tbuckley/cabot-search huggingface dataset:
SPONTANEOUS RUPTURE OF THE HEART IN A CASE OF ULCERATIVE ENDOCARDITIS
Authors: THOMAS A. CLAYTOR
Journal: JAMA (1923)

Spontaneous rupture of the heart, though a rare occurrence, has many examples in literature. To Harvey is attributed the first observation of a case, and Morgagni himself, who wrote much on the subject, strangely enough succumbed to this unusual accident. George II of England also died from a tear in the wall of the right ventricle. The history of this case is so typical and is so quaint in its wording that I make a short quotation from Dr. Frank Nicholl's<sup>1</sup>report: "About seven o'clock in the morning a noise was somewhere heard, as if a large billet had fallen down, and upon inquiry His Majesty was found fallen down on the ground, speechless and motionless. He appeared to have come from his necessary stool and as if going to his escritoir." An attempt was made to let blood, but the king did not revive. At the necropsy an
“Seeing” is believing
Authors: Sumita Verma
Journal: BMJ (2006)

The skin surrounding a highly exuding wound may be further protected through the use of emollients (such as 50:50 mix of white soft paraffin and liquid paraffin) or the application of barrier films (such as Cavilon).Conversely, use of a highly absorptive dressing on a dry wound may lead to disruption of healthy tissue on the wound surface and cause pain when removed.Allergic reactions are not uncommon: the dressing should be avoided, and the allergy may need to be treated with potent topical steroids.Tapes used to keep dressings in place are common causes of allergy.Many dressings require secondary dressings-for example, padding on highly exuding wounds-which may make them bulky.Secondary dressings should not be too tight, especially on patients with peripheral vascular disease.Competing interests: For series editors' competing interests, see the first article in this series.Abdominoperineal resection wound treated with vacuum assisted closure.The skin edges are protected with a barrier cream to prevent maceration Left: Allergy to dressing used to treat arterial leg ulceration.Note erythematous skin with sharply demarcated edges corresponding to the shape of the offending dressing.Right: Ulceration over the anterior aspect of the ankle caused by inappropriately tight bandage
Neurogenetics: A Guide for Clinicians
Authors: Patricia E. Greenstein
Journal: JAMA Neurology (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Neurology journal
A Simple Method for Estimating Respiratory Solute Dilution in Exhaled Breath Condensates
Authors: Richard M. Effros, Julie Biller, Bradley Foss, Kelly Hoagland, Marshall B. Dunning, Daniel Castillo, Mark Bosbous, Feng Sun, Reza Shaker
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Exhaled breath condensates have been widely used to detect inflammatory mediators in the fluid that covers airway surfaces of patients with inflammatory lung disorders. This approach is much less invasive than bronchoalveolar lavage, but respiratory droplets are markedly diluted by large and variable amounts of water vapor. We estimated the dilution of respiratory droplets by comparing concentrations of nonvolatile, reference indicators (total nonvolatile cations, urea or conductivity) in 18 normal subjects with normal plasma concentrations by assuming similar concentrations in the respiratory fluid and plasma. The volatile cation, NH4+ (most of which is delivered as NH3 gas from the mouth), represented 93 ± 3% (SEM) of the condensate cations. More than 99% of the NH4+ was removed by lyophilization, making it possible to use conductivity to estimate total nonvolatile ionic concentrations and facilitating analysis of urea. Conductivity was significantly correlated with electrolyte and urea concentrations. Estimates of dilution based on total cations, conductivity, and urea were not significantly different (cations: 20,472 ± 2,516; conductivity: 21,019 ± 2,427; and urea: 18,818 ± 2,402). These observations suggest that the conductivity of lyophilized samples can be used as an inexpensive, simple, and reliable method for estimating dilution of nonvolatile, hydrophilic mediators in condensates.
Review: Prehospital noninvasive ventilation for severe respiratory distress reduces hospital mortality
Authors: Brian H. Rowe
Journal: Annals of Internal Medicine (2014)

Source Citation Mal S, McLeod S, Iansavichene A, Dukelow A, Lewell M. Effect of out-of-hospital noninvasive positive-pressure support ventilation in adult patients with severe respiratory distress: a systematic review and meta-analysis. Ann Emerg Med. 2014;63:600-7. 24342819
Sickle cell disease and pulmonary hypertension in Africa: A global perspective and review of epidemiology, pathophysiology, and management
Authors: Zakari Y. Aliyu, Gregory J. Kato, James Taylor, Aliyu Babadoko, Aisha I. Mamman, Victor R. Gordeuk, Mark T. Gladwin
Journal: American Journal of Hematology (2007)

Abstract Secondary pulmonary hypertension (PAH) has been shown to have a prevalence of 30% in patients with sickle cell disease (SCD) with mortality rates of 40% at 40 months after diagnosis in the United States. The burden of SCD is highest in sub‐Saharan Africa, especially in Nigeria (West Africa), where approximately 6 million people are afflicted. The true global incidence, prevalence, and burden of SCD and its associated end organ complications however remain unknown. Chronic hemolysis represents a prominent mechanistic pathway in the pathogenesis of SCD‐associated pulmonary hypertension via a nitric oxide (NO) scavenging and abrogation of NO salutatory effects on vascular function, including smooth muscle relaxation, downregulation of endothelial adhesion molecules and inhibition of platelet activation. Many known infectious risk factors for PAH are also hyperendemic in Africa, including Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), chronic hepatitis B and C, and possibly malaria. Interactions between these infectious complications and SCD‐related hemolysis could yield an even higher prevalence of pulmonary hypertension and compound the existing global health systems challenges in managing SCD. Indeed, our preliminary analysis of African immigrants currently in the United States suggests that pulmonary hypertension represents a significant complication of SCD in the African subcontinent. There is clearly a need to include Africa and other parts of the world with high SCD prevalence in future comprehensive studies on the epidemiology and treatment of end organ complications of an aging SCD population world‐wide. Am. J. Hematol., 2008. Published 2007 Wiley‐Liss, Inc.
Interleukin 13 Mediates Signal Transduction through Interleukin 13 Receptor α2 in Pancreatic Ductal Adenocarcinoma: Role of IL-13 <i>Pseudomonas</i> Exotoxin in Pancreatic Cancer Therapy
Authors: Takeshi Shimamura, Toshio Fujisawa, Syed R. Husain, Bharat Joshi, Raj K. Puri
Journal: Clinical Cancer Research (2010)

Interleukin-13 receptor alpha2 (IL-13Ralpha2) is a tumor antigen that is overexpressed in certain human tumors. However, its significance and expression in pancreatic cancer is not known. It is also not known whether IL-13 can signal through IL-13Ralpha2 in cancer.The expression of IL-13Ralpha2 was assessed in pancreatic cancer samples by immunohistochemistry and in cell lines by flow cytometry and reverse transcription-PCR. The role of IL-13Ralpha2 was examined by IL-13-induced signaling in pancreatic cancer cell lines. IL-13Ralpha2-positive tumors were targeted by IL-13PE cytotoxin in vitro and in vivo in an orthotopic murine model of human pancreatic cancer.Of the pancreatic tumor samples 71% overexpressed moderate to high-density IL-13Ralpha2 chain compared with normal pancreatic samples. IL-13 induced transforming growth factor-beta1 promoter activity in IL-13Ralpha2-positive tumor cells and in cells engineered to express IL-13Ralpha2 but not in IL-13Ralpha2-negative or RNA interference knockdown cells. c-Jun and c-Fos of the AP-1 family of nuclear factors were activated by IL-13 only in IL-13Ralpha2-positive cells. In the orthotopic mouse model, IL13-PE significantly decreased tumor growth when assessed by whole-body imaging and prolonged the mean survival time. Similar results were observed in mice xenografted with a surgically resected human pancreatic tumor sample.These results indicate that IL-13Ralpha2 is a functional receptor as IL-13 mediates signaling in human pancreatic cancer cell lines. IL-13 causes transforming growth factor-beta activation via AP-1 pathway, which may cause tumor induced immunosuppression in the host. In addition, IL13-PE cytotoxin may be an effective therapeutic agent for the treatment of pancreatic cancer.
Screen Camelford residents, researchers say, after woman's death linked to poisoned water supply
Authors: Kaye McIntosh
Journal: BMJ (2006)

Researchers investigating the death of a woman in 2004 from a rare form of Alzheimer's disease, which has been linked to the poisoning of the drinking water supply in a town in south west England, are calling for all local residents to be monitored for any signs of impaired cognitive function ( Journal of Neurology, Neurosurgery, and Psychiatry 2006 doi: 10.1136/jnnp.2005.086553).

But local heath officials say that the health of local people is already under review. North and East Cornwall Primary Care Trust's director of public health, Denis Cronin, told the BMJ , “When you …
Specific recruitment of regulatory T cells into the CSF in lymphomatous and carcinomatous meningitis
Authors: Jürgen Haas, Laila Schopp, Brigitte Storch-Hagenlocher, Benedikt Fritzsching, Christian Jacobi, Linda Milkova, Brigitte Fritz, Alexander Schwarz, Elisabeth Suri-Payer, Manfred Hensel, Brigitte Wildemann
Journal: Blood (2007)
The Consult Guys - Perioperative Risk Assessment: Can You Get It Right?
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2013)

Web ExclusivesSeptember 17, 2013The Consult Guys - Perioperative Risk Assessment: Can You Get It Right?FREEGeno J. Merli, MD, Howard H. Weitz, MDGeno J. Merli, MDSearch for more papers by this author, Howard H. Weitz, MDSearch for more papers by this authorAuthor, Article and Disclosure Informationhttps://doi.org/10.7326/G13-3001 SectionsSupplemental MaterialAboutVisual AbstractAbstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Consult Guys bring a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.For more videos from and information on The Consult Guys, visit www.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment J. Roberto Mendoza, MDFSU/TMH IMRP16 December 2013 Good Very clear, down to earth advice on the evaluation of the surgical patient. Nicholas H.E. Mezitis, MD Ohio University - UMA Diabetes Endocrine Care Center 4 May 2015 Preoperative Assessment Very enjoyable and clear exposition of relevant information on an important topic.A pleasure to watch two master clinicians in educational interaction.Thank you for hosting this series. Andrew R. Rosen, MDElliot Health System, Manchester, NH18 August 2014 peroperative assessment thank you for the update- wonderfully clear and concise. Author, Article and Disclosure InformationAffiliations: Disclosures: Geno J. Merli, MD, reports the following: Research grants/contracts: Bristol-Myers Squibb, Bayer, sanofi-aventis; Consultancies: Bristol-Myers Squibb, Bayer, sanofi-aventis. Howard H. Weitz, MD, reports that he has no financial relationships or interests to disclose. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics September 17, 2013Volume 159, Issue 6Page: CG1 ePublished: 17 September 2013 Issue Published: September 17, 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.Loading ...
90 IMMUNODOMINANCE OF HLA-A*0201 RESTRICTED HEPATITIS C VIRUS-SPECIFIC CD8+ T CELL RESPONSES IS DETERMINED BY THE NAIVE PRECURSOR FREQUENCY
Authors: J. Schmidt, T. Altay, D.A. Price, V. Lohmann, H.E. Blum, C. Neumann-Haefelin, R. Thimme
Journal: Journal of Hepatology (2011)
S79 Specific functional antibody deficiency is associated with a reduction lung function in the severe asthma population
Authors: H. Wardman, R. Niven, G. McCumesky, L. J. Holmes, D. Menzies, G. Tavernier
Journal: Thorax (2011)

<h3>Background</h3> <i>Haemophilus influenzae type B (Hib)</i> and <i>Streptoccus pneumoniae</i> are leading causes of LRTI in the severe asthma population. Patients attending our regional severe asthma service have functional antibody levels tested against these two bacteria. Those with weakened immune systems may go on to require immunoglobulin therapy. The prevalence and impact of specific antibody deficiency within the severe asthma population has yet to be established. <h3>Objective</h3> We sought to quantify the number of patients who are deficient in antibodies against <i>Hib</i> and <i>S pneumoniae</i> within the severe asthma population, both at initial assessment and after vaccination. <h3>Methods</h3> Data from our regional clinic stored on a National Severe Asthma database was supplemented with information from the UHSM clinical results database, which contains blood antibody levels against <i>Hib</i> and <i>S pneumoniae</i> and lung physiology. Deficiency in <i>Hib</i> was defined as antibody levels of &lt;0.15 μg/ml and for <i>S pneumoniae</i>, 6 out of 12 strains tested measuring &gt;0.35 μg/ml. Only patients assessed after January 2008 were included. The prevalence of radiological abnormality, <i>Aspergillus</i> sensitisation, blood and sputum eosinophil counts, and lung function between severe asthma patients with antibody deficiency, and those with normal antibody levels were then compared. <h3>Results</h3> Among the patients tested for immunity to <i>S pneumoniae</i> (n=94) and <i>Hib</i> (n=97), 33% and 51% respectively were found to be deficient at initial assessment. In patients with baseline immune deficiency, 70% of those that received the Pneumovax vaccine had persistently low antibody levels against <i>S pneumoniae</i>, (p=0.03), and 20% who received Menitorix remained deficient in <i>Hib</i> antibodies. The mean post bronchodilator FEV<sub>1</sub> for patients with normal <i>S pneumoniae</i> antibody levels was 82.4% predicted compared to 68.8% predicted in those who were deficient at initial assessment (p=0.018), and 65.3% predicted in patients with persistently low antibody levels even after vaccination (p=0.049). All other variables showed no difference between the groups. <h3>Conclusion</h3> This study demonstrates for the first time that antibody deficiency to <i>S pneumoniae</i> and <i>Hib</i> is common in patients with severe asthma, can persist despite vaccination in a significant proportion of individuals and is associated with worse lung function.
First seven years of a new NHS mental handicap service 1974-81.
Authors: A M Myers
Journal: BMJ (1982)

A new community-focused mental handicap service was started in a single-district area health authority in 1974. Almost 90% of all the severely mentally handicapped people in a population of 250,000 are now known to the service. Although two-thirds of long stay inpatients originally admitted with major behavioural problems have had them resolved, the remaining one-third with persisting problems are noted to have spent many years in large understaffed wards before transfer. Specialist services to mentally handicapped people are not synonymous with beds. The learning opportunities during the waking hours of a mentally handicapped person are where professional help must be concentrated, and extensive support services for those caring for the mentally handicapped at home must be set up. Absence of shared philosophies, policies, and planning among the health and local authorities has produced the problems and frustrations familiar to many professionals in mental handicap. Future developments must be based on clearly defined and declared principles.
Pre-exposure prophylaxis in women fails to prevent HIV infection in African study
Authors: S. Mayor
Journal: BMJ (2015)

Pre-exposure prophylaxis with an oral or vaginal antiretroviral drug failed to reduce HIV-1 infection in a large study of young women in South Africa, Uganda, and Zimbabwe. Blood tests showed poor adherence with the treatment, which is likely to explain the lack of effect.

The study randomised 5029 women aged 18 to 45 (mean age 25.3 years) to daily treatment with 1% tenofovir vaginal gel or placebo or alternatively to oral tenofovir disoproxil fumarate, oral tenofovir …
T cells migrate to tumour sites after extracorporeal interleukin 2 stimulation and reinfusion in a patient with metastatic melanoma
Authors: R. DUMMER, J.C. BECKER, C. EILLES, E. SCHAFER, W. BORNER, G. BURG
Journal: British Journal of Dermatology (1993)

Peripheral blood mononuclear cells (PBMC) were taken by leukapheresis from a patient with melanoma skin metastases and stimulated in vitro using 1000 IU recombinant interleukin 2 (IL-2)/ml to generate lymphokine-activated killer cells (LAK cells). Two-colour immunofluorescence analysis demonstrated an IL-2-induced up-regulation of CD25 on natural killer cells (CD56+) as well as on T lymphocytes (CD3+). After radiolabelling with indium-111, the cells were reinfuse. Gamma-camera imaging revealed an enrichment at the tumour sites. Immunostaining of tumour tissue taken before and after scintigraphy demonstrated CD25+ Tlymphocytes (CD2+, CD3+), but no natural killer cells (CD16+, CD56+) infiltrating the metastases. LAK cell enrichment at melanoma metastases in vivo did not involve natural killer cells, but was characterized by increased numbers of activated T lymphocytes in this patient.
Reply to Florian Jentzmik, Andres Jan Schrader and Mark Schrader’s Letter to the Editor re: Beat Roth, Frédéric D. Birkhäuser, Pascal Zehnder, et al. Readaptation of the Peritoneum Following Extended Pelvic Lymphadenectomy and Cystectomy Has a Significant Beneficial Impact on Early Postoperative Recovery and Complications: Results of a Prospective Randomized Trial. Eur Urol 2011;59:204–10
Authors: Urs E. Studer
Journal: European Urology (2011)
Digitalis and myocardial infarction in man.
Authors: J Morrison, J Coromilas, M Robbins, L Ong, S Eisenberg, R Stechel, M Zema, P Reiser, L Scherr
Journal: Circulation (1980)

The use of digitalis after acute myocardial infarction is controversial. The effect of digoxin on computer-quantitated thallium-201 perfusion scintigrams (Tl-201), left ventricular (LV) ejection fraction (EF), and percentage of abnormally contracting LV regions (% ACR) was determined in 23 patients. A correlation was established between creatine kinase MB isoenzyme release and initial radionuclide-gated blood pool wall motion estimates of EF (r = -0.73) and % ACR (r = 0.71). After radionuclide assessments, 14 patients received digoxin 18 +/- 23 hours (mean +/- SD) after the rise in CK-MB from baseline, while the remaining nine patients served as controls. In the control group, the mean EF was 0.33 +/- 0.12 on the first study and 0.30 +/- 0.08 on the second study (p = NS). In the digoxin group, the EF after digoxin administration (mean 0.33 +/- 0.11) was significantly different from the initial EF (mean 0.29 +/- 0.09, p less than 0.03); however, digoxin had no apparent effect on infarct size as assessed by sequential % ACR and Tl-201 perfusion data. These data indicate that digoxin resulted in a minimal but significant improvement in EF that did not occur at the expense of LV perfusion or regional wall motion.
Lactate dehydrogenase production and release in a newly established human myeloma cell line
Authors: Nobuo Hatakeyama, Masanori Daibata, Yuiko Nemoto, Yuji Ohtsuki, Hirokuni Taguchi
Journal: American Journal of Hematology (2001)

Abstract Aggressive multiple myeloma with high serum lactate dehydrogenase (LDH) often has unusual clinical features and is considered to be a distinct clinical entity of multiple myeloma. A myeloma cell line, designated Maska‐98, was established from the bone marrow of a patient with aggressive myeloma with extremely high serum LDH that was resistant to conventional chemotherapy. Maska‐98 cells had morphological features of immature plasma cells, and immunophenotypic analysis showed that the cells expressed the plasma cell‐associated surface antigens including CD38, 49d, and 56, but no T‐ or B‐cell antigens, such as CD2, 3, 4, 8, 19, and 20. Maska‐98 cells contained cytoplasmic immunoglobulin (IgG λ). By utilizing this cell line we demonstrated that the myeloma cells produce and release a large amount of LDH, since (i) abundant LDH was found in the culture supernatant of Maska‐98, (ii) immunocytochemical analysis showed that cytoplasm of the cells was strongly stained with anti‐LDH monoclonal antibody, and (iii) Maska‐98 cells expressed a greater amount of LDH mRNA than the T‐cell line TALL‐1, as shown by reverse transcription–polymerase chain reaction. As far as we know, there is no report of a myeloma cell line producing excess LDH. Therefore, Maska‐98 would provide a novel source for further studies of the pathogenesis of aggressive multiple myeloma with high serum LDH. Am. J. Hematol. 66:267–273, 2001. © 2001 Wiley‐Liss, Inc.
Neuropeptide-Y. A peptide found in human coronary arteries constricts primarily small coronary arteries to produce myocardial ischemia in dogs.
Authors: M F Maturi, R Greene, E Speir, C Burrus, L M Dorsey, D R Markle, M Maxwell, W Schmidt, S R Goldstein, R E Patterson
Journal: Journal of Clinical Investigation (1989)

Neuropeptide-Y (NPY), a brain peptide, is located in the walls of human coronary arteries. This study assessed the effects of NPY on the coronary circulation in 40 chloralose-anesthetized, open-chest dogs. Intracoronary NPY (42 nmol over 5.2 min) caused a 39% reduction in coronary blood flow without changing heart rate or aortic pressure. To determine whether this vasoconstriction could produce ischemia, intramyocardial pH was measured in seven dogs (group I) and decreased from 7.45 +/- 0.06 to 7.37 +/- 0.06 pH units after NPY in the subendocardium (P less than 0.0002), and from 7.45 +/- 0.06 to 7.40 +/- 0.05 pH units (P less than 0.04) in the subepicardium of the infused zone. Left ventricular ejection fraction (LVEF), measured by radionuclide angiography, decreased from 0.52 +/- 0.08 to 0.42 +/- 0.12 U (n = 5, P less than 0.01) during NPY. NPY-induced vasoconstriction was also associated with ST-T wave changes on the electrocardiogram (ECG) in eight of nine other animals (group V). In another group of six dogs (group IV), the change in small vessel resistance accounted for 94% of the increase in total resistance, so that the primary vasoconstrictor effect of NPY was exerted on small coronary arteries. Thus, NPY, a peptide found in human coronary arteries, caused constriction of primarily small coronary arteries that was severe enough to produce myocardial ischemia as determined by ECG ST-T wave changes, and decreases in intramyocardial pH and LVEF in dogs.