tbuckley/cabot-search huggingface dataset:
Determinants of hemodynamic compromise with severe right ventricular infarction.
Authors: J A Goldstein, B Barzilai, T L Rosamond, P R Eisenberg, A S Jaffe
Journal: Circulation (1990)

To elucidate determinants of hemodynamic compromise in patients with acute right ventricular (RV) infarction, we studied 16 patients with hemodynamically severe RV infarction by right heart catheterization and two-dimensional ultrasound. Severe RV systolic dysfunction, evident by ultrasound in all patients as RV dilatation and depressed RV free wall motion, was associated with a broad sluggish RV waveform, diminished peak RV systolic pressure (27.6 +/- 4.5 mm Hg), and depressed RV stroke work (4.6 +/- 2.4 g.m/m2). Paradoxical septal motion was consistently noted. In some cases, the septum bulged into the right ventricle in a pistonlike fashion and appeared to mediate systolic ventricular interaction through which left ventricular septal contraction contributed to RV pressure generation. RV diastolic dysfunction was indicated by elevated RV end-diastolic pressures (13.7 +/- 2.7 mm Hg), RV "dip and plateau," equalization of diastolic filling pressures, and reversal of diastolic septal curvature toward the volume-deprived left ventricle. A prominent right atrial (RA) X and blunted Y descent, indicative of impairment of RV filling throughout diastole, were confirmed in all patients by their relation to RV systolic events. Patients manifested one of two distinct RA waveform morphologies differentiated by A wave amplitude and associated with disparate clinical courses. In eight patients, an RA W pattern was evident, characterized by augmented A waves; eight others manifested an M pattern constituted by depressed A waves. Compared with those with an M pattern, patients with a W pattern had higher peak RV pressures (29.6 +/- 3.8 versus 25.5 +/- 4.3 mm Hg, p less than 0.05), better cardiac output (3.4 +/- 0.3 versus 2.9 +/- 0.7 l/min, p less than 0.05), more favorable response to volume and inotropes, and less frequently required emergency revascularization for refractory shock (none versus five for those with an M pattern). Patients with a W pattern were more severely compromised if atrioventricular dyssynchrony developed and were more dramatically improved by restoration of physiological rhythm. Angiography in patients with depressed A waves demonstrated more proximal coronary obstruction leading to ischemic compromise of RA function, whereas in those with augmented A waves, the culprit lesion was proximal to the RV but distal to the RA branches. These results indicate that hemodynamic compromise in patients with RV infarction is exacerbated by decreased preload reserve that is dependent on atrial systole. The amplitude of the RA A wave, an indication of the status of RA function, is an important determinant of RV performance and hemodynamic compromise.
Underlying Causes and Survival in Patients with Heart Failure
Authors: Michael M. Givertz
Journal: New England Journal of Medicine (2000)

Heart failure is a major health problem in the United States. It is estimated that 4.6 million Americans are currently treated for heart failure and that approximately 550,000 new cases are diagnosed each year.1 Despite advances in therapy, including the widespread use of angiotensin-converting–enzyme inhibitors and the introduction of beta-adrenergic antagonists, mortality associated with heart failure remains high.2 In a recent community-based survey, one-year and five-year survival rates after the onset of heart failure were 76 percent and 35 percent, respectively.3 In 1998, heart failure contributed to 260,000 deaths in the United States.1 The accurate assessment of prognosis in heart . . .
Reconsidering the Role for Digoxin in the Management of Acute Heart Failure Syndromes
Authors: Mihai Gheorghiade
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
Prevalence of Asymptomatic Bacteriuria in Subjects with NIDDM in San Luis Valley of Colorado
Authors: Ellen M Keane, Edward J Boyko, L Barth Reller, Richard F Hamman
Journal: Diabetes Care (1988)

This study examined whether non-insulin-dependent diabetic (NIDDM) subjects have an increased prevalence of asymptomatic bacteriuria compared with subjects with normal glucose tolerance. Diabetic (n = 206) and normal (n = 418) subjects were identified from a defined geographic area in the San Luis Valley of southern Colorado. Presence of asymptomatic bacteriuria was determined by testing the subjects' urine with a reagent-strip test for nitrite and leukocyte esterase (Chemstrip LN). The ability of the Chemstrip LN to detect bacteriuria was evaluated by comparing its results with those from urine culture on a subsample of subjects. There were 7 control and 12 diabetic subjects with bacteriuria as measured by the Chemstrip LN. The prevalence of urinary tract colonization among diabetic compared with control subjects was increased 3.5-fold (95% confidence interval 1.4–8.6). Adjustment for confounding by age, sex, ethnicity, and county of residence resulted in an adjusted prevalence ratio of 4.4 (95% confidence interval 1.1–17.4). Among diabetic subjects, prevalence of bacteriuria increased with longer disease duration but was not affected by measures of glucose control. We conclude that NIDDM increases the prevalence of bacterial colonization of the urine and, therefore, probably also increases the risk of symptomatic urinary tract infection.
Model for human carcinogenesis: action of environmental agents.
Authors: S H Moolgavkar
Journal: Environmental Health Perspectives (1983)

Current statistical prescriptions for low-dosage extrapolation of carcinogenic risk make no distinction between exposure to initiators and exposure to promoters despite the abundant data that these two classes of carcinogens have different modes of action. One reason for this is the lack of an appropriate model. In this paper, a model for carcinogenesis is presented which provides a framework for understanding the roles of
Reciprocal Inhibition between Intracellular Antiviral Signaling and the RNAi Machinery in Mammalian Cells
Authors: Gil Ju Seo, Rodney P. Kincaid, Teva Phanaksri, James M. Burke, Justin M. Pare, Jennifer E. Cox, Tien-Ying Hsiang, Robert M. Krug, Christopher S. Sullivan
Journal: Cell Host & Microbe (2013)
Failure to "keep up" as negligence
Authors: A. R. Holder
Journal: JAMA (1973)

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
Leukotrienes as mediators of skin inflammation
Authors: A.W. FORD-HUTCHINSON, ANITA RACKMAN
Journal: British Journal of Dermatology (2006)

Leukotrienes (LTs) derived from the 5‐lipoxygenase pathways of arachidonic acid metabolism, are a new group of biologically active mediators. LTC4, LTD4 and LTE4 are considered collectively to account for the activity of slow reacting substance of anaphylaxis (SRS‐A). They have potent smooth muscle contracting activity (Drazen et al., 1980; Holme et al., 1980) and cause vascular permeability changes in guinea‐pig skin (Peck, Piper & Williams, 1981). LTB4 has been shown to be a potent chemotactic and chemokinetic agent for polymorphonuclear leucocytes (PMNs) (Ford‐Hutchinson et al., 1980; Smith, Ford‐Hutchinson & Bray, 1980) and to cause vascular permeability changes in rabbit, rat and guinea‐pig skin (Bray et al., 1981a). In human skin LTB4 has been shown to be a chemotactic agent for neutrophils (Bray, Ford‐Hutchinson & Smith, 1981b; Camp et al., 1982). LTC4 and LTD4 have pronounced inflammatory actions in human skin causing weal and flare responses and increases in blood flow at low concentrations (Camp et al., 1982; Bisgard, Kristensen & Sondergaard, 1982). The present studies were designed to investigate a variety of leukotrienes on permeability responses in rabbit and guinea‐pig skin.
INTERPRETATION OF CHEST X-RAY FILMS
Authors: David Louis Engelsher
Journal: JAMA (1952)

<h3>To the Editor:—</h3> Your editorial "Reliability of Interpretation of Chest X-Ray Films," which appeared inThe JournalDec. 29, 1951 (<b>147</b>:1765) was most interesting. The high percentage of disagreements, up to 30%, by various physicians and 15% among the same doctors on the same films, at a later date, accounts for the fact that not a few persons receive tuberculosis care when the actual diagnosis may be allergic bronchial asthma, existing alone or concurrently with healed tuberculosis. Over 25 years ago, at a medical school and large tuberculosis hospital, I called attention to a number of such cases diagnosed as active tuberculosis that really were allergic bronchial asthmas, alone or coexisting with inactive tuberculosis. Too much reliance was placed, as now, on the x-ray. In one patient who had coexisting active syphilis of the larynx with active pulmonary tuberculosis, the prognosis and result were completely changed by recognition of
Splenectomy in Hematologic Disorders
Authors: William H. Crosby
Journal: New England Journal of Medicine (1972)

DURING the past sixty years splenectomy (Sx) has become a common procedure for the treatment of hypersplenism. Hypersplenism is a hematologic term describing premature destruction of blood cells by the spleen, usually with consequent anemia or leukocytopenia or thrombocytopenia — or all three. Dameshek established four signs of hypersplenism, the tetralogy consisting of cytopenia of the blood, corresponding hyperplasia of the precursor tissue in the bone marrow (e.g., thrombocytopenia with increased megakaryocytes), splenomegaly and — the clincher — cure of the cytopenia after Sx. There are exceptions to the first three rules. For example, in hereditary spherocytosis (HS) the red-cell . . .
Conformational Rearrangement in C-Reactive Protein Is Required for Proinflammatory Actions on Human Endothelial Cells
Authors: Tarek Khreiss, Levente József, Lawrence A. Potempa, János G. Filep
Journal: Circulation (2004)

C-reactive protein (CRP) has been suggested to actively amplify the inflammatory response underlying coronary heart diseases by directly activating endothelial cells. In this study, we investigated whether loss of the cyclic pentameric structure of CRP, resulting in formation of modified or monomeric CRP (mCRP), is a prerequisite for endothelial cell activation.We examined the impact of native CRP and mCRP on the production of monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8), key regulators of leukocyte recruitment, and on the expression of intercellular adhesion molecule-1 (ICAM-1), E-selectin, and vascular adhesion molecule-1 (VCAM-1) in human cultured coronary artery endothelial cells (HCAECs). Incubation with mCRP for 4 hours increased MCP-1 and IL-8 secretion and mRNA levels and expression of ICAM-1, E-selectin, and VCAM-1 protein and mRNA. Significant induction occurred at 1 to 5 microg/mL, reached a maximum at 30 microg/mL, and did not require the presence of serum. Native CRP was without detectable effects at 4 hours, whereas it enhanced cytokine release after a 24-hour incubation. An anti-FcgammaRIII (CD16) but not an anti-FcgammaRII (CD32) antibody produced a 14% to 32% reduction of the mCRP effects (P<0.05). mCRP but not CRP evoked phosphorylation of p38 mitogen-activated protein kinase, and inhibition of this kinase with SB 203580 reversed the effects of mCRP. Furthermore, culture of HCAECs in the presence of SB203580 markedly decreased mCRP-stimulated E-selectin and ICAM-1-dependent adhesion of neutrophils to HCAECs (P<0.001).Loss of pentameric symmetry in CRP, resulting in formation of mCRP, promotes a proinflammatory HCAEC phenotype through a p38 MAPK-dependent mechanism.
The real issues
Authors: M. H Basler
Journal: BMJ (2009)

Underwood and Littlejohns say that the real issue concerning the guideline from the National Institute for Health and Clinical Excellence (NICE) on back pain is the limited evidence base for injections into the spine.1 2 But the real issue is that the evidence base for any intervention is poor and that back pain is hugely complex. The fact that there are …
Genital yeast infections.
Authors: A B Maclean
Journal: BMJ (1977)

normal breakfast, before his daily digoxin dose, and after at least 15 minutes' rest.Patients had become familiar with the technique during the period on digoxin prior to this study.Had we measured systolic time intervals in patients whose failure worsened clinically on placebo the influence of changes in ventricular volume, pre-load, after-load, etc, would have been predominant.Although Weissler and Schoen- feld found that the effect of a single intravenous dose of deslanoside in patients with severe heart failure was better reflected by the pre-ejection period (PEP) than the left ventricular ejection time (LVET), the indices (PEPI and LVETI) showed equally significant correlations with conventional haemodynamic measurements.Hoeschen and Cuddy,' in patients on maintenance digoxin, found that doubling the dose had no effect on the PEPI but significantly shortened the LVETI.
Outpatient Oxygen for Chronic Airway Obstruction
Authors: Thomas L. Petty
Journal: JAMA (1974)

ALL primary physicians who provide ambulatory care encounter large and increasing numbers of patients with emphysema and chronic bronchitis that together are called chronic airway obstruction. Many have advanced disease and are disabled. Since significant hypoxemia is present in many of these patients, the value and practicality of outpatient oxygen therapy for both objective and subjective benefit has recently become of interest. Pertinent questions remain concerning indications, economic problems, safety, and the possibility of oxygen toxicity. The purpose of this commentary is to review our nine experiences with oxygen provided to ambulatory patients and to give at least preliminary answers to these remaining questions.  In 1965, we embarked on a systematic study of what we then called long-term oxygen therapy for a group of highly selected patients with chronic airway obstruction. Briefly, this initial group of only six patients had the bronchitic type of chronic airway obstruction, with clinical evidence
Sutureless amniotic membrane transplantation for ocular surface reconstruction with a chemically defined bioadhesive
Authors: Maho Takaoka, Takahiro Nakamura, Hajime Sugai, Adam J. Bentley, Naoki Nakajima, Nigel J. Fullwood, Norihiko Yokoi, Suong-Hyu Hyon, Shigeru Kinoshita
Journal: Biomaterials (2008)
IMPEDANCE-GUIDED TREATMENT PREVENTS ACUTE HEART FAILURE IN THE COURSE OF ACUTE MYOCARDIAL INFARCTION AND REDUCED LONG-TERM MORTALITY
Authors: Michael Shochat, Avraham Shotan, David Blondhaim, Mark Kazatsker, Vladimir Gurovich, Aya Asif, Lubov Vasilenko, Elena Neiman, Morris Mosseri, Aaron Frimerman, Paul Rabinovich, Simcha Meisel
Journal: Journal of the American College of Cardiology (2010)
Re: R. Houston Thompson, Tom Atwell, Grant Schmit, et al. Comparison of Partial Nephrectomy and Percutaneous Ablation for cT1 Renal Masses. Eur Urol 2015;67:252–9
Authors: Aaron M. Potretzke, Jeffrey A. Larson, Sam B. Bhayani
Journal: European Urology (2014)
P1-08-04: Obesity, Adjuvant Therapy, and Survival Outcomes in Early-Stage Breast Cancer.
Authors: S Jiralerspong, T Wang, MF Rimawi, JR Nangia, R Schiff, SH Giordano, MN Pollak, CC Chenault, CK Osborne, SG Hilsenbeck
Journal: Cancer Research (2011)

Abstract BACKGROUND: Obesity has risen to epidemic proportions and is associated with worse breast cancer (BC) prognosis in most studies. However, the effects of obesity according to adjuvant therapy choice are largely unknown. To address this issue, we examined the relationship between body mass index (BMI), adjuvant therapy, and survival outcomes in a large cohort of early-stage BC patients. METHODS: We retrospectively studied patients from the Baylor Breast Center Tumor Bank treated from 1970–1995. Patients were divided into 3 BMI classes: normal/underweight (N, BMI&amp;lt;25), overweight (Ov, BMI 25–30), obese (Ob, BMI≥30); and 4 treatment groups: no adjuvant therapy, chemotherapy (mainly CMF), endocrine therapy (mainly tamoxifen), both chemo- and endocrine therapy. Time-to-recurrence (TTR), disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method and compared among groups via the log-rank test. Multivariate analysis was conducted via Cox proportional hazards models. RESULTS: There were 4,368 patients. Median age was 58. 74% were postmenopausal. 72% had stage I-II disease, 28% stage III. 76% were estrogen receptor (ER)-positive, 24% ER-negative. Patients distributed into BMI classes as follows: N 48%, Ov 30%, Ob 22%. Higher BMI was associated with postmenopausal status and increasing age, tumor size, positive lymph nodes, and stage, as well as a higher likelihood of receiving treatment. Median follow-up was 5 years. Kaplan-Meier analysis showed that TTR was significantly shorter in the Ov and Ob groups as compared to the N group (p=0.019), due to distant (p=0.001) rather than local (p=0.970) recurrences. DFS was also significantly worse in the Ov and Ob groups (p=0.002), as was OS (p=0.001). The Table shows the hazard ratios for the various survival outcomes after adjustment for age, tumor size, nodal status, and treatment groups. For all patients, TTR, DFS, and OS were significantly worse in the Ob vs. N groups. TTR and DFS were significantly worse in the chemo treated Ob vs. N groups. DFS and OS were significantly better in the endo treated Ov vs. N groups. DISCUSSION: In this large cohort of BC patients, survival outcomes (TTR, DFS, OS) were significantly worse in the obese group. This remained true after adjustment for multiple factors. Obesity was associated with worse survival outcomes in the chemo treated (CMF) group. Overweight was associated with better survival outcomes in the endo treated (tamoxifen) group. These results confirm and extend the results of previous studies. Further studies to discover the reasons for these differences in outcomes are underway. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-08-04.
GMC to consult on fitness to practise committees Health minister begins primary care tour GMSC gives guidance on assessing mentally ill people Public health doctors advised not to sign package
Authors: L. Beecham
Journal: BMJ (1996)

# GMC to consult on fitness to practise committees {#article-title-2}

The General Medical Council is to consult widely on a consultation document on the constitution of its fitness to practise committees. At present there are three committees: the preliminary proceedings committee (the committee which decides whether to refer doctors to the conduct committee or to the health committee), the professional conduct committee, and the health committee. The GMC has to create two new committees to deal with the performance procedures when they begin operating in 1997. These will be the committee on professional performance, which will determine whether a doctor's professional performance has been seriously deficient and the assessment referral committee, which will determine whether doctors who have refused to undergo performance assessment voluntarily should be required to do so.

The problem is that this could add a potential extra workload of 200 days of meetings a year in addition to the current 123. And although the council's constitution is expected to change this year, adding 12 additional lay members the overall size will stay the same at 104 members: 25 lay, 54 elected, and 25 appointed.

The council agreed at its recent meeting that there should be a flexible approach. It has decided that members should be able to serve concurrently on more than one fitness to practise committee and that members of the preliminary proceedings committee should be able to sit on the professional conduct committee in the following year.

At present the elected members must outnumber the joint total of lay and appointed members on the fitness to practise committees. In future, although this arrangement will continue for the main committees, the panels which will …
Serum free light chain analysis
Authors: Matthew S. Davids, Mandakolathur R. Murali, David J. Kuter
Journal: American Journal of Hematology (2010)

Abstract In a variety of hematologic malignancies, immunoglobulin light chains (LC) are overproduced clonally and circulate without being linked by disulphide bonds to the immunoglobulin heavy chain. The recent development of a robust assay known as κ and λ “free” LC (FLC) to quantify the levels of these unbound LC in the serum, and thereby determine their ratio, has led to an explosion of studies that demonstrate its utility in a wide range of hematologic disorders. This article summarizes laboratory testing for serum FLC, with a particular focus on clinical applications for the test. Am. J. Hematol., 2010. © 2010 Wiley‐Liss, Inc.
Recombinant allergens for immunotherapy: A Der p 2 variant with reduced IgE reactivity retains T-cell epitopes☆☆☆★★★
Authors: Alisa M. Smith, Martin D. Chapman, Ernesto A. Taketomi, Thomas A.E. Platts-Mills, Sun-sang J. Sung
Journal: Journal of Allergy and Clinical Immunology (1998)