associated Apo A-I levels were decreased, and free Apo A-I levels were increased. After in vitro incubation of HDL with increasing amounts of Apo A-II, Apo A-I in HDL was displaced by Apo A-II, with the parallel decrease in stability of PGI2. Free Apo A-I cannot stabilize PGI2. HDL-associated Apo A-I, whose amount is affected by Apo A-II, stabilized PGI2 and correlated well with stability of PGI2 in patients with CAD and control patients. Decreased PGI2 half-life may play an important role in the pathogenesis of atherosclerosis and thrombus formation in the coronary arteries, especially thrombus formation during an acute coronary event.
Idiopathic Retroperitoneal Fibrosis
Authors: John K. Ormond
Journal: JAMA (1960)

Idiopathic retroperitoneal fibrosis was first reported in 1948. Its etiology is unknown. It is not primarily a urological condition although it usually manifests itself by urological symptoms. The fibrotic process seems to originate about the great vessels and to spread from them, enveloping, but not usually invading, the retroperitoneal structures. Among these the ureter is the most vulnerable, and its obstruction inevitably results in damage to the kidney. The two cases here described, and analysis of succeeding case reports show that such fibrosis is sometimes responsible for obscure but severe abdominal and back pains. It was unrecognized and proved fatal in a 45-year-old man; in the second patient, a 43-year-old man, exploratory laparotomy led to the diagnosis, and liberation of the ureters from the surrounding fibrotic structures restored the patient to health.
Potential for Ultrasonography to Reduce the Cost and Cumulative Radiation Dose in Routine Incisional Hernias
Authors: Matthew I. Goldblatt
Journal: JAMA Surgery (2014)

As our population ages, becomes more obese, continues to smoke, and develops type 2 diabetes mellitus, incisional hernias and recurrences are becoming more prevalent. Management of these complex hernias has become so challenging that the Americas Hernia Society has become one of the fastest growing surgical specialty organizations. As surgeons becomemore skilled at treating incisional hernias, theneed todiagnose recurrences andcharacterize the abdominal wall of an affected patient has become increasingly important.1 Computed tomography (CT) is the criterion standard for evaluating the abdominalwall, butBaucomet al2 have shown that ultrasonography can beused to characterize the dimensions of the hernia defects as effectively as CT. The advantage of CT for a hernia is that it shows the layers of the abdomen in a formatwithwhichmost surgeons are familiar. Sagittal and coronal reconstructions aid in preoperativeplanning,particularly in recurrentherniaoperations.However, if a patient has had multiple abdominal operations and recurrenthernias, thenumberof lifetimeCTsperpatient is often in the double digits. In addition to multiple CTs increasing the cost of treating incisional hernias, it has been hypothesized that the cumulative radiation could contribute to abdominal cancers.3 The level of ionizing radiation during a single multiphase CT of the abdomen-pelvis has been estimated to increase the lifetime risk to 4 cancers per 1000 patients.4 Although the risk for additional cancers associated with modern imaging is up for debate, reducing the number of CT scans will help decrease both the radiation exposure and the cost of treating abdominalwall hernias.Ultrasonographymay not completely replace CT, particularly inmore complex hernias; however, it can be useful in the diagnosis andmeasurementof a suspectedhernia andmay reduce thenumberofCTs that are obtained.
Randomized Controlled Trials
Authors: Janet M. Torpy
Journal: JAMA (2005)

Randomized Controlled TrialsM edical research answers many questions about health, illness, and treatment options.Evaluating new medicines and treatments may involve research using randomized controlled trials.In such trials the participants who receive the treatment under study are assigned at random (by chance, like the flip of a coin).This is necessary to ensure that the outcomes are determined only by the treatment under study and not by other factors that could otherwise influence treatment assignment.Other participants who, by the randomization process, serve as controls receive a standard treatment or placebo treatment (a pill or procedure that does not include active ingredients).The November 2, 2005, issue of JAMA includes an article about randomized clinical trials.
Venous thromboembolism prevention in the acutely ill medical patient: A review of the literature and focus on special patient populations
Authors: Robert Pendleton, Michelle Wheeler, George Rodgers
Journal: American Journal of Hematology (2005)

Although venous thromboembolism (VTE) is a major public health problem, until recently, our understanding of the risk of VTE in hospitalized acutely ill medical patients has been incomplete. Fortunately, over the past 5 years, there has been an increasing body of literature that highlights the risk of VTE in the nonsurgical patient, identifies unique patient-risk factors, and defines adequate preventative measures. This review highlights the current literature with regard to epidemiology of VTE in hospitalized medical patients and the risk-stratification of these patients and deals with optimal preventative regimens and prevention strategies in special patient groups.
Role of the School Eye Clinic in Modern Ophthalmology
Authors: R. M. Ingram
Journal: BMJ (1973)

Routine sight tests for children at intervals throughout their school career are clearly important; three-quarters of those referred to the school eye clinics in this area had some ocular defect. It is probably no longer necessary for myopic schoolchildren to be treated by a consultant ophthalmologist after their initial examination.Forty-five per cent. of children referred to the school eye clinics in this area were found to have squint and/or hypermetropic/anisometropic/astigmatic refractive errors. Priority should be given to this group because of the association of amblyopia with these conditions. Their treatment requires closer association with the hospital ophthalmic department, perhaps even complete unity. Transfer of children at present seen in the school eye clinic to a hospital-based "children's eye clinic" would also fit in with a unified health service administration structure and be better placed to indicate, evaluate, and control future developments towards the prevention of amblyopia.
Contingent Workers and Contingent Health
Authors: Kristin J. Cummings, Kathleen Kreiss
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
187 INDEPENDENT INFLUENCERS OF TRANSIENT ELASTOGRAPHY ASSESSMENT OF LIVER FIBROSIS IN HEPATITIS B AND HEPATITIS C PATIENTS
Authors: M. Fraquelli, C. Rigamonti, G. Casazza, M.F. Donato, D. Conte, G. Ronchi, S. Massironi, M. Rumi, P. Lampertico, M. Colombo
Journal: Journal of Hepatology (2009)
310 CHROMATIN DYNAMICS OF GENES REPRESSION IN RESPONSE TO IFNa REVEAL NEW ROLES FOR STAT2, PHOSPHO-STAT2, HISTONE DEACETYLASES (HDACS) AND HISTONE METHYLATION MARKS
Authors: B. Testoni, C. Voellenke, F. Guerrieri, V. Schinzari, S. Gerbal, G. Blandino, M. Levrero
Journal: Journal of Hepatology (2011)
PIN IN APPENDIX.
Authors: EVAN O'NEILL KANE
Journal: JAMA (1904)

For the notes of the following case I am indebted to Dr. Hamilton of Smethport. C. W., aged 52, a bookkeeper, always enjoyed good health until four years ago, when he had an attack of appendicitis, which confined him to his bed about a week, and from which he recovered. A week prior to the date of my summons, he ate inordinately of apples, mince pie and other indigestible viands, and an attack of acute indigestion followed, merging gradually into a pronounced attack of appendicitis. I found the temperature nearly normal, the pulse slow and full, the facial expression good, and the patient almost free from pain. The tongue was heavily coated and the abdomen resistant and tender to pressure. A mass was felt under McBurney's point. The patient felt better than for several days, and was almost reluctant to consent to operation. On opening the peritoneum a quantity of
S6 kinase 2 deficiency enhances ketone body production and increases peroxisome proliferator-activated receptor alpha activity in the liver
Authors: KyeongJin Kim, Suhkneung Pyo, Sung Hee Um
Journal: Hepatology (2011)

Nutrient homeostasis is tightly regulated by the balance between energy production and utilization. During fasting, production of ketone bodies as an alternative energy source is critical to maintain nutrient homeostasis. An important component in the nutrient-sensitive signaling pathway is S6 kinase 2 (S6K2), a downstream effector of mammalian target of rapamycin. Here, we show that mice lacking S6K2 exhibit elevated levels of ketone bodies and enhanced peroxisome proliferator-activated receptor alpha (PPARα) activity upon nutrient availability. Consistent with this, knockdown of S6K2 increases the transcriptional activity of PPARα. S6K2 suppresses PPARα by associating with its corepressor, nuclear receptor corepressor 1 (NCoR1), and by inducing the recruitment of NCoR1 to the nucleus. Moreover, ob/ob mice, a genetic model of obesity, have markedly elevated S6K2 activity, and S6K2 was strongly associated with NCoR1 in the nucleus of liver cells.Our findings suggest that S6K2 regulates hepatic energy homeostasis by repressing PPARα activity and point to its potential relevance for therapeutic strategies designed to modulate S6K2 activity as a treatment for deregulated ketone body production.
Fine Needle Aspiration of Palpable Masses
Authors: M Wolfendale
Journal: BMJ (1994)

Michael W Stanley, Torsten lowhagen Butterworth-Heinemann (pounds sterling )50, pp 156 Isbn 0-7506-9455-6

Stanley and Lowhagen's book is eminently practical and contains much useful advice on the whole range of the practice of fine needle aspiration. As the authors emphasise, it is failures in sampling and preparation of aspirates rather than the diagnostic shortcomings of the cytological examination that limit the success of this useful and inexpensive technique.

The recent proliferation of books on fine needle aspiration bears witness to a resurgence of interest in it, but they …
Deprivation and health in one general practice.
Authors: G N Marsh, D M Channing
Journal: BMJ (1986)

A detailed comparison made in late 1984 of 587 matched pairs of patients from neighbouring deprived and more endowed urban communities, both served by the same experienced primary health care team, showed much worse morbidity, with almost three times as much mental illness, in the deprived group. This group also had 60% more hospital admissions and 75% more casualty attendances. In contrast, they had a much lower uptake of preventive health care, especially childhood immunisations and cervical cytology in older women. A much higher birthrate within the deprived group, contributing to ill health by worsening overcrowding and deprivation, indicates that family planning is ineffective where it is most needed. Practical measures have now been instituted to improve the preventive care of the deprived community.
Cardiorenal and neurohumoral effects of endogenous atrial natriuretic peptide in dogs with severe congestive heart failure using a specific antagonist for guanylate cyclase-coupled receptors.
Authors: A Wada, T Tsutamoto, Y Matsuda, M Kinoshita
Journal: Circulation (1994)

To elucidate the extent of the compensatory role of endogenous atrial natriuretic peptide (ANP) in severe congestive heart failure (CHF), we examined the changes in hemodynamics and neuroendocrine and renal functions after incremental administration of an ANP antagonist, HS-142-1 (HS), in dogs with CHF.We assessed the effects of HS on the suppression of plasma and urinary cGMP levels as a marker of endogenous ANP activity in dogs without CHF. Bolus injections of 0.3 and 1.0 mg/kg HS reduced plasma cGMP levels to 77% and 60% and urinary cGMP excretion to 78% and 61% of the relevant control levels, respectively. Then the study was performed in dogs with CHF induced by chronic rapid ventricular pacing, and the plasma ANP level was sixfold higher than that in the controls. Hemodynamic, hormonal, and renal variables were determined both before and after subsequent incremental administration (0.3, 1.0, and 3.0 mg/kg every 30 minutes) of HS. HS lowered the plasma and urinary cGMP levels dose dependently to 32% and 37% of the control levels, respectively. Mean arterial, pulmonary capillary wedge, and right atrial pressures and cardiac output did not change significantly. However, plasma renin activity, aldosterone level, and norepinephrine level increased rapidly to 226%, 179%, and 252% of the control values, respectively. Urine flow rate and urinary sodium excretion were significantly inhibited, with no concomitant change in glomerular filtration rate or renal plasma flow.These findings suggest that endogenous ANP contributes to the suppression of the activation of the renin-aldosterone system and sympathetic nervous activity and body fluid retention but that the vasodilative action of this peptide is attenuated in advanced CHF.
Rapid development of severe aortic stenosis from calcification of congenital bicuspid valve.
Authors: N Brooks
Journal: BMJ (1980)

Conversion: SI to traditional units-Serum creatinine: 1 mmol/lz 11-3 mg/100 ml.Serum urea: 1 mmol/1 6 mg/l00 ml.Sodium and potassium excretion: 1 mmol/ 24 h= 1 mEq/24 h.
CONGENITAL STENOSIS OF THE PYLORUS: TWO CASES
Authors: Charles E. Tribble
Journal: JAMA (1933)

I am placing on record a report of multiple cases of pyloric stenosis occurring in the same family. Other instances of this occurrence have been reported by Freund,<sup>1</sup>Grissen,<sup>2</sup>Heubner,<sup>3</sup>Rosenhaupt,<sup>4</sup>Ibrahim,<sup>5</sup>Still,<sup>6</sup>Finkelstein,<sup>7</sup>Richter,<sup>8</sup>Sauer,<sup>9</sup>Davis,<sup>10</sup>Moore<sup>11</sup>and Caulfield.<sup>12</sup> There are three children in the family which came under my observation. The patients were the first and last born; the second child passed through infancy without any gastro-intestinal trouble. The first child came under observation in the New Haven Hospital at the age of 8 weeks. He had been vomiting for five weeks. In the hospital, projectile vomiting occurred after all feedings, peristaltic waves were visible over the stomach, and a hard rounded mass was palpable just to the right of the epigastrium. A Fredet-Rammstedt operation was performed at the end of the third hospital week; recovery
Formation and structure of human Hageman factor fragments.
Authors: J T Dunn, A P Kaplan
Journal: Journal of Clinical Investigation (1982)

Autodigestion of activated Hageman factor (HFa) yields a 40,000-mol wt activated enzyme as well as Hageman factor fragment (HFf); HFf consists of two molecular weight species of 28,500 and 30,000. We have investigated the structure of these active fragments and demonstrate that upon reduction, each possesses a heavy chain of 28,000. The associated light chains were identified by subjecting iodinated proteins to two-dimensional slab gel electrophoresis in which the second dimension is run reduced. The 40,000-dalton enzyme has a light chain of 15,000, the 30,000-dalton form of HFf has a light chain of 2,000 and we have suggestive evidence of a light chain associated with the 28,500-dalton form of HFf (putative mol wt approximately 500). We also demonstrate that the 30,000-dalton form of HFf precedes the 28,500 form. These data indicate that digestion of native HF to form HFa precedes cleavages that fragment the molecule and diminish its molecular weight. The 28,500-dalton light chain of HFa becomes the heavy chain of each of the fragmentation products while cleavage at different points along the heavy chain of HFa determines which fragments will be produced. In contrast to autoactivation, kallikrein digestion of HFa yields primarily HFf; however, the 40,000-dalton enzyme may be seen when prekallikrein-deficient (Fletcher trait) plasma is activated.
Analysis of regional ischemic left ventricular dysfunction by quantitative cineangiography.
Authors: D Tzivoni, G Diamond, M Pichler, K Stankus, R Vas, J Forrester
Journal: Circulation (1979)

The ability of left ventricular angiography to detect regional ischemic dysfunction was assessed in 10 closed-chest dogs during the course of acute balloon occlusion of the anterior descending coronary artery. During the 2-minute period of occlusion, serial cineangiography revealed a sequence of wall motion abnormalities over the anteroapical region almost identical to that observed using directly implanted gauges. This sequence consisted of progressive reduction in regional systolic shortening with eventual replacement by systolic expansion. These changes preceded both electrocardiographic ST-segment and hemodynamic alterations, and were readily observed by gross subjective inspection of the cineangiograms, but with an intraobserver variability of 22%. Frame-by-frame motional analysis of the ventricular perimeter relative to its centroid of mass allowed more precise characterization of regional dysfunction. These data are consistent with previous studies demonstrating that regional wall motion abnormalities are both sensitive and specific markers of acute ischemia, and support the use of computerized left ventricular angiography for the quantitative assessment of clinical ischemic dysfunction.