tbuckley/cabot-search huggingface dataset:
Contempo 1997: End-of-Life Care-Reply
Authors: Daniel P. Sulmasy
Journal: JAMA (1997)

<h3>In Reply.</h3> —We agree with Drs Burke and Steele that opportunities abound for teaching medical students and resident physicians how to provide excellent care for the dying. However, these opportunities are ignored routinely in medical education, and pernicious financial barriers still provide disincentives for changing this situation. Patients nearing the end of life in hospitals should be a focus of special concern. However, it seems that these patients continue to be marginalized by educational programs and discounted as "uninteresting teaching material." End-of-life care often is miscategorized by medical educators as ethics. While ethical issues in the care of the dying might attract considerable attention, there is no ethical dilemma to be faced in response to questions about treatment, such as whether students should know equi-analgesic dosages of various narcotic drugs. Yet students learn quickly that they will be rewarded more for knowing the patients' serum potassium levels than for attending to the
Colonic Symptoms with Active Duodenal Ulcer
Authors: Stewart P. Seigle, Benjamin V. White
Journal: New England Journal of Medicine (1954)

THE case reported below and similar experiences have made it increasingly clear that recurrent symptoms of an irritable colon are sometimes the principal or only clinical evidence of active duodenal ulcer. This observation led to a study of the frequency and importance of this phenomenon.In October, 1946, A.S., a 44-year-old tool-and-die worker, was seen at the Hartford Hospital because of severe abdominal distress over the cecum and along the descending colon. In April of the same year he had been studied because of pain in the epigastrium, with radiation down the left side of the abdomen. A gastrointestinal series . . .
THE TREATMENT OF ACUTE DYSENTERY.
Authors: J. M. ANDERS
Journal: JAMA (1903)

The subject will be considered under three heads : 1. Regiminal Treatment; 2, Internal Remedies; 3, Topical Applications. <h3>I. REGIMINAL TREATMENT.</h3> The regiminal treatment, properly carried out in its various details, is potent to render the course of this affection distinctly milder and more favorable. Among the eminently important measures in bacillary dysentery I should regard rest in bed throughout the attack as deserving of a prominent place, and it should be rigidly enforced in all instances, not excepting the milder sporadic cases. As a means to conserve the bodily strength and energy, absolute repose is never uncertain in its effects; its extreme importance to the inflamed and ulcerated bowel, with a view to promoting resolution and the healing process, is universally acknowledged. The efficiency of rest in bed can be appreciably enhanced by constant, careful attention to the ventilation of the sick chamber. Fresh
Arsine-Induced Anuria
Authors: ROBERT C. MUEHRCKE
Journal: Annals of Internal Medicine (1968)

A correlative clinicopathological study was made of a 32-year-old truck driver with arsine-induced anuria. Treatment consisted of massive exchange whole blood transfusions to remove the "arsenic-hemoglobin complex," prolonged peritoneal dialysis, and extracorporeal hemodialysis with supportive, nutritional, and medical measures as needed. Five serial renal biopsy specimens were studied by light and four by electron microscopy. Acute tubular necrosis was followed by rapid regeneration of tubular cells. However, in the proximal tubules, these new cells had a modified and apparently functionally defective structure. Return to a normal appearance took place in a period of more than 6 months. A striking morphological feature was a diffuse interstitial fibrosis which became focal. This together with profound nephron atrophy produced irreversible chronic renal disease. A literature review was made of arsine-induced anuria, its treatment and prognosis. Finally, the morphological changes were discussed as to the damage and repair in each of the four major kidney components: tubules, glomeruli, interstitium, and vessels.
Effect of gastrin heptadecapeptide (G17) on oesophageal contractions in patients with diffuse oesophageal spasm.
Authors: W H Lane, A F Ippoliti, R W McCallum
Journal: Gut (1979)

An intravenous bolus of pentagastrin significantly increased the amplitude and duration of oesophageal body contractions in seven patients with diffuse oesophageal spasm (DES) when compared with five normal subjects (P greater than 0.05). In order to determine whether this stimulation also occurred at physiological gastrin concentrations, the effect of an intravenous infusion of gastrin heptadecapeptide (G17), 25 pmol/kg-h, on oesophageal contractions was studied in DES patients. G17 had no significant effect on the amplitude and duration of oesophageal contractions compared with a saline control. This dose of G17 was near the D50 for gastric acid secretion and produced a rise in serum gastrin concentration comparable with a meal. G17 infusions at doses of 100 and 200 pmol/kg-h increased the amplitude and duration of oesophageal contractions, but the corresponding serum gastrin concentrations were higher than postprandial levels. Thus, endogenous fluctuations in serum gastrin heptadecapeptide, alone, are unlikely to alter oesophageal contractions in DES patients.
An improved model of acetaminophen-induced fulminant hepatic failure in dogs
Authors: James H. Kelly, Tarek Koussayer, Da-Er He, Maria G. Chong, Thomas A. Shang, Hartwell H. Whisennand, Norman L. Sussman
Journal: Hepatology (1992)

We have established an improved model of fulminant hepatic failure in dogs. Buthionine sulfoximine is used to inactivate glutathione synthesis, and small increments of acetaminophen are given intravenously to maintain the plasma level at approximately 200 micrograms/ml for 20 hr. This regimen produces severe liver injury along with many of the features seen in humans with acetaminophen poisoning. The first sign of impending liver failure is hypoglycemia. This occurs about 15 hr into the experiment and requires treatment with a continuous infusion of glucose. Between 15 and 20 hr, serum ALT activity begins to rise, indicating the onset of liver necrosis. Over the following 15 to 20 hr ALT activity continues to rise and is accompanied by an increase in bilirubin, a prolongation of the prothrombin time and the development of fetor hepaticus. Thirty to 48 hr after the initial acetaminophen dose, the animals begin to exhibit symptoms of encephalopathy and progress from lethargy to the inability to maintain posture and then coma, seizures and death. Liver biopsy specimens obtained at several stages throughout the study showed progressive necrosis, ultimately resulting in the complete destruction of zones 2 and 3.
Kinetics of hemopoietic recovery after peripheral blood stem cell transplantation: Impact of stem cell purification and G‐CSF
Authors: Nicola Piccirillo, Federica Sorà, Luca Laurenti, Patrizia Chiusolo, Riccardo Serafini, Silvia Cicconi, Giuseppe Leone, Simona Sica
Journal: American Journal of Hematology (2001)

Abstract We investigated the role of stem cell purification and G‐CSF (early vs. delayed vs. no G‐CSF) administration on hemopoietic recovery and supportive care requirements after stem cell transplantation. Thirty‐two patients submitted to autologous CD34 + peripheral blood stem cell transplantation (PBSCT) were studied, and data were compared to patients undergoing unfractionated peripheral blood stem cell transplantation (uPBSCT) matched for age, disease, and conditioning regimen. Except for PMN, hemopoietic recovery was significantly slower and supportive care requirements were significantly higher after CD34 + PBSCT. Median time to PMN &gt;0.5 × 10 9 /l was 13 days (range 9‐27) and 13 d (range 9‐23); reticulocytes (Ret) &gt;1% was 14.5 d (range 12‐34) and 12 d (range 10‐27); high‐fluorescence reticulocytes (HFR) &gt;5% was 12 d (range 9‐26) and 9 d (range 7‐11); platelets &gt;50 × 10 9 /l and &gt;100 × 10 9 /l was 20 d (range 10‐240), 12 d (range 9‐60) and 33 d (range 15‐720), 15 d (range 11‐210). When the analysis was performed on subgroups of patients (early/delayed/no G‐CSF), early G‐CSF significantly promoted PMN recovery (&gt;0.5 × 10 9 /l and &gt;1.0 × 10 9 /l) compared to no G‐CSF, without affecting RBCs or platelet recovery. Delayed G‐CSF did not improve PMN recovery compared to patients not receiving G‐CSF, did not result in a significant reduction of drug requirements, and had a negative impact on erythroid and platelet recovery. In conclusion, these preliminary data suggest that G‐CSF is useful if given early after CD34 + PBSCT. CD34 + PBSCT may overall require a significant increase of resource utilization that should be outweighed by proven clinical benefit. Am. J. Hematol. 69:7‐14, 2002. © 2002 Wiley‐Liss, Inc.
US Congress and European Research Council insist on open access to research results
Authors: Jeanne Lenzer
Journal: BMJ (2008)

The US Congress and the European Research Council (ERC) have announced mandatory open access policies that direct researchers to deposit their manuscripts with PubMed Central or other specified online medical databases that are freely available to the public.

The US mandate was signed into law by the president, George Bush, on 26 December and follows nearly four years of contentious debate. The Association of American Publishers opposed the policy, saying that it “eliminates the concept of permission and effectively allows the agency to take important property interests without compensation, including the value added to the article …
The Supreme Court and the Affordable Care Act
Authors: Stephen Vaccarezza
Journal: Annals of Internal Medicine (2013)

Letters5 March 2013The Supreme Court and the Affordable Care ActStephen Vaccarezza, MDStephen Vaccarezza, MDFrom Rockville, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-5-201303050-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Doherty's commentary (1) clearly looks at only potential benefits of universal health care. Unfortunately, the devil is in the details on several levels. The details can make the utopian ideal unworkable. The detail is in the very nature of humans—people are people. People as a group will look out for themselves. This applies to the people who comprise the population in need of health insurance as well as those who will ostensibly be in charge of providing it. The latter does not refer to physicians but to the policymakers in charge of running health care programs.First, ...Reference1. Doherty RB. The Supreme Court and the Affordable Care Act: milestone or detour on the road to universal coverage? Ann Intern Med. 2012;157:577-9. [PMID: 22777567] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Rockville, Maryland.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Supreme Court and the Affordable Care Act: Milestone or Detour on the Road to Universal Coverage? Robert B. Doherty The Supreme Court and the Affordable Care Act Robert B. Doherty Metrics 5 March 2013Volume 158, Issue 5_Part_1Page: 363KeywordsConflicts of interestDecision makingHabitsHealth careHealth insuranceRunning ePublished: 5 March 2013 Issue Published: 5 March 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Abstract 631: Role of thymidylate synthase in genomic instability and tumorigenesis.
Authors: Lidia V. Kulemina, Min Chen, Kyungah Maeng, Akbar Nawab, Maria Zajac-Kaye
Journal: Cancer Research (2013)

Abstract Thymidylate synthase (TS) is a well-established chemotherapy target frequently overexpressed in cancer. Multiple clinical studies demonstrated that high levels of TS correlate with the disease stage and resistance to fluoropyrimidine chemotherapy. Previous studies from our laboratory reassessed the paradigm of TS as a passive proliferation biomarker by providing evidence towards its tumor-promoting capabilities (Cancer Cell 2004; Oncogene 2007). We demonstrated that ectopic TS overexpression combined with loss of tumor suppressor genes significantly enhances the rate and severity of tumorigenesis; however the underlying mechanism of this process remained unclear. TS fuels DNA replication and repair through dTMP and folate biosynthesis. We hypothesized that TS overexpression could become a strong tumor-promoting force by inducing nucleotide imbalance that results in DNA misincorporation and damage. In this study, we analyze effects of TS overexpression in context of aberrant DNA repair and cell cycle misregulation by using Ink4/Arf−/- genetically engineered mouse model. We show that ectopic TS overexpression markedly enhances tumorigenesis in hTS/Ink4/Arf−/- mice compared to Ink4/Arf−/- control resulting in more aggressive tumors. HPLC analyses of mouse tumor-derived cell lines confirmed significant nucleotide imbalance and increase in dTMP, dTDP and dTTP levels in hTS/Ink4/Arf−/- mice compared to control. Analysis of chromosomal changes by spectral karyotyping demonstrated 4 to 5 fold increase in chromosomal aberrations and aneuploidy in hTS positive tumor cell lines. Chromosomal translocations were only found in hTS/Ink4/Arf−/- subtype, indicative of strand-break damage. We assessed extent of damage by Comet assay and yH2AX phosphorylation in mouse tumor cell lines and found increased DNA fragmentation and high yH2AX signal in hTS/Ink4/Arf−/- cells as opposed to Ink4/Arf−/- control. In summary, these studies demonstrate a novel capacity for TS to promote nucleotide imbalance, increase DNA susceptibility to damage and chromosomal aberrations, suggesting a new model where TS overexpression plays a role in the development of genomic instability and tumorigenesis. Citation Format: Lidia V. Kulemina, Min Chen, Kyungah Maeng, Akbar Nawab, Maria Zajac-Kaye. Role of thymidylate synthase in genomic instability and tumorigenesis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 631. doi:10.1158/1538-7445.AM2013-631
Implants aside, silicon is no stranger to the body
Authors: T. Randall
Journal: JAMA (1992)

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
Public health advantages of biological insect controls.
Authors: R Bosch
Journal: Environmental Health Perspectives (1976)

Biological control is not new, it is simply newly appreciated. This renewed appreciation stems from the widespread insecticide treadmill which is largely a product of insecticide disruption of the balance of insect communities. Biological control is a natural phenomenon; the regulation of plant and animal numbers by natural enemies. In this broad sense, biological control is vital to public health because it keeps the myriad insect species from out-competing us. It also has direct public health advantages as where natural enemies are manipulated to control disease vectoring insects. Insecticide distruption of biological control by insecticides and the resulting pesticide treadmill have serious public health implications. One is the increased pesticide load in the environment. The other is the acceleration of pesticide resistance in disease vectoring insects. The treadmill and its associated hazards will not abate so long as chemical control dominates our pest management strategy.
Hypocholesterolemia in hairy cell leukemia: A marker for proliferative activity
Authors: John Pandolfino, David Hakimian, Alfred W. Rademaker, Martin S. Tallman
Journal: American Journal of Hematology (1997)

Hypocholesterolemia is a well-documented phenomenon associated with a variety of hematological malignancies and nonmalignant disorders associated with splenomegaly. To determine the incidence of hypocholesterolemia in patients with hairy cell leukemia (HCL), we measured the serum cholesterol levels before and after a single cycle of 2-chlorodeoxyadenosine (2-CdA) in 46 patients. The mean pre-treatment serum cholesterol level was 152.8 mg/dl (range, 60 to 293 mg/dl). The mean post-treatment serum cholesterol level was 190.0 mg/dl. This was significantly higher than the pre-treatment values (P <0.0001). Twelve patients who had previously undergone splenectomy showed a similar response to treatment, with a pre-treatment value of 180.0 mg/dl and a post-treatment value of 219.8 mg/dl (P < 0.0001). However, there was a significant difference in the pre-treatment serum cholesterol levels in the nonsplenectomized patients (143.0 mg/dl) compared to the splenectomized patients (180.0 mg/dl) (P < 0.03). The pre-treatment serum cholesterol did not correlate with the pre-treatment splenic index (correlation coefficient = -0.39, P < 0.065). Similarly, there was no correlation between the change in splenic index and the change in serum cholesterol level post-treatment. These findings suggest that hypocholesterolemia in HCL is related to tumor burden and not to splenomegaly alone. Since cholesterol is critical to hairy cell metabolism and structure, treatment strategies interfering with cholesterol synthesis may be productive.
MRSA and C difficile deaths continue to fall in England and Wales
Authors: A. Cole
Journal: BMJ (2013)

OBJECTIVES: To correlate glenohumeral translation in the anterior/posterior direction with medial and lateral rotation of the humerus. In addition, the length of the anterior and posterior component of the glenohumeral capsuloligamentous complex was varied in order to gain insight into the contribution of each component to limiting translation. All measurements were made with the humerus positioned at 90 degrees of abduction and 0 degrees of flexion/ extension. METHODS: Six fresh cadaveric shoulders were used. Each scapula was mounted in a cement pot to rest it in its correct anatomical position. Seven tests were carried out on each shoulder. A series of measurements of translation of the humerus in the anterior direction and posterior direction were taken at 20 degrees intervals of lateral rotation and then at 20 degrees intervals of medial rotation until the limit of lateral or medial rotation had clearly been reached (test 1). The capsuloligamentous complex was then incised and a beaded chain and catches were sutured across the joint to mimic the capsuloligamentous complex at different lengths (tests 2 to 7). RESULTS/CONCLUSIONS: (a) When the glenohumeral capsuloligamentous complex is intact, the humerus translates maximally in the glenoid (between 20 and 30 mm) when the humerus is between 40 degrees and 100 degrees of lateral rotation. (b) As the glenohumeral capsuloligamentous complex increases in length, so does the extent of translation. (c) In medial rotation, the length of the posterior capsule, rather than the length of the anterior capsule, has the greater effect on anterior/posterior translation. (d) In lateral rotation the length of the anterior capsule, rather than the length of the posterior capsule, has the greater effect on anterior/posterior translation. (e) The glenohumeral ligamentous complex acts more as a cuff, enclosing the joint, rather than as a sling, as is commonly thought.
Positive and Negative Selection in the DAZ Gene Family
Authors: Joseph P. Bielawski, Ziheng Yang
Journal: Molecular Biology and Evolution (2001)

Because a microdeletion containing the DAZ gene is the most frequently observed deletion in infertile men, the DAZ gene was considered a strong candidate for the azoospermia factor. A recent evolutionary analysis, however, suggested that DAZ was free from functional constraints and consequently played little or no role in human spermatogenesis. The major evidence for this surprising conclusion is that the nonsynonymous substitution rate is similar to the synonymous rate and to the rate in introns. In this study, we reexamined the evolution of the DAZ gene family by using maximum-likelihood methods, which accommodate variable selective pressures among sites or among branches. The results suggest that DAZ is not free from functional constraints. Most amino acids in DAZ are under strong selective constraint, while a few sites are under diversifying selection with nonsynonymous/ synonymous rate ratios (dN/dS) well above 1. As a result, the average dN/dS ratio over sites is not a sensible measure of selective pressure on the protein. Lineage-specific analysis indicated that human members of this gene family were evolving by positive Darwinian selection, although the evidence was not strong.
Peace at the Minneapolis V.A.
Authors: Cynthia Scott
Journal: Annals of Internal Medicine (2008)

Ad Libitum5 August 2008Peace at the Minneapolis V.A.Cynthia Scott, MDCynthia Scott, MDFrom Dallas, TX 75225.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-3-200808050-00004 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail He hears his own wide deep voice there are breezes of October light on his face and cool wet grass under his feet the plastic tube rapes his throat and grips his vocal cords hostage. The pillowwoman. She is near his face tugs his blanket. She sends the mist of something strong into the tube high-pitched wheezes echo out of his mouth and scream down the tube toward the machine. It startles him That's.— it, Mr. Lonewolf, cough it all up. The ceiling lights pull his eyes. The machine pushes air into his throat. His chest risesfalls, risesfalls, like a ... Author, Article, and Disclosure InformationAffiliations: From Dallas, TX 75225.Current Author Address: Cynthia Scott, MD, 3720 Stanford Avenue, Dallas, TX 75225. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 5 August 2008Volume 149, Issue 3Page: 160KeywordsBloodBreathingHand strengthHeartMouthPharynxRibsThorax ePublished: 5 August 2008 Issue Published: 5 August 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...