tbuckley/cabot-search huggingface dataset:
Chromium in Welding Fumes as Cause of Eczematous Hand Eruption
Authors: Walter B. Shelley
Journal: JAMA (1964)

ECZEMATOUS ERUPTIONS of the palms are a reaction pattern of highly diverse etiology. Commonly one may find the cause to be due to hypersensitivity to foods, drugs, or fungi. In some cases the hyperidrotic response to psychic tension may be a critical determinant. In other instances the cause may elude detection unless the physician has a high index of suspicion for all environmental exposures, both contactant as well as inhalant. We have recently observed a chromium-sensitive patient in whom inhalation of acetylene welding fumes triggered a severe eczematous eruption of his palms. <h3>Report of a Case</h3> A 40-year-old healthy male crane operator gave us the history of having had a chronic eczematous eruption of both hands for 14 years. At the time of onset he had been employed in a factory where he worked with a linoleum paste. He had had repeated attacks of vesicular lesions on the palmar and
Cubital tunnel syndrome
Authors: A. J. Wilbourn
Journal: JAMA (1979)

To the Editor.—  Clark stressed the reliability of his seven tests in preference to electrodiagnostic studies (electromyography and nerve conduction studies) for the diagnosis of the ulnar nerve cubital tunnel syndrome. The seven tests described are all part of a routine neurological examination. In actuality, positive findings on all of these tests reflect an advanced state of deficit. We have seen few patients with symptoms consistent with an ulnar neuropathy with such marked neurological deficit on examination.  We are impressed that electrodiagnostic studies can often show accurately, first, the presence (or perhaps more important, the absence) of neuropathy, and second, the exact location of the injury along the nerve, often in the absence of findings on most of the seven tests.  If surgery is being considered to relieve a clinically suspected nerve entrapment, electrodiagnostic studies should be performed routinely.
Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study Commentary: Varied preferences reflect the reality of clinical practice
Authors: P J Devereaux, D. R Anderson, M. J Gardner, W. Putnam, G. J Flowerdew, B. F Brownell, S. Nagpal, J. L Cox, T. Fahey
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To determine and compare physicians9 and patients9 thresholds for how much reduction in risk of stroke is necessary and how much risk of excess bleeding is acceptable with antithrombotic treatment in people with atrial fibrillation. <b>Design:</b> Prospective observational study. <b>Setting:</b> Tertiary and peripheral referral centres in Nova Scotia, Canada. <b>Participants:</b> 63 physicians who were treating patients with atrial fibrillation and 61 patients at high risk for atrial fibrillation. <b>Main outcome measures:</b> Participants underwent a face to face interview with a probability trade-off tool. Thresholds were determined for the minimum reduction in risk of stroke necessary and the maximum increase in risk of excess bleeding acceptable for treatment with aspirin and warfarin in people with atrial fibrillation. <b>Results:</b> The minimum number of strokes that needed to be prevented in 100 patients over two years for warfarin to be justified was significantly lower for patients than for physicians (1.8 (SD 1.9) <i>v</i> 2.5 (1.6), P=0.009), whereas for aspirin there was no difference between patients and physicians (1.3 (1.3) <i>v</i> 1.6 (1.5), P=0.29). The maximum number of excess bleeds acceptable in 100 patients over two years for use of warfarin and aspirin was significantly higher for patients than for physicians (warfarin 17.4 (7.1) <i>v</i> 10.3 (6.1); aspirin 14.7 (8.5) <i>v</i> 6.7 (6.2); P&lt;0.001 for both comparisons). <b>Conclusions:</b> Patients at high risk for atrial fibrillation placed more value on the avoidance of stroke and less value on the avoidance of bleeding than did physicians who treat patients with atrial fibrillation. The views of the individual patient should be considered when decisions are being made about antithrombotic treatment for people with atrial fibrillation. <h3>What is already known on this topic</h3> Several observational studies have shown an apparent underuse of antithrombotic drugs in patients with atrial fibrillation, despite evidence of efficacy <h3>What this study adds</h3> There is considerable variability between physicians and patients in their weighing up of the potential outcomes associated with atrial fibrillation and its treatment For anticoagulation treatment to be acceptable patients required less reduction in risk of stroke and were more tolerant of an increase in risk of bleeding than physicians Physicians varied considerably in how much risk of bleeding they thought was acceptable for a given reduction in risk of stroke associated with antithrombotic drugs
Increased cycle length variability during ventricular fibrillation: a novel predictor of arrhythmia recurrence
Authors: Hisashi Yokoshiki, Tetsuro Kohya, Minoru Sato, Koji Sasaki, Akihiko Yotsukura, Masayuki Sakurai, Akira Kitabatake
Journal: Journal of the American College of Cardiology (2002)
IMPROVEMENT IN METHOD OF OPERATING IN FISSURE AND FISTULA
Authors: A. T. Custer
Journal: JAMA (1923)

Much improvement in the technic of rectal surgery has been made in the last five years, although there has been little improvement in the method of operating in fissure and fistula. Having been frequently placed in a position of responsibility for a possible incontinence from operation for repair following unsuccessful primary operation, I have devised a method which I have not seen reported and which may prove of interest. The technic is that usually accepted for fistula operation up to the point of severance of the sphincter muscles. In other words, all tissue is severed on a grooved director until the sphincters appear in sight. All tissue is dissected away from sphincters, the fistulous tract is curetted and carefully cleaned out, and the wound is packed in the usual manner, leaving the sphincter muscles intact at the site of operation. Opposite the site of operation or at the point of
The Cause of the Nostrum Evil as Seen by a Recent Graduate.
Authors: W. J. Browning
Journal: JAMA (1907)

Purgen Now Being Exploited in this Country.The physicians of the United States are receiving a neat package containing samples of a German proprietary-Purgen.The container is an ingenious one and, besides the tab¬ lets, includes a circular in English, although mailed in Europe, describing the remarkable virtues of this "new synthetic aperient."It has been considered strange that this proprie¬ tary, which has been advertised so thoroughly in Europe, Aus¬ tralia, etc., should not have made its appearance in this coun¬
Ophthalmia Neonatorum Caused by β-Lactamase— Producing Neisseria gonorrhoeae
Authors: Brinda Doraiswamy
Journal: JAMA (1983)

ALTHOUGH infections caused by penicillinase-producing strains of<i>Neisseria gonorrhoeae</i>have been increasing since 1976,<sup>1,2</sup>to our knowledge, there has been to date only one case of ophthalmia neonatorum caused by penicillinase-producing strains of<i>N gonorrhoeae</i>in the United States.<sup>3</sup>A second case of ophthalmia neonatorum caused by penicillinase-producing strains of<i>N gonorrhoeae</i>occurred in a 4-day-old female neonate, who was successfully treated with cefotaxime sodium. <h3>Report of a Case</h3> A 1,940-g female neonate was born on Sept 11, 1982, to a 34-year-old, para 3, gravida 2, woman by normal spontaneous vaginal delivery at Kings County Hospital, Brooklyn, NY. Apgar scores were 9 at one minute and 10 at five minutes. Estimated gestational age was 36 to 37 weeks. Routine ocular prophylaxis with 1% silver nitrate was given in the delivery room. On the third day of life, the neonate had a copious bilateral conjunctival discharge. Cultures from the
Impaired Cardiac Functional Reserve and Left Ventricular Hypertrophy in Adult Sheep After Prenatal Dexamethasone Exposure
Authors: Miodrag Dodic, Chrishan Samuel, Karen Moritz, E. Marelyn Wintour, John Morgan, Leeanne Grigg, James Wong
Journal: Circulation Research (2001)

Abstract— We have shown that exposure of pregnant ewes to dexamethasone (11.5 mg/d for 2 days) at 27 days of gestation (term, 150 days) led to increased blood pressure and cardiac output in adult offspring. In this study, we hypothesized that dexamethasone-induced hypertension is associated with left ventricular hypertrophy and a reduced cardiac functional reserve (CO max-0 ). Six control animals (group C) and five dexamethasone-exposed animals (group D) were volume-loaded with Hemaccel until the wedge pressure was 13 mm Hg (baseline). The wedge pressure was held constant during an infusion of dobutamine at incremental doses (0.4 to 12 μg/kg/min) while blood pressure and cardiac output were measured. The same protocol was repeated in each animal 5 days later under mild general anesthesia (1.5% isoflurane), when transthoracic echocardiography (M-mode) was obtained. Group D showed a reduced CO max-0 in response to dobutamine during both conscious (89±22 versus 150±25 mL/kg/min in control; P &lt;0.01) and anesthetized states (91±38 versus 156±56 mL/kg/min in control; P &lt;0.05). Reduced CO max-0 in group D was associated with higher left ventricular mass index compared with group C (2.6±0.67 versus 1.8±0.51 g/kg; P &lt;0.05). In addition, group D showed a reduced cardiac contractility reserve (FS max-0 ) in response to dobutamine (21±22% versus 54±34% in group C; P &lt;0.05). An impaired cardiac functional reserve in group D was associated with increased left ventricular type I collagen content. In conclusion, brief prenatal exposure to dexamethasone led to the development of hypertension, left ventricular hypertrophy, and reduced cardiac functional reserve in adult life.
Measurement of sebum excretion rate and skin temperature above and below the neurological lesion in paraplegic patients
Authors: SARAH E. THOMAS, J. CONWAY, F.J.G. EBLING, CHRISTINE I. HARRINGTON
Journal: British Journal of Dermatology (2006)

The sebum excretion rate (SER) was measured above and below the neurological lesion in seventeen male and four female paraplegic patients and at comparable sites in a similar number of age‐matched controls. There was no significant difference between paraplegics and controls for forehead SER. For the thigh SER there was a highly significant difference between paraplegics and controls (t= 6.27; P < 0.001), the level for paraplegics being twice that for controls. Simultaneous thigh skin temperature measurements showed no significant difference between paraplegics and controls.
Fingolimod and Risk of Varicella-Zoster Virus Infection
Authors: Kenneth L. Tyler
Journal: JAMA Neurology (2014)

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
Allele 2 of the Interleukin-1 Receptor Antagonist Gene Is Associated With Early Gastric Cancer
Authors: Jürgen Glas, Helga-Paula Török, Agnes Schneider, Günter Brünnler, Reinhard Kopp, Ekkehard D. Albert, Manfred Stolte, Christian Folwaczny
Journal: Journal of Clinical Oncology (2004)

Purpose In advanced gastric cancer (tumor stages T2-T4), associations with polymorphisms of the interleukin-1 (IL-1) gene cluster have been made. In early-stage gastric cancer, which we defined as adenocarcinoma confined to the mucosa or submucosa (stage T1), the role of host genetic susceptibility remains to be determined. Patients and Methods Eighty-eight patients with early-stage gastric cancer (stage T1, 77 positive for Helicobacter pylori) and 145 controls were genotyped for polymorphisms in the IL-1 gene cluster and the tumor necrosis factor alpha (TNF-A) gene. Statistical analysis was performed using the χ 2 test and the Fisher's exact test, respectively. Results The homozygous genotype IL-1RN*2/2 of the IL-RN gene was strongly associated with early-stage gastric cancer (P &lt; .0001), whereas further associations with the IL-1 gene cluster were not observed. A weak association of the TNF-A−308A allele with the diffuse type of early-stage gastric cancer, and an association with a composite of two or three proinflammatory polymorphisms, which predispose to increased production of the proinflammatory cytokines IL-1β and TNF-α, could also be demonstrated. Conclusion The genotype IL-1RN*2/2 seems to be associated with early-stage gastric cancer. As opposed to advanced-stage gastric cancer, further proinflammatory cytokine polymorphisms were not associated independently, but might act in combination and mirror early steps of gastric carcinogenesis in hosts colonized by Helicobacter pylori. However, these findings await confirmation in future trials and should be underscored by gene expression studies.
Immunohistological studies, with anti-connective tissue and anti-immunoglobulin antisera, of the skin in lupus erythematosus and scleroderma
Authors: N.R ROWELL, D.G SCOTT
Journal: British Journal of Dermatology (1975)

Skin lesions from six patients with systemic lupus erythematosus, five patients with discoid lupus erythematosus, twelve patients with systemic sclerosis, five patients with localized morphoea and twenty controls were examined by immunohistological techniques using fluorescein-labelled anti-human IgG, anti-human C3 and anti-human renal glomerulus antisera. The major immunohistological changes in systemic sclerosis and in localized morphoea consisted of foci of intercollagenous staining for connective tissue antigens in the reticular layer of the dermis. It is suggested that these findings indicate collagen neogenesis. In lupus erythematosus the major changes occur in the dermo-epidermal junction and consist of deposits of IgG and C3 and thickening and disruption of the membrane as demonstrated by the use of heterologous sera containing antibasement membrane antibodies. Immunohistological techniques are useful in the diagnostic differentiation between scleroderma and lupus erythematosus.
Simultaneous Occurrence of Intracranial Aneurysm and Arteriovenous Malformation
Authors: R. Fine, A. Paterson, L. Steven, J. B. Gaylor
Journal: BMJ (1960)

~~~MEDICAL JOUHNA 11 thyroid replacement therapy (Thompson et al., 1929).The "paretic" Lange curve in the C.S.F. of Case 2, however, requires further explanation.It suggests a relative increase in C.S.F.gamma-globulin due to the combination of hypothyroidism and hyperglobulinaemia (found in many cases of autoimmune thyroiditis, including non-goitrous myxoedema).Such an increase was demonstrated electrophoretically in myxoedema by Bronsky et al. (1958). SummaryAntibody to thyroglobulin was detected in the spinal fluid of five patients with autoimmune thyroiditis.In two out of three patients who had complement-fixing antibody in the serum, this antibody could also be detected in the C.S.F.In three patients who were hypothyroid the total C.S.F. protein was raised.We are grateful to Professor G. A. Smart and Dr. T. H. Boon for allowing us to study their patients.
Fosinoprilate prolongs the action potential: reduction of iK and enhancement of the L-type calcium current in guinea pig ventricular myocytes
Authors: H.-F. Racke, D. Koppers, P. Lemke, H. Casaretto, O. Hauswirth
Journal: Cardiovascular Research (1994)

Objective: The aim was to study the effect of fosinoprilate, a new ACE inhibitor, on the action potential and plateau currents of cardiac muscle. Methods: Whole cell patch technique was used to record action potentials (n = 6), the L-type iCa (iCaL; n = 5), in some cases (n = 4) also using Cs+ loaded pipettes; with 5 mM Co2+, the time dependent K+ current (IK) underlying delayed rectification was analysed in guinea pig ventricular myocytes (n = 3). Results: Fosinoprilate prolonged the 50% repolarisation (APD50) from 440(SEM 50) ms to 485(48) ms (0.1 μM), to 525(46) ms (0.3 μM), to 632(58) ms (1 μM), and to 702(69) ms (3.0 μM). The APD90 was delayed from 510(63) ms to 540(45) ms (0.1 μM), to 583(42) ms (0.3 μM), to 702(62) ms (1.0 μM), and to 765(72) ms (3.0 μM). Higher concentrations (10-100 μM) caused early afterdepolarisations, very long action potentials, and irregular oscillations. ICaL was enhanced by up to 183%, showing a Kd of 0.2 μM; in contrast to the steady state activation (d∞), the inactivation curve f∞, was shifted in the depolarising direction, considerably enlarging the Ca2+ window. Slow inactivation time course was unchanged, whereas the fast time constant (τf) was accelerated. Fosinoprilate reduced the outward current during depolarising clamps from 1.7(0.2) nA to 1.41(0.11) nA with a 0.1 μM dose, and to 0.54(0.14) nA with a 1.0 μM dose; the tails were decreased from 0.39(0.03) nA to 0.27(0.03) nA with 0.1 μM and to 0.13(0.02) nA with 1.0 μM. Kinetics of IK were unaltered. Computer simulations based on these data using the OXSOFT-HEART program mimicked the results rather closely. Conclusions: The results suggest that fosinoprilate prolongs the plateau due to a partial block of iK and an extension of the Ca2+ window by 10 mV, causing a class III antiarrhythmic effect. High concentrations further open the Ca2+ window resulting in early afterdepolarisations and plateau oscillations and may cause an inward transport of Ca2+ ions by the Na-Ca exchange. Cardiovascular Research 1994;28:201-208
Assessment of Microcirculatory Remodeling With Intracoronary Flow Velocity and Pressure Measurements
Authors: Javier Escaned, Alex Flores, Pablo García-Pavía, Javier Segovia, Jesús Jimenez, Paloma Aragoncillo, Clara Salas, Fernando Alfonso, Rosana Hernández, Dominick J. Angiolillo, Pilar Jiménez-Quevedo, Camino Bañuelos, Luis Alonso-Pulpón, Carlos Macaya
Journal: Circulation (2009)

Intracoronary physiology techniques have been validated extensively for the assessment of epicardial stenoses but not for the lone study of coronary microcirculation. We performed a comparison between 4 intracoronary physiological indices with the actual structural microcirculatory changes documented in transplanted hearts.In 17 cardiac allograft patients without coronary stenoses, ECG, intracoronary Doppler flow velocity, and aortic pressure were digitally recorded before and during maximal hyperemia with a dedicated system. Postprocessing of data yielded 4 indices of microcirculatory status: coronary flow velocity reserve (2.13+/-0.59), instantaneous hyperemic diastolic velocity pressure slope (2.33+/-1.25 cm x s x (-1)mm Hg(-1)), coronary resistance index (1.65+/-0.88 mm Hg x cm(-1) x s(-1)), and coronary resistance reserve (2.36+/-0.65). Quantitative morphometry was performed in endomyocardial biopsies during the same hospital intake; arteriolar obliteration (76.57+/-6.95%) and density (2.00+/-1.22 arterioles per 1 mm(2)) and capillary density (645+/-179 capillaries per 1 mm(2)) were measured. Univariate regression analysis between intracoronary measurements and histological findings revealed that instantaneous hyperemic diastolic velocity-pressure slope correlated with arteriolar obliteration (r=0.58, P=0.014) and capillary density (r=0.60, P=0.012). Statistical adjustment revealed an independent contribution of arteriolar obliteration (beta=0.61, P=0.0009) and capillary density (beta=-0.60, P=0.0008) to instantaneous hyperemic diastolic velocity-pressure slope values, resulting in an excellent predictive model (r=0.84, P=0.0002). Coronary resistance index correlated only with capillary density (r=0.70, P=0.019). Relative indices (coronary flow velocity reserve and coronary resistance reserve) did not correlate significantly with arteriolar obliteration, capillary density, or arteriolar density.Intracoronary indices derived from pressure and flow, particularly instantaneous hyperemic diastolic velocity-pressure slope, appear to be superior to coronary flow velocity reserve in detecting structural microcirculatory changes. Both arteriolar obliteration and capillary rarefaction seem to influence microcirculatory hemodynamics independently.
577 EVOLUTION OF NATURALLY OCCURRING HEPATITIS B VIRUS TEST AND IMMUNE ESCAPE MUTATIONS FACILITATING PERSISTENCE AND SYMPTOMATIC VIRAL FLARE
Authors: S. Amini-Bavil-Olyaee, C. Henke-Gendo, D. Challapalli, C. Trautwein, A. Heim, F. Tacke
Journal: Journal of Hepatology (2008)
Regulation of Cardiac Ca <sup>2+</sup> Release Channel (Ryanodine Receptor) by Ca <sup>2+</sup> , H <sup>+</sup> , Mg <sup>2+</sup> , and Adenine Nucleotides Under Normal and Simulated Ischemic Conditions
Authors: Le Xu, Geoffrey Mann, Gerhard Meissner
Journal: Circulation Research (1996)

In myocardial ischemia, pHi and [ATP] fall, whereas the free [Ca2+] and [Mg2+] rise. The effects of these changes on cardiac Ca2+ release channel (ryanodine receptor) activity were investigated in [3H]ryanodine binding and single-channel measurements, using isolated membrane and purified channel preparations. In the absence of the two channel ligands Mg2+ and ATP, cardiac Ca2+ release channels were half-maximally activated at pH 7.4 by approximately 4 mumol/L cytosolic Ca2+ and half-maximally inhibited by approximately 9 mmol/L cytosolic Ca2+. Regulation of channel activity by Ca2+ was modulated by Mg2+ and ATP. Single-channel activities were more sensitive to a change of cytosolic pH than SR lumenal pH. Reduction in lumenal and/or cytosolic pH from 7.3 to 6.5 and 6.0 resulted in decreased single-channel activities without a change in single-channel conductance. [3H]Ryanodine binding measurements also indicated that acidosis impairs cardiac Ca2+ release channel activity. Mg2+ and adenine nucleotide concentrations regulated the extent of inhibition and the Ca2+ dependence of binding. In the presence of 5 mmol/L Mg2+ and 5 mmol/L beta, gamma-methyleneadenosine 5'-triphosphate (AMPPCP, a nonhydrolyzable ATP analogue), the free [Ca2+] for half-maximal [3H]ryanodine binding was increased from 1.9 mumol/L at pH 7.3 to 36 mumol/L at pH 6.5 and to 89 mumol/L at pH 6.2. These results suggest that ionic and metabolic changes that might be expected to affect sarcoplasmic reticulum Ca2+ release channel activity in ischemic myocardium include an altered Ca2+ sensitivity of the channel, a fall in pH, and a loss of the high-energy adenine nucleotide pool, leading to an increased inhibition by Mg2+.
Generic substitution of drugs to be introduced in 2010
Authors: A. Jack
Journal: BMJ (2008)

UK doctors will be drawn into new efforts to boost cost effective prescribing in the next few months as part of a deal agreed this month between the government and industry.

The newly revised pharmaceutical price regulation scheme (PPRS), designed to cut the overall NHS drug bill by about 5% in its five year life, will result in two initiatives to change current prescribing practice.

The first initiative, to be phased in by 2010, introduces generic substitution, which is designed to save costs directly by ensuring that pharmacists switch from any branded drugs named on prescriptions to cheaper generic alternatives unless a doctor ticks a …