tbuckley/cabot-search huggingface dataset:
PMO-216 Is coffee ground vomiting “hemodynamically” significant?
Authors: E Said, E Lunn, A Mohamed, F Gohar, A Soliman, K Kapur, D P Hurlstone
Journal: Gut (2012)

<h3>Introduction</h3> Coffee ground vomiting is defined as the passage of black material which is assumed to be blood. Its presence implies that bleeding has ceased or has been relatively modest.<sup>1</sup> It is therefore considered as low to medium risk upper GI bleeding compared to frank haematamesis and/or malena. Sign guidelines recommend admission and early endoscopy with Rockall score for patients above 60 years who present only with witnessed haematemesis or suspected continued bleeding. <h3>Methods</h3> Aim: evaluate the outcome of coffee ground vomiting in patients above the age of 60 in our hospital. Retrospective analysis of all OGD9s performed in our hospital over the last 3 years (December 2007–December 2011) using the endoscopy register (Endosoft). Patients with the indication of coffee ground vomiting, excluding associated haematamesis and/or malena were identified. Hb urea level and intervention at the time of the procedure were recorded. <h3>Results</h3> Overall, 93 patients were identified. 73 patients were more than 60 years old, 46 females (64%) and 27 males (36%), 24 had ulcer or evidence of bleeding (32%), the causes of bleeding includes: gastric ulcers 6, duodenal ulcers 4, oesophageal ulcers 4, severe gastritis/oesophagitis 5, others 5. Endoscopic Interventions includes: adrenalin injection, banding, heat probe and endoclips. 11 patients (42%) had more than 1 gm drop in Hb while 17 patients (65%) had raised urea. On the other hand, 20 patients were 60 years old or less, three patients had ulcers or evidence of bleeding (15%), four females (20%) and 16 males (80%), the cause of bleeding in all cases were gastric ulcers, two of them treated endoscopically with adrenalin and heat probe. Only one patient had more than one gm drop in Hb and raised urea. <h3>Conclusion</h3> Increase age is an independent risk factor in the assessment of bleeding and is part of the Rockall score. In this small cohort, Patients above 60 years old presenting with coffee ground vomiting were predominantly females with around third had a major cause for upper GI bleeding requiring endoscopic intervention. Raised urea appear to be more significant parameter than drop in Hb. Coffee ground vomiting in this age group should regarded as severe GI bleeding equivalent to haematamesis. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Scottish Intercollegiate Guidelines Network</b>. Management of Acute Upper and Lower Gastrointestinal Bleeding, 2008.
Computed Tomography Reflects Lower Airway Inflammation and Tracks Changes in Early Cystic Fibrosis
Authors: Stephanie D. Davis, Lynn A. Fordham, Alan S. Brody, Terry L. Noah, George Z. Retsch-Bogart, Bahjat F. Qaqish, Bonnie C. Yankaskas, Robin C. Johnson, Margaret W. Leigh
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Detecting and tracking early cystic fibrosis (CF) lung disease are difficult due to lack of sensitive markers of airway dysfunction.The goals were to detect regional distribution of airway disease through high-resolution computed tomography, correlate abnormalities to lower airway inflammation/infection, and compare computed tomography findings before and after intravenous antibiotic therapy in children with CF younger than 4 years experiencing a pulmonary exacerbation.High-resolution computed tomography was performed in 17 children scheduled for bronchoscopy. The radiologist identified the lobes with the "greatest" and "least" disease based on computed tomography, and bronchoalveolar lavage was performed in these areas. In 13 subjects, imaging was repeated after antibiotic completion. Modified Brody scores were assigned by two radiologists.The lobe with greatest disease was predominantly localized to the right and had higher modified Brody scores, indicating more severe abnormalities (p < 0.01), compared with the lobe with least disease. The total modified Brody score (p < 0.01), hyperinflation subscore (p < 0.01), and bronchial dilatation/bronchiectasis subscore (p < 0.01) improved after antibiotics and intensified airway clearance. Interleukin-8 levels (p < 0.01) and % neutrophils (p = 0.04) were increased in the lobe with greatest disease compared with the lobe with least disease.These results indicate that, in young children with CF experiencing a pulmonary exacerbation, computed tomography detects regional differences in airway inflammation, may be a sensitive outcome to evaluate therapeutic interventions, and identifies early lung disease as being more prominent on the right.
A Markov decision analysis of allogeneic hematopoietic cell transplantation versus chemotherapy in patients with acute myeloid leukemia in first remission
Authors: Saiko Kurosawa, Takuhiro Yamaguchi, Shuichi Miyawaki, Naoyuki Uchida, Heiwa Kanamori, Kensuke Usuki, Takuya Yamashita, Masato Watanabe, Kazuaki Yakushiji, Shingo Yano, Yuichiro Nawa, Jun Taguchi, Jin Takeuchi, Junji Tomiyama, Yuko Nakamura, Ikuo Miura, Yoshinobu Kanda, Yoichi Takaue, Takahiro Fukuda
Journal: Blood (2010)
Effect of sulphasalazine and its metabolites on the generation of reactive oxygen species.
Authors: A Williams
Journal: Gut (1987)

The pentraxin 3 (PTX3) is an acute phase proinflammatory protein produced by fibroblasts and alveolar epithelial cells. We have previously demonstrated that PTX3 is a key modulator of inflammation. Mechanical ventilation (MV) is a life saving therapeutic approach for patients with acute lung injury that, nevertheless could lead to an inflammatory response and tissue injury (ventilator-induced lung injury: VILI), representing a major cause of iatrogenic lung damage in intensive units. Our objective was to investigate the role of PTX3 in VILI. PTX3 transgenic, knockout and Wt control mice (n = 12/group) were ventilated (45ml·kg<sup>−1</sup>) until respiratory system Elastance increased 50% (Ers150%), an indicator of VILI. Histological analysis demonstrated that using a Ers150% was appropriate for our analysis since identical degrees of inflammation were observed in Tg, KO and Wt mice as assessed by leukocyte infiltration, oedema, alveolar collapse and number of breaks in alveolar septa. However, Tg mice reached Ers150% faster than Wt controls (p = 0.0225). We also showed that the lack of PTX3 does not abolish the occurrence of VILI in KOs. Gene expression profile of PTX3, IL-1beta, IL-6, KC, IFNgamma, TGFbeta and PCIII were investigated by QPCR. MV drastically up modulated PTX3 as well as IL-1beta, IL-6, IFNgamma and KC. Alternatively, mice were ventilated for 20, 40 and 60 min. The faster kinetics of Tg mice to reach Ers150% was accompanied by an earlier augmentation of IL-1b and PTX3 expression. The kinetics of local PTX3 expression in the lungs of ventilated mice strongly suggests the involvement of this pentraxin in the pathogenesis of VILI.
Medical Screening and the Employee Health Cost Crisis
Authors: Arthur L. Frank
Journal: JAMA (1990)

New things sometimes have a "me too" appearance. In the work<i>Medical Screening and the Employee Health Cost Crisis</i>we have a "me again" approach. Professor Rothstein, an attorney, states in his preface that this book was written as a sequel to the 1984 book<i>Medical Screening of Workers</i>and that it is intended to both "stand alone" and to follow up on issues raised earlier. If one judges this book by its cover, one will be disappointed. The current cost of health care is one of the significant issues of both labor-management relations and national policy for the 1990s and can be expected to continue as such. Strikes can already be traced to who will pay for employee and retiree health benefits. If one were looking for an insightful review of this issue, this would not be the book to read. The book is replete with numerous difficulties and
SPECT Evaluation of Unilateral Spondylolysis
Authors: JOHN O. LUSINS, JAMES J. ELTING, ANTHONY D. CICORIA, STANLEY J. GOLDSMITH
Journal: Clinical Nuclear Medicine (1994)

Three patients with unilateral spondylolysis were evaluated with SPECT and Lumbar CT. All three cases had positive scans. However, the SPECT images were unique to each case. Therefore, the interpretation of the SPECT activity was undertaken in terms of the known natural history of both unilateral and bilateral spondylolysis.
Phthalate Concentrations and Dietary Exposure from Food Purchased in New York State
Authors: Arnold Schecter, Matthew Lorber, Ying Guo, Qian Wu, Se Hun Yun, Kurunthachalam Kannan, Madeline Hommel, Nadia Imran, Linda S. Hynan, Dunlei Cheng, Justin A. Colacino, Linda S. Birnbaum
Journal: Environmental Health Perspectives (2013)

Phthalates have been found in many personal care and industrial products, but have not previously been reported in food purchased in the United States. Phthalates are ubiquitous synthetic compounds and therefore difficult to measure in foods containing trace levels. Phthalates have been associated with endocrine disruption and developmental alteration.Our goals were to report concentrations of phthalates in U.S. food for the first time, specifically, nine phthalates in 72 individual food samples purchased in Albany, New York, and to compare these findings with other countries and estimate dietary phthalate intake.A convenience sample of commonly consumed foods was purchased from New York supermarkets. Methods were developed to analyze these foods using gas chromatography-mass spectroscopy. Dietary intakes of phthalates were estimated as the product of the food consumption rate and concentration of phthalates in that food.The range of detection frequency of individual phthalates varied from 6% for dicyclohexyl phthalate (DCHP) to 74% for di-2-ethylhexyl phthalate (DEHP). DEHP concentrations were the highest of the phthalates measured in all foods except beef [where di-n-octyl phthalate (DnOP) was the highest phthalate found], with pork having the highest estimated mean concentration of any food group (mean 300 ng/g; maximum, 1,158 ng/g). Estimated mean adult intakes ranged from 0.004 μg/kg/day for dimethyl phthalate (DMP) to 0.673 μg/kg/day for DEHP.Phthalates are widely present in U.S. foods. While estimated intakes for individual phthalates in this study were more than an order of magnitude lower than U.S. Environmental Protection Agency reference doses, cumulative exposure to phthalates is of concern and a more representative survey of U.S. foods is indicated.
The role of skin and muscle resistance vessels in reflexes mediated by the baroreceptor system
Authors: G. David Beiser, Robert Zelis, Stephen E. Epstein, Dean T. Mason, Eugene Braunwald
Journal: Journal of Clinical Investigation (1970)

The role of skin and muscle vascular beds in baroreceptor-mediated alterations of peripheral vascular resistance was evaluated in six normal subjects in whom the skin circulation in one forearm was temporarily suppressed by epinephrine iontophoresis. Baroreceptor activity was enhanced by application of negative pressure to the neck (neck suction) and inhibited by application of lower body negative pressure. Forearm blood flow was measured simultaneously in both arms with strain gauge plethysmographs. Since blood flow in the treated arm consisted entirely of muscle flow, skin flow was calculated from the difference between total forearm flow in the intact arm and muscle flow in the treated arm. Vascular resistances were calculated as the ratio of mean arterial pressure to the blood flow of each vascular bed. During neck suction, mean arterial pressure decreased from an average of 89 to 75 mm of Hg (P < 0.005), heart rate decreased from an average of 60 to 55 beats/min (P < 0.005), and total skin and muscle flows remained essentially unchanged. Cutaneous vascular resistance decreased from an average of 75 to 49 mm of Hg/ml per 100 g per min (P < 0.05), muscle vascular resistance from 68 to 51 (P < 0.005), and total forearm vascular resistance from 36 to 24 (P < 0.025). During lower body negative pressure, heart rate increased from an average of 59 to 69 beats/min (P < 0.005), mean arterial pressure did not change significantly, and significant decreases occurred in forearm blood flow from 5.4 to 2.7 ml/100 g per min, in skin blood flow from 3.1 to 1.4, and in muscle blood flow from 2.3 to 1.3. Cutaneous vascular resistance increased from an average of 47 to 110 mm of Hg/ml per 100 g per min (P < 0.05), muscle vascular resistance from 43 to 72 (P < 0.005), and total forearm vascular resistance from 20 to 38 (P < 0.001). These results demonstrate that both the skin and muscle resistance vessels participate in reflex changes initiated by alterations in baroreceptor activity.
Anatomy of Postural Slouch
Authors: Robert D. Ray
Journal: JAMA (1965)

<h3>To the Editor:—</h3> If underlying orthopedic disease has been excluded as a cause of poor posture, shoulder or back braces are not helpful, nor are they likely to be tolerated. A proper brassiere would be in order, otherwise the program of weight reduction and postural exercises originally mentioned would be the correct line of treatment.
Remission of Maternal Depression and Children’s Psychopathology
Authors: Stefan P. Kruszewksi, Kristopher S. Shumway, Barry X. Kuhle
Journal: JAMA (2006)

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
Arachidonic acid and prostaglandin endoperoxide metabolism in isolated rabbit and coronary microvessels and isolated and cultivated coronary microvessel endothelial cells.
Authors: M E Gerritsen, C D Cheli
Journal: Journal of Clinical Investigation (1983)

Isolated microvessels and isolated and cultured microvessel endothelial cells were prepared from rabbit cardiac muscle. Pathways of arachidonic acid metabolism were determined by measurement of exogenous substrate utilization [( 1-14C]arachidonic acid incorporation and release from intact tissue and cells; [1-14C]prostaglandin H2 (PGH2) metabolism by broken cell preparations) and by quantification of endogenous products (immunoreactive 6-keto-prostaglandin F1 alpha (PGF1 alpha) and prostaglandin E (PGE) release) by selective radioimmunoassay. Rabbit coronary microvessels and derived microvascular endothelial cells (RCME cells) synthesized two major products of the cyclooxygenase pathway: 6-keto-PGF1 alpha (hydrolytic product of prostaglandin I2) and PGE2. A reduced glutathione requiring PGH-E isomerase was demonstrated in coronary microvessels and RCME cells, but not in rabbit circumflex coronary artery or aorta. In addition, a minor amount of a compound exhibiting similar characteristics to 6-keto-PGE1 was found to be produced by microvessels and RCME cells. Measurement of endogenously released prostaglandins indicated that under basal and stimulated conditions, PGE release exceeded that of 6-keto-PGF1 alpha. Microvessels and microvessel endothelial cells derived from cardiac muscle of rabbit exhibit pathways of arachidonate metabolism that are different from those of many large blood vessels and derived endothelial cells.
Calcium ionophore, phorbol ester, and chemotactic peptide-induced cytoskeleton reorganization in human neutrophils.
Authors: T H Howard, D Wang
Journal: Journal of Clinical Investigation (1987)

Formyl-methionylleucylphenylalanine (fMLP) activation of neutrophils causes an increase in intracellular Ca2+, activation of protein kinase C and an increase in F-actin content. To examine the role of Ca2+ and protein kinase C activation as determinants of change in F-actin content of neutrophils, we used the NBD-phallacidin extraction assay to compare the kinetics and extent of change in F-actin content of cells activated with fMLP, the calcium ionophore A23187 or phorbol myristate acetate (PMA). All stimuli increase the F-actin content in a dose-dependent manner; however, the rate of increase is slower and the maximum F-actin content is less for calcium ionophore and PMA than for fMLP-activated cells. The A23187-induced increase in F-actin content, but not that of fMLP, depends upon external free [Ca2+]. In A23187-activated cells, F-actin content increases at [Ca2+]free greater than or equal to 5 microM, is maximal at [Ca2+]free greater than or equal to 10 microM and is negligible at physiologic free [Ca2+] (10(-7)-10(-6) M). Combinations of PMA with A23187 or fMLP inhibit the A23187, but not the fMLP, activated actin polymerization. Comparison and combination of these activators shows that neither Ca2+-dependent activation with A23187 nor activation with PMA alone or in combination mimic the fMLP-induced changes in cytoskeleton organization of neutrophils.
The Osteoporosis Revolution
Authors: Lawrence G. Raisz
Journal: Annals of Internal Medicine (1997)

Our concepts of the pathogenesis, diagnosis, prevention, and treatment of osteoporosis are radically changing.Some changes, such as the study of genetic determinants of bone mass and turnover and the identification of local factors in pathogenesis, have just begun. The use of bone densitometry to diagnose and predict fracture risk is well developed but not yet widely applied. Measurement of bone turnover done by using biochemical markers is a promising new diagnostic method that has already proved useful in assessing a patient's response to therapy. Options for prevention and treatment have increased substantially with the Food and Drug Administration's recent approval of alendronate (a bisphosphonate) and nasal calcitonin for treatment of osteoporosis. Some are concerned that these new agents will unduly reduce the use of estrogen, which should remain the mainstay for prevention of bone loss and fractures in postmenopausal women. New therapeutic approaches are needed to treat the established disease. Our goal should be to develop inexpensive and widely applicable methods for diagnosis, prevention, and treatment to limit the enormous increase in osteoporotic fractures that has been predicted as the aging population expands worldwide.
Trends in Hospitalizations for Pneumonia Among Persons Aged 65 Years or Older in the United States, 1988-2002
Authors: Alicia M. Fry
Journal: JAMA (2005)

Pneumonia causes significant mortality and morbidity among persons aged 65 years or older. However, few studies have explored trends according to age groups, which may affect intervention strategies.To examine trends in hospitalizations for pneumonia among persons aged 65 years or older and to compare characteristics, outcomes, and comorbid diagnoses.Data from 1988 through 2002 on pneumonia and comorbid diagnoses among patients aged 65 to 74 years, 75 to 84 years, and 85 years or older from the National Hospital Discharge Survey.Hospitalization rates by first-listed and any-listed discharge codes for pneumonia; proportions of hospitalizations reporting comorbid diagnoses for the 3 age groups (65-74 years, 75-84 years, > or =85 years).Hospitalization rates by both first-listed and any-listed discharge codes for pneumonia increased by 20% from 1988-1990 to 2000-2002 for patients aged 65 to 74 years (P = .01) and for patients aged 75 to 84 years (P<.001). Rates of hospitalization for pneumonia were 2-fold higher for patients aged 85 years or older (51 per 1000 population for first-listed discharge code of pneumonia; 95% confidence interval [CI], 46-55 per 1000 population) than among patients aged 75 to 84 years (26 per 1000 population; 95% CI, 24-28 per 1000 population), but did not significantly increase from 1988-1990 to 2000-2002. The proportion of patients aged 65 years or older diagnosed with pneumonia and a chronic cardiac disease, chronic pulmonary disease, or diabetes mellitus increased from 66% (SE, 1.0%) in 1988-1990 to 77% (SE, 0.8%) in 2000-2002. The risk of death during a hospitalization for pneumonia compared with the risk of death during a hospital stay for the 10 other most frequent causes of hospitalization was 1.5 (95% CI, 1.4-1.7) and remained constant from 1988-1990 to 2000-2002.Hospitalization rates for pneumonia have increased among US adults aged 64 to 74 years and aged 75 to 84 years during the past 15 years. Among those aged 85 years or older, at least 1 in 20 patients were hospitalized each year due to pneumonia. Concomitantly, the proportion of comorbid chronic diseases has increased. Efforts to prevent pneumonia should include reducing preventable comorbid conditions and improving vaccine effectiveness and vaccination programs in elderly persons.
Clinical efficacy and safety of local nasal immunotherapy
Authors: L. Andri, G. E. Senna, A. R. Dama
Journal: Allergy (1997)

Local nasal immunotherapy represents an alternative route of allergen administration. It was proposed to overcome the risk of systemic reactions rarely reported during the traditional subcutaneous immunotherapy. Some studies carried out in the past generally showed good efficacy but poor tolerability. The aqueous extracts mostly used in these studies carry some drawbacks such as the volume effect, self‐digestion and the difficulty of administering reproducible dosages. The recent availability of allergen extracts in powder form has led to better stability and standardization. The studies carried out with these freeze‐dried allergens showed clinical efficacy and good tolerability in perennial (mite, cat) and seasonal (grass, birch, Purieturia ) allergic rhinitis. According to these findings this new local nasal immunotherapy with extract in powder form represents a suitable alternative to the traditional immunotherapy in the treatment of allergic rhinitis.