tbuckley/cabot-search huggingface dataset:
High-Dose Weekly Intravenous Immunoglobulin to Prevent Infections in Patients Undergoing Autologous Bone Marrow Transplantation or Severe Myelosuppressive Therapy: A Study of the American Bone Marrow Transplant Group
Authors: Steven N. Wolff
Journal: Annals of Internal Medicine (1993)

Objective: To determine whether intravenous immunoglobulin (IVIG) prevents severe infections during autologous bone marrow transplantation or equivalent high-dose myelosuppressive therapy. Design: Randomized, stratified, nonblinded study. Setting: Three tertiary care university hospitals. Patients: One hundred seventy patients entered the study; 82 received IVIG and 88 were untreated controls. The study groups were similar for parameters capable of influencing the likelihood of infection. Interventions: Intravenous immunoglobulin was given weekly at a dose of 500 mg/kg body weight from the initiation of cytotoxic therapy to the resolution of neutropenia. Measurements: The development of bloodstream or other clinically proven infection, platelet use, and the development of alloimmunity to platelet transfusion. Results: Clinical infection, bacteremia, and fungemia occurred in 43%, 35%, and 6% of the IVIG-treated patients and in 44%, 34%, and 9% of the control patients. Gram-positive bacteremia and gram-negative bacteremia occurred in 28% and 11% of the IVIG group and in 23% and 13% of the control group. Death due to infection occurred in 4.9% of IVIG recipients and in 2.3% of controls. None of these observations was statistically significant (P > 0.2). Survival to hospital discharge was achieved in 86.6% of the IVIG group and in 96.6% of the control group. The survival difference (10%; 95% CI, 1.7% to 18.3%; P = 0.02) was due to a higher incidence of regimen-related toxic death in the IVIG-treated group. Conclusions: The use of IVIG did not prevent infection. Fewer deaths occurred among controls due to a higher incidence of fatal hepatic veno-occlusive disease in patients receiving IVIG.
Allergy to Drugs
Authors: Edward A. Carr
Journal: New England Journal of Medicine (1951)

THE seventeenth century must have been the nadir of therapeutics, if we can believe Molière, for one of his characters remarks: "Almost everyone dies of the remedy, not the malady." Fortunately, since then many drugs that were poisonous to the majority of patients have been abandoned, and, more recently, the adoption of preliminary toxicity tests on animals has done much to prevent new examples from reaching the clinic. In the past few decades, however, as advances in synthetic chemistry have made increasing numbers of new drugs available, one type of poisoning, — allergy to drugs, — has become more and . . .
International Textbook of Diabetes Mellitus
Authors: G. Stephen DeCherney
Journal: JAMA (1993)

Diabetes mellitus is the most expensive disease in the Western world. There are 14 million people with diabetes in the United States. That translates to more than one in 20 citizens. Diabetes is the leading cause of adult blindness and nontraumatic amputation. It is the primary cause of end-stage renal failure leading to dialysis. People with diabetes are two to five times more likely to have a stroke and twice as likely to have heart disease. Diabetes mellitus is said to be the third most common reason a patient visits a doctor's office. In our 1100-bed medical center, one in nine patients had diabetes mellitus as a discharge diagnosis for 1991. The combination of diabetes mellitus and syndrome X (hypertension, lipid abnormalities, and android obesity) perhaps accounts for most of the deaths in the United States. The net result of these extremely common problems—diabetes, hypertension, hyperlipidemia—is heart disease: the leading
NOX4/NADPH oxidase expression is increased in pulmonary fibroblasts from patients with idiopathic pulmonary fibrosis and mediates TGF 1-induced fibroblast differentiation into myofibroblasts
Authors: N. Amara, D. Goven, F. Prost, R. Muloway, B. Crestani, J. Boczkowski
Journal: Thorax (2010)

<h3>Background</h3> Persistence of myofibroblasts is believed to contribute to the development of fibrosis in idiopathic pulmonary fibrosis (IPF). Transforming growth factor β1 (TGFβ1) irreversibly converts fibroblasts into pathological myofibroblasts, which express smooth muscle α-actin (α-SMA) and produce extracellular matrix proteins, such as procollagen I (α1). Reactive oxygen species produced by NADPH oxidases (NOXs) have been shown to regulate cell differentiation. It was hypothesised that NOX could be expressed in parenchymal pulmonary fibroblasts and could mediate TGFβ1-stimulated conversion of fibroblasts into myofibroblasts. <h3>Methods</h3> Fibroblasts were cultured from the lung of nine controls and eight patients with IPF. NOX4, α-SMA and procollagen I (α1) mRNA and protein expression, reactive oxygen species production and Smad2/3 phosphorylation were quantified, in the absence and in the presence of incubation with TGFβ1. Migration of platelet-derived growth factor (PDGF)-induced fibroblasts was also assessed. <h3>Results</h3> It was found that (1) NOX4 mRNA and protein expression was upregulated in pulmonary fibroblasts from patients with IPF and correlated with mRNA expression of α-SMA and procollagen I (α1) mRNA; (2) TGFβ1 upregulated NOX4, α-SMA and procollagen I (α1) expression in control and IPF fibroblasts; (3) the change in α-SMA and procollagen I (α1) expression in response to TGFβ1 was inhibited by antioxidants and by a NOX4 small interfering RNA (siRNA); (4) NOX4 modulated α-SMA and procollagen I (α1) expression by controlling activation of Smad2/3; and (5) NOX4 modulated PDGF-induced fibroblast migration. <h3>Conclusion</h3> NOX4 is critical for modulation of the pulmonary myofibroblast phenotype in IPF, probably by modulating the response to TGFβ1 and PDGF.
Extrapancreatic Origin of Chronic Unexplained Hyperamylasemia
Authors: Michael D Levitt, Carol J. Ellis, Peter B. Meier
Journal: New England Journal of Medicine (1980)

ELEVATED serum amylase activity in a patient with abdominal pain usually indicates pancreatitis. Ordinarily, the amylase level returns to normal within several days; however, a small percentage of subjects manifest more persistent hyperamylasemia. Although continued activity of pancreatitis, a pseudocyst, or pancreatic ascites accounts for some of these cases of persistent hyperamylasemia, in many subjects diagnostic evaluation fails to reveal pancreatic disease. This report, which describes the isoamylase finding in 28 patients with chronic hyperamylasemia, indicates that the pancreas is seldom responsible for persistent, unexplained elevations of serum amylase activity.Subjects and MethodsIsoamylase studies were carried out in serums . . .
The effect of multiple sub-concussive blows on brain structural and functional integrity: combined virtual reality and neuroimaging study
Authors: Semyon Slobounov, Wayne Sebastianelli
Journal: British Journal of Sports Medicine (2013)

Objective To determine the differential sensitivity of subjects, with and without prior history of concussion, towards multiple sub-concussive impacts. We hypothesised that previous concussions may increase the athletes' vulnerability to repetitive blows leading to brain metabolic, structural and/or functional compromised integrity. Design A set of Virtual Reality (VR) tests and MRI scans (fMRI, DTI, MRS) before and within 3 h after a competition was implemented. The number and type of sub-concussive blows was documented via observational charts incorporated with reconstruction of impacts captured on video. Setting Subjects were recruited from Penn State collegiate football and rugby teams. Subjects 12 football and rugby players (with n=6 and without n=6 history of concussion) often experiencing multiple blows during practices and games were recruited for this study. Outcome Measures Spatial working memory, balance, and speed of information processing were assessed by VR testing using Head Mounted Display. Brain metabolic profile (MRS NAA/Cho; NAA/CR of the corpus callosum), functional connectivity (DMN during rs-fMRI) and white matter tracks integrity (DTI, FA) were the primary neuroimaging measures. Results We observed decreased interhemispheric functional connectivity (rs-fMRI, left-right hippocampus; r=0.82/0.55), reduced FA (DTI in Genu, 0.7/0.4), and reduced NAA/Cho ratio (MRS measures) at frontal (2.21/1.72) ROI after the competition only in subjects with prior history of concussion. These subjects also experienced deficient balance and spatial memory problems assessed by VR. Conclusions This study provides a solid foundation to begin improving the current understanding of the neural substrate(s) differential response(s) to sub-concussive blows occurring in athletics. Competing interests None.
Predicting Brain Cell Death
Authors: Mike Mitka
Journal: JAMA (2001)

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
Medicine Science and Dreams: The Making of Physician-Scientists
Authors: Derek S. Wheeler
Journal: JAMA (2011)

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
Mixing short and intermediate acting insulins: effect on postprandial blood glucose concentrations.
Authors: M Edwards, M Murphy, T Chadwick
Journal: BMJ (1985)

were representative of a wider group.However, we are grateful to Drs Dally and Grant for underlining this important point.Unlike Dr Dally we do not find it gratifying that most deaths of notified addicts were due to prescribed drugs.The medical profession cannot control the availability of illicitly imported drugs but is collectively responsible for the drugs that doctors prescribe.Indeed this paper showed very clearly that when the availability of barbiturates was restricted by collective action on the part of the profession the number of deaths among addicts from this cause was dramatically reduced.Although out- side the remit of our recent study, there is evidence that prescribed drugs are also im- plicated in the deaths of non-notified addicts: we have previously studied death due to addiction identified in coroners' courts,' where barbiturates caused the deaths of 38¾0 of cases not known to the Home Office.More re- cently Spear reported, "A further significant trend is the increase in the involvement of dipipanone in the form of Diconal amongst the 'unknown' deaths"-that is, deaths un- known to the Home Office.2We said in our paper, but in view of the vehement response of Dr Dally and Dr Grant it should perhaps be repeated, that our results do not minimise the problems presented by illicitly imported drugs, problems which are vastly greater now than in 1981, the last year of our study period.
A Randomized, Controlled Comparison of Instruction by a Diabetes Educator Versus Self-Instruction in Self-Monitoring of Blood Glucose
Authors: W Kenneth Ward, Linda B Haas, James C Beard
Journal: Diabetes Care (1985)

It is not clear whether diabetic patients can learn accurate self-monitoring of blood glucose (SMBG) by use of written package instructions. In addition, it is unclear whether the improvement in accuracy of monitoring that results from professional training is due to the professional intervention or to a personal practice effect. For these reasons, improvement in accuracy of SMBG (using Chemstrip bG, Biodynamics Division, Boehringer-Mannheim, Indianapolis, Indiana) after a 30-min session of professional instruction in one group of diabetic patients was compared with improvement after 30 min of practice and study of package instructions in another group. After initial reading of package instructions in both groups, and after the practice session in the control group, mean percent error was 22–37%. In contrast, mean percent error declined to 9% after a professional training session. We conclude that learning SMBG solely by reading package instructions leads to unacceptable inaccuracy. However, by use of short, intensive instruction sessions, a diabetes educator can reduce such errors and teach highly accurate monitoring to most diabetic patients.
Benefits of coronary revascularisation in diabetic and non‐diabetic patients with ischaemic cardiomyopathy: Role of myocardial viability
Authors: Vittoria Rizzello, Don Poldermans, Elena Biagini, Arend F.L. Schinkel, Eric Boersma, Abdou Elhendy, Fabiola B. Sozzi, Alexander Maat, Jos R.T.C. Roelandt, Jeroen J. Bax
Journal: European Journal of Heart Failure (2005)
Neurological Differential Diagnosis: An Illustrated Approach
Authors: Nicholas A. Vick
Journal: JAMA (1978)

Dr Patten's book is a primer, in large format, with clean typography and abundant white space. There are many line drawings, all attractive and informative. Brief case reports are used freely to emphasize important points. The book is practical, sensible in its emphasis, and well written. Who should read this book? It seems to me to be a good bet for psychiatrists, generalists, or internists who wish to review clinical neurology in as painless a fashion as possible, unencumbered by references and esoterica. It is too basic for the neurology resident. If, as I am convinced, medical students learn neurology best by the case method (reading in depth after examining their patients and reviewing the case with their teacher), there is not enough in this book to fulfill their needs. Unfortunately, many medical schools lack such an approach; perhaps the reading of<i>Neurological Differential Diagnosis</i>can provide a reasonable alternative.
Prevention of postischemic cardiac injury by the orally active iron chelator 1,2-dimethyl-3-hydroxy-4-pyridone (L1) and the antioxidant (+)-cyanidanol-3.
Authors: A M van der Kraaij, H G van Eijk, J F Koster
Journal: Circulation (1989)

In this study, we investigated the role of oxygen-derived free radicals and iron in mediating myocardial injury during ischemia and reperfusion. Iron is of special interest because it may enhance tissue injury during ischemia and reperfusion by catalyzing the formation of highly reactive hydroxyl radicals (by modified Haber-Weiss or Fenton reactions). Rat hearts, perfused by the Langendorff method, were subjected to global ischemia (15 minutes at 37 degrees C) and reperfusion. The effects of two iron chelators, 1,2-dimethyl-3-hydroxy-4-pyridone (L1) and 5-hydroxy-2-hydroxymethyl-4-pyrone (kojic acid), and one antioxidant, (+)-cyanidanol-3, on contractile function, coronary flow, lactate dehydrogenase release, and lactate production were studied. The combination of these iron chelators is of special importance because L1 is known to prevent lipid peroxidation, induced by ADP/Fe3+ and NADPH in microsomes, in contrast to kojic acid. We found significant protection of contractile function (apex displacement) during reperfusion with 50 microM L1 and 20 microM (+)-cyanidanol-3 (p less than 0.01, n = 6), whereas no protection was found with 50 microM kojic acid (n = 6). Measurements of lactate dehydrogenase release during reperfusion showed a protective pattern similar to that found for heart contractile function, although 50 microM kojic acid also showed a significantly lower lactate dehydrogenase release during the first 10 minutes of reperfusion. No differences in coronary resistance or lactate release were found between the various groups. Our findings indicate that iron and oxygen-derived free radicals are important in the pathogenesis of postischemic reperfusion injury probably because of the formation of hydroxyl radicals.(ABSTRACT TRUNCATED AT 250 WORDS)
The role of doctors in promoting smoking cessation.
Authors: S Chapman
Journal: BMJ (1993)

gonadotrophin in Melbourne between 1976 and 1978.Creutzfeldt-Jakob disease was the cause of death in a woman aged 39 also living in Adelaide who had received human pituitary gonadotrophin in 1979.She had been treated with the same batch of human pituitary gonadotrophin as the index case.Twenty eight other Australian women are known to have been treated with that batch.A fourth woman died from Creutzfeldt-Jakob disease in Western Australia in 1991 after receiving human pituitary gonadotrophin.The human pituitary hormone programme started in Australia in 1964.By 1985 the programme had supplied human growth hormone for 664 children with short stature and pituitary gonadotrophin for 1447 adults with infertility.8From its inception the Australian programme used a column chromatographic purification procedure to extract the hormones.Up to 800 cadaver pituitary glands were pooled to provide a single batch.Australia was one of the few countries in which gonadotrophins derived from pituitary glands were used to treat infertility.Most countries preferred to use gonadotrophins derived from urine from postmenopausal women.More recently both gonadotrophins and growth hormone have been derived with recombinant technologies.In Britain a few women were treated with pituitary gonadotrophin at the Birmingham and Midland Hospital for Women in the 1960s, but urinary gonadotrophins were substituted in the early 1970s.Any women who acquired Creutzfeldt-Jakob disease from this source are likely already to have died.9The chief medical adviser to the Australian Commonwealth Department of Health recommended in 1990 that patients who had received pituitary hormones should be advised by their medical practitioners never to donate blood, corneas, or other tissues.Although it was believed that vertical transmission from a pregnant woman to her baby could not occur, Japanese workers have already found infectious material in placental and umbilical cord blood.10The Australian government has funded a special counselling service in addition to that provided by individual consultants and clinics for patients who received pituitary hormones.Further research is needed into the natural mechanism of spread of the agent causing Creutzfeldt-Jakob disease.The Australian Attorney General's Department is examining the issue of compensation for the families concerned in these tragedies.A prospective case registry is being established to enable continued epidemiological surveillance of all Australian patients who received pituitary hormones.This is no easy task, but it is hoped that these mechanisms will provide patients and their families with accurate information on this public health issue.
Metallothionein synthesis and degradation: relationship to cadmium metabolism.
Authors: R J Cousins
Journal: Environmental Health Perspectives (1979)

Metallothionein is an integral component of the mechanism that regulates the metabolism of cadmium and zinc. The synthesis of this protein can be "induced" by oral or parenteral administration of either metal. The metallothionein mRNA content of liver polysomes is increased shortly after an influx of small amounts of either metal into hepatocytes. After sufficient amounts of this poly (A+) RNA have been synthesized, there is a concomitant increase in metallothionein biosynthesis and metal binding. Unlike synthesis, the degradation of metallothionein is markedly influenced by the species of metal bound. By using in vivo and in vitro techniques, it has been possible to demonstrate that resistance of metallothionein to degradation follows the order: thionein less than zinc metallothionein less than cadmium metallothionein. Moreover, while the polypeptide chains of cadmium metallothionein are degraded, it appears that liberated cadmium ions are quickly incorporated into nascent chains of thionein. The latter explains why the cadmium content of liver and kidney increases with age and environmental exposure. Since both zinc and cadmium bind to metallothionein, it appears that the binding sites provided by this inducible species provide a locus for interaction between zinc, a nutrient, and cadmium, an environmental contaminant.
The cells that knew too much
Authors: Alan G. Baxter
Journal: Journal of Clinical Investigation (2000)

In this issue of the JCI, Ikehara et al. (1) report a novel function for an unusual population of lymphocytes — natural killer T (NKT) cells. These cells were originally identified as CD4–CD8– (double negative, DN) T cells responsible for rapid production of large amounts of IL-4 (2, 3), a cytokine that plays a critical role in supporting immunoglobulin production and inhibiting some inflammatory responses. NKT cells are now usually identified either by the coexpression of the NK cell marker NKR-P1 (NK1.1 in mice) and the T-cell antigen receptor (TCR), or by the presence of unusually restricted TCRα chains (termed Vα24JαQ in humans and Vα14Jα281 in mice and rats; refs. 4, 5). Although these cells may either be DN or express intermediate levels of the CD4 accessory molecule (CD4int), the fact that most NKT cells in humans, mice, and rats use similar TCRα chains has led to the suggestion that they recognize a restricted range of targets (4). Consistent with this hypothesis, many NKT-cell clones appear to be stimulated by the MHC class I–like molecule CD1, and NKT cells are severely depleted in mice carrying a targeted deletion of CD1d (6, 7).