tbuckley/cabot-search huggingface dataset:
Thyroid Status, Disability and Cognitive Function, and Survival in Old Age
Authors: Jacobijn Gussekloo
Journal: JAMA (2004)

ContextDespite the equivocal outcomes of randomized controlled trials, general clinical opinion favors screening and treatment of elderly individuals with subclinical thyroid disorders.ObjectivesTo determine whether subclinical thyroid dysfunction should be treated in old age and the long-term impact of thyroid dysfunction on performance and survival in old age.Design, Setting, and ParticipantsA prospective, observational, population-based follow-up study within the Leiden 85-Plus Study of 87% of a 2-year birth cohort (1912-1914) in the municipality of Leiden, the Netherlands. A total of 599 participants were followed up from age 85 years through age 89 years (mean [SD] follow-up, 3.7 [1.4] years).Main Outcome MeasuresComplete thyroid status at baseline; disability in daily life, depressive symptoms, cognitive function, and mortality from age 85 years through 89 years.ResultsPlasma levels of thyrotropin and free thyroxine were not associated with disability in daily life, depressive symptoms, and cognitive impairment at baseline or during follow-up. Increasing levels of thyrotropin were associated with a lower mortality rate that remained after adjustments were made for baseline disability and health status. The hazard ratio (HR) for mortality per SD increase of 2.71 mIU/L of thyrotropin was 0.77 (95% confidence interval [CI], 0.63-0.94; P = .009). The HR for mortality per SD increase of 0.21 ng/dL (2.67 pmol/L) of free thyroxine increased 1.16-fold (95% CI, 1.04-1.30; P = .009).ConclusionsIn the general population of the oldest old, elderly individuals with abnormally high levels of thyrotropin do not experience adverse effects and may have a prolonged life span. However, evidence for not treating elderly individuals can only come from a well-designed, randomized placebo-controlled clinical trial.
The Falling Sickness: A History of Epilepsy From the Greeks to the Beginnings of Modern Neurology
Authors: Lester S. King
Journal: JAMA (1972)

Originally published in 1945, Temkin's history of epilepsy has been the definitive work on the subject. It not only gave a detailed historical account of the disease with great erudition, but it also cast light on the entire history of medicine. Indeed, when we investigate one aspect thoroughly enough, we can gain insight into the whole. The study of a single disease in sufficient depth can involve the entire course of medical history—its changing theory and practice, its progressive differentiations and discriminations, its therapeutic successes, its religious and social aspects—and can represent a microcosm through which we may penetrate to the macrocosm. And so it is with the history of epilepsy as Temkin has given it to us. He has placed the disease, with all its complex meanings, into a very broad context, nothing less than Western civilization. The book had been out of print far too long. The new
Effect of acetylsalicylate on cardiac and muscular pain induced by intracoronary and intra-arterial infusion of bradykinin in humans
Authors: Achille Gaspardone, Filippo Crea, Fabrizio Tomai, Francesco Versaci, Antonio Pellegrino, Luigi Chiariello, Pier A Gioffré
Journal: Journal of the American College of Cardiology (1999)
Prescription of heroin to treatment resistant heroin addicts: Replacement therapies need to be tested on a level playing field
Authors: L. J Reed
Journal: BMJ (2004)

Editor—The study of medical prescription of heroin by van den Brink et al should be interpreted with caution.1

Firstly, the selection of opiate dependent patients with at least four weeks of continuous treatment in the past five years does not define resistance to treatment with methadone treatment, but rather, early treatment intervention. This may explain the substantial treatment response to longer term methadone in the control group, where the only intervention is randomisation into a controlled trial.

Secondly, in such a study taking methadone and heroin dosage levels into account is crucial when evaluating clinical outcome; adequate doses of opiate replacement are critical to treatment success.2 Actual doses are reported only in the electronic version of the paper and show that doses of combined heroin and methadone in the heroin treatment groups are about 20% higher in terms of methadone equivalents compared with the control methadone only treatment group. Furthermore, this latter group received a mean methadone dose of about 75 mg/day, which may be suboptimal. The discrepancy in methadone dosage equivalents between the two groups may account for the apparently favourable effects of additional heroin.

Lastly, the deterioration after discontinuing heroin at the end of the study may simply reflect a transition from adequate to inadequate amounts of prescribed opiate replacement therapy.

Heroin treatment needs robust evaluation as it is intensive and expensive compared with other opiate replacement drugs, including methadone and buprenorphine.3 Clinical studies comparing heroin with other opiate replacement therapies need to be conducted on a level playing field.​field.




Figure 1
Impact of Baseline Heart Failure Burden on Post-Implantable Cardioverter-Defibrillator Mortality Among Medicare Beneficiaries
Authors: Chih-Ying Chen, Lynne Warner Stevenson, Garrick C. Stewart, John D. Seeger, Lauren Williams, Jessica J. Jalbert, Soko Setoguchi
Journal: Journal of the American College of Cardiology (2013)
662 Heterogeneity of iron overload: Clinical, biochemical, histopathologic and genetic study of 70 patients
Authors: A. Riva, S. Pelucchi, G. Bovo, P. Trombini, A. Salvioni, R. Mariani, A. Vergani, G. Casati, S. Fargion, A. Piperno
Journal: Journal of Hepatology (2006)
The genome of the platyfish, Xiphophorus maculatus, provides insights into evolutionary adaptation and several complex traits
Authors: Manfred Schartl, Ronald B Walter, Yingjia Shen, Tzintzuni Garcia, Julian Catchen, Angel Amores, Ingo Braasch, Domitille Chalopin, Jean-Nicolas Volff, Klaus-Peter Lesch, Angelo Bisazza, Pat Minx, LaDeana Hillier, Richard K Wilson, Susan Fuerstenberg, Jeffrey Boore, Steve Searle, John H Postlethwait, Wesley C Warren
Journal: Nature Genetics (2013)

Several attributes intuitively considered to be typical mammalian features, such as complex behavior, live birth and malignant disease such as cancer, also appeared several times independently in lower vertebrates. The genetic mechanisms underlying the evolution of these elaborate traits are poorly understood. The platyfish, X. maculatus, offers a unique model to better understand the molecular biology of such traits. We report here the sequencing of the platyfish genome. Integrating genome assembly with extensive genetic maps identified an unexpected evolutionary stability of chromosomes in fish, in contrast to in mammals. Genes associated with viviparity show signatures of positive selection, identifying new putative functional domains and rare cases of parallel evolution. We also find that genes implicated in cognition show an unexpectedly high rate of duplicate gene retention after the teleost genome duplication event, suggesting a hypothesis for the evolution of the behavioral complexity in fish, which exceeds that found in amphibians and reptiles.
Pertussis epidemiology in Argentina: trends over 2004–2007
Authors: D. Hozbor, F. Mooi, D. Flores, G. Weltman, D. Bottero, S. Fossati, C. Lara, M.E. Gaillard, L. Pianciola, E. Zurita, A. Fioriti, D. Archuby, M. Galas, N. Binsztein, M. Regueira, C. Castuma, M. Fingermann, A. Graieb
Journal: Journal of Infection (2009)
A polymorphism in CD14 modifies the effect of farm milk consumption on allergic diseases and CD14 gene expression
Authors: Christian Bieli, Waltraud Eder, Remo Frei, Charlotte Braun-Fahrländer, Walt Klimecki, Marco Waser, Josef Riedler, Erika von Mutius, Annika Scheynius, Göran Pershagen, Gert Doekes, Roger Lauener, Fernando D. Martinez
Journal: Journal of Allergy and Clinical Immunology (2007)
Localization of a proton-pumping ATPase in rat kidney.
Authors: D Brown, S Hirsch, S Gluck
Journal: Journal of Clinical Investigation (1988)

The distribution of vacuolar H+ATPase in rat kidney was examined by immunocytochemistry using affinity-purified antibodies against the 31-, 56-, and 70-kD subunits of the bovine kidney proton pump. Proximal convoluted tubules were labeled over apical plasma membrane invaginations, and in the initial part of the thin descending limb, apical and basolateral plasma membranes were moderately stained. Thick ascending limbs and distal convoluted tubules were apically stained although the intensity was greater in the distal convoluted tubule. Collecting duct principal cells were virtually unlabeled, but intercalated cells had intense staining with an apical, basolateral or diffuse pattern in the cortex, and exclusively apical staining in the medulla. These results (a) show the presence of an H+ATPase in the apical plasma membrane of the proximal tubule that may contribute to H+ transport in this segment; (b) provide direct evidence that the intercalated cell contains most of the H+ATPase detectable in the collecting duct, supporting its proposed role in H+ transport; (c) demonstrate that subpopulations of cortical intercalated cells have opposite polarities of an H+ATPase, consistent with the presence of both proton- and bicarbonate-secreting cells; and (d) suggest a role for the H+ATPase in acid/base regulation or H+ transport in segments other than the collecting duct and the proximal tubule.
Liver transplantation from hepatitis B surface antigen positive donors: A safe way to expand the donor pool
Authors: Elisabetta Loggi, Lorenzo Micco, Giorgio Ercolani, Alessandro Cucchetti, Florian K. Bihl, Gian Luca Grazi, Stefano Gitto, Andrea Bontadini, Mauro Bernardi, Paolo Grossi, Alessandro Nanni Costa, Antonio Daniele Pinna, Christian Brander, Pietro Andreone
Journal: Journal of Hepatology (2011)
Endoscopic Treatment for Portal Hypertension: What’s New in the Last 12 Months?
Authors: H. Imazu, S. Seewald, S. Omar, Y. Zhong, N. Soehendra
Journal: Endoscopy (2005)

For some 20 years now, endoscopy has been revolutionizing the management of variceal hemorrhage as the most life-threatening sequela of portal hypertension. Portal shunt procedures and decompressive surgery have largely been replaced by endoscopic treatment modalities. However, endoscopic treatment is still a palliative measure, as it does not alter the underlying portal hypertension. Pharmacotherapy and transjugular intrahepatic portosystemic shunting (TIPS) are therefore still indispensable adjuncts for controlling and preventing variceal hemorrhage. Papers published in this field between June 2003 and August 2004 focusing on endoscopic topics are reviewed here.
APPENDICITIS FROM THE STANDPOINT OF THE GYNECOLOGIST.
Authors: HENRY P. NEWMAN
Journal: JAMA (1903)

In general, the diagnosis of appendicitis is not difficult to-day. Scarcely a decade and a half ago we were either losing the severe cases as acute peritonitis or inflammation of the bowels, or nursing them through the more protracted stages of typhlitis or perityphlitis, while the mild catarrhal cases were regarded as attacks of cholera morbus or congestion of the bowels. To-day the laity are almost as alert as the practitioners to recognize even the premonitory symptoms. When we meet exceptions to this rule, the case is apt to be one associated with or simulating disease of the pelvic organs in the female. A case in point is one which was brought to my attention recently. A young girl of about sixteen years of age, healthy in appearance, but nervous and slightly anemic, suffered from recurrent attacks of pain and soreness in the lower abdomen. These attacks occurred every three
NUP98 is fused to the NSD3 gene in acute myeloid leukemia associated with t(8;11)(p11.2;p15)
Authors: Roberto Rosati, Roberta La Starza, Angelo Veronese, Ana Aventin, Christine Schwienbacher, Teresa Vallespi, Massimo Negrini, Massimo F. Martelli, Cristina Mecucci
Journal: Blood (2002)
3D ECHOCARDIOGRAPHIC EVALUATION OF MITRAL APPARATUS DURING PRELOAD MANIPULATION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
Authors: Hyemoon Chung, Ji-Hyun Yoon, Jong-Youn Kim, Pil-Ki Min, Young Won Yoon, Byoung-Kwon Lee, Bum-Kee Hong, Se-Joong Rim, Hyuck Moon Kwon, Eui-Young Choi
Journal: Journal of the American College of Cardiology (2013)
Phytase activity in the human and rat small intestine.
Authors: T H Iqbal, K O Lewis, B T Cooper
Journal: Gut (1994)

Phytate is the major storage form of phosphorus in seeds and so is a common dietary constituent. Excessive ingestion of undegraded phytates can cause mineral deficiencies in humans. In addition, phytic acid is antineoplastic in animal models of both colon and breast carcinoma. There have been no previous studies quantifying phytase activity in the human small intestine although it is present in animals. Small intestinal phytase and alkaline phosphatase activity and distribution was measured in vitro in mucosal homogenates from two human small intestinal specimens obtained from transplant donors. Rat intestine was also studied for comparison. Phytase activity was found in human small intestine at low values (30 times less than that in rat tissue and 1000-fold lower than alkaline phosphatase in the same tissue). The activity was greatest in the duodenum and lowest in the ileum. In conclusion, the normal human small intestine has very limited ability to digest undegraded phytates. Although this may have adverse nutritional consequences with respect to metabolic cation imbalances, the presence of undigested phytate in the colon may protect against the development of colonic carcinoma.
Increased mitral-aortic separation in discrete subaortic stenosis.
Authors: G C Rosenquist, E B Clark, H A McAllister, S Bharati, J E Edwards
Journal: Circulation (1979)

We recently speculated that mitral-aortic separation (MAS) might be increased in discrete subaortic stenosis (DSS). We have examined this hypothesis in 22 heart specimens in which the subaortic obstruction originated on the muscular ventricular septum below the right aortic sinus, either as a discrete band, an accumulation of several bands or a diffuse ridge, and extended posteriorly into the MAS or anterior leaflet of the mitral valve or both, with a variable relationship to the aortic cusps and sinuses. No specimen had ventricular septal defect, supravalvular aortic stenosis or other features of Shone syndrome. The mean MAS was nearly twice that of 80 normal specimens (4.9 vs 2.5 mm), the range of MAS was increased from normal (0.11 vs 0.7 mm) and the mean diameter of the aortic annulus was decreased compared with the normal specimens, data that will be of interest to echo- and angiocardiographers in the clinical description of DSS, and to the surgeon who must resect these lesions.
Functional Status Assessment in the Preoperative Evaluation of Older Adults
Authors: Preeti N. Malani
Journal: JAMA (2009)

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
Time course of flow-induced smooth muscle cell proliferation and intimal thickening in endothelialized baboon vascular grafts.
Authors: R L Geary, T R Kohler, S Vergel, T R Kirkman, A W Clowes
Journal: Circulation Research (1994)

Polytetrafluoroethylene (PTFE) grafts placed into the arterial circulation of baboons for 8 weeks under high blood flow (HF) conditions develop a thin intima composed of smooth muscle cells (SMCs) and extracellular matrix beneath an endothelial monolayer. When these grafts are returned abruptly to normal flow (NF), they develop marked intimal thickening within 1 month. The mechanisms underlying this thickening are unclear. We studied the SMC response to altered flow by placing bilateral aortoiliac PTFE grafts into baboons with bilateral femoral arteriovenous fistulas. After 8 weeks, one fistula was closed, returning the graft flow on that side to NF. The opposite graft remained under HF conditions. Flow differences were monitored with duplex ultrasound (for all grafts: NF, 135 +/- 21 [mean +/- SEM] mL/min; HF, 507 +/- 35 mL/min; P &lt; .001). Grafts were removed 2, 4, 7, 14, or 28 days later (five animals per group). Endothelial coverage, as assessed by scanning electron microscopy, was intact in each graft. Intimal area and SMC number increased progressively in NF grafts through 28 days (for area: NF, 3.0 +/- 0.3 mm2; HF, 0.6 +/- 0.2 mm2; P &lt; .001; and for SMCs per cross section: NF, 11.8 +/- 1.1 x 10(3); HF, 2.6 +/- 1.0 x 10(3); P &lt; .002). Intimal SMC proliferation (thymidine labeling) was increased significantly in NF grafts at 4 and 7 days (at 4 days: NF, 5.9 +/- 1.5%; HF, 1.4 +/- 0.6%; P &lt; .05). Extracellular matrix accounted for an equal proportion of intimal mass in NF and HF grafts (percent matrix at 28 days: NF, 62.9 +/- 1.6%; HF, 63.7 +/- 4.7%; P = NS). We conclude that intimal thickening in this model of flow-induced vascular remodeling is due to increased SMC proliferation and accumulation of SMCs with a proportionate amount of extracellular matrix.
Stimulation of renin by acute selective chloride depletion in the rat.
Authors: H E Abboud, R G Luke, J H Galla, T A Kotchen
Journal: Circulation Research (1979)

To determine whether acute chloride depletion per se stimulates renin, we produced selective chloride depletion without sodium depletion in rats by peritoneal dialysis (PD) against 0.15 M NaHCO3 or 0.15 M NaNO3. Control rats were dialyzed against 0.15 M NaCl. Plasma renin activity (PRA) was measured before (PRA1) and 105 minutes after (PRA2) PD. Plasma volume was expanded after PD by infusion of salt-free albumin and was measured immediately after PRA2 by [131I]albumin. In experiment 1, rats were prepared on a normal diet. PRA2 (7.0 +/- 1.0 ng/ml per hr, mean +/- SEM) was increased (P less than 0.05) over PRA1 (4.7 +/- 0.7 ng/ml per hr) in Cl-depleted but not in control rats (PRA1 = 5.3 +/- 0.7, PRA2 = 6.1 +/- 0.7, P = NS). In experiment 2, to produce greater chloride depletion, all rats were prepared for 2 weeks on a low salt diet. PRA2 (47 +/- 5 ng/ml per hr) was increased as compared to PRA1 (24 +/- 2 ng/ml per hr, P less than 0.005) in the Cl-depleted group but not in the control group (PRA1 = 24 +/- 3, PRA2 = 27 +/- 6 ng/ml per hr, P = NS). Serum potassium and final plasma volume were slightly but not significantly lower than controls in these Cl-depleted rats. To exclude an additive effect of these two stimuli for renin, in experiment 2a we infused chloride-depleted rats with three times as much albumin as controls and with KHCO3, 100 mEq/liter. Despite volume expansion and potassium loading, PRA2 (41 +/- 6 ng/ml per hr) was significantly elevated as compared to PRA1 (25 +/- 4 ng/ml per hr, P less than 0.01). Since acute metabolic alkalosis also was present in all Cl-depleted renin-stimulated rats, an additional group (2b) was dialyzed against 0.15 M NaNO3; final plasma arterial pH (7.43) was not different from controls (7.42). Nevertheless, PRA2 levels again were higher (36 +/- 6 ng/ml per hr, P less than 0.05) as compared to PRA1 (23 +/- 4 ng/ml per hr). In all experiments, arterial blood pressure, glomerular filtration rate, and filtered sodium load were not different. Free water reabsorption was lower in Cl-depleted than in control rats. We conclude that acute selective chloride depletion per se is a potent stimulus for renin release.
Information Leaflet and Antibiotic Prescribing Strategies for Acute Lower Respiratory Tract Infection
Authors: Paul Little, Kate Rumsby, Joanne Kelly, Louise Watson, Michael Moore, Gregory Warner, Tom Fahey, Ian Williamson
Journal: JAMA (2005)

Acute lower respiratory tract infection is the most common condition treated in primary care. Many physicians still prescribe antibiotics; however, systematic reviews of the use of antibiotics are small and have diverse conclusions.To estimate the effectiveness of 3 prescribing strategies and an information leaflet for acute lower respiratory tract infection.A randomized controlled trial conducted from August 18, 1998, to July 30, 2003, of 807 patients presenting in a primary care setting with acute uncomplicated lower respiratory tract infection. Patients were assigned to 1 of 6 groups by a factorial design: leaflet or no leaflet and 1 of 3 antibiotic groups (immediate antibiotics, no offer of antibiotics, and delayed antibiotics).Three strategies, immediate antibiotics (n = 262), a delayed antibiotic prescription (n = 272), and no offer of antibiotics (n = 273), were prescribed. Approximately half of each group received an information leaflet (129 for immediate antibiotics, 136 for delayed antibiotic prescription, and 140 for no antibiotics).Symptom duration and severity.A total of 562 patients (70%) returned complete diaries and 78 (10%) provided information about both symptom duration and severity. Cough rated at least "a slight problem" lasted a mean of 11.7 days (25% of patients had a cough lasting > or =17 days). An information leaflet had no effect on the main outcomes. Compared with no offer of antibiotics, other strategies did not alter cough duration (delayed, 0.75 days; 95% confidence intervals [CI], -0.37 to 1.88; immediate, 0.11 days; 95% CI, -1.01 to 1.24) or other primary outcomes. Compared with the immediate antibiotic group, slightly fewer patients in the delayed and control groups used antibiotics (96%, 20%, and 16%, respectively; P<.001), fewer patients were "very satisfied" (86%, 77%, and 72%, respectively; P = .005), and fewer patients believed in the effectiveness of antibiotics (75%, 40%, and 47%, respectively; P<.001). There were lower reattendances within a month with antibiotics (mean attendances for no antibiotics, 0.19; delayed, 0.12; and immediate, 0.11; P = .04) and higher attendance with a leaflet (mean attendances for no leaflet, 0.11; and leaflet, 0.17; P = .02).No offer or a delayed offer of antibiotics for acute uncomplicated lower respiratory tract infection is acceptable, associated with little difference in symptom resolution, and is likely to considerably reduce antibiotic use and beliefs in the effectiveness of antibiotics.