tbuckley/cabot-search huggingface dataset:
Detection of expiratory flow limitation in COPD using the forced oscillation technique
Authors: R.L. Dellacà, P. Santus, A. Aliverti, N. Stevenson, S. Centanni, P.T. Macklem, A. Pedotti, P.M.A. Calverley
Journal: European Respiratory Journal (2004)

Expiratory flow limitation (EFL) during tidal breathing is a major determinant of dynamic hyperinflation and exercise limitation in chronic obstructive pulmonary disease (COPD). Current methods of detecting this are either invasive or unsuited to following changes breath-by-breath. It was hypothesised that tidal flow limitation would substantially reduce the total respiratory system reactance (Xrs) during expiration, and that this reduction could be used to reliably detect if EFL was present. To test this, 5-Hz forced oscillations were applied at the mouth in seven healthy subjects and 15 COPD patients (mean +/- sD forced expiratory volume in one second was 36.8 +/- 11.5% predicted) during quiet breathing. COPD breaths were analysed (n=206) and classified as flow-limited if flow decreased as alveolar pressure increased, indeterminate if flow decreased at constant alveolar pressure, or nonflow-limited. Of these, 85 breaths were flow-limited, 80 were not and 41 were indeterminate. Among other indices, mean inspiratory minus mean expiratory Xrs (deltaXrs) and minimum expiratory Xrs (Xexp,min) identified flow-limited breaths with 100% specificity and sensitivity using a threshold between 2.53-3.12 cmH2O x s x L(-1) (deltaXrs) and -7.38- -6.76 cmH2O x s x L(-1) (Xexp,min) representing 6.0% and 3.9% of the total range of values respectively. No flow-limited breaths were seen in the normal subjects by either method. Within-breath respiratory system reactance provides an accurate, reliable and noninvasive technique to detect expiratory flow limitation in patients with chronic obstructive pulmonary disease.
Predictive Factors in Chronic Graft-Versus-Host Disease in Patients with Aplastic Anemia Treated by Marrow Transplantation from HLA-Identical Siblings
Authors: RAINER STORB
Journal: Annals of Internal Medicine (1983)

One hundred ten of 175 patients with aplastic anemia conditioned by cyclophosphamide had sustained engraftment of marrow from human leukocyte antigen (HLA)-identical siblings and lived for more than 6 months. Forty-nine of the 110 patients developed chronic graft-versus-host disease between 85 and 464 days. Ninety-seven patients are alive from 1.4 to 11 years after engraftment; 13 died between 208 and 726 days. Twenty of the 36 surviving patients with chronic graft-versus-host disease have Karnofsky performance scores of 100%, 7 of 90%, 5 of 80%, 1 of 70%, 2 of 60%, and 1 of 40%. Our analysis, using a binary logistic regression model, identified three factors predicting chronic graft-versus-host disease: moderate to severe acute graft-versus-host disease with an estimated relative risk of 11.65; increasing patient age; and the use of viable donor buffy coat cells in addition to the marrow to prevent graft rejection. The last two factors were significant only in patients without acute graft-versus-host disease.
The Bronchographic Appearance of "Peripheral Pooling" Attributed to the Filling of Centrilobular Emphysematous Spaces
Authors: J. G. Leopold, R. M. Seal
Journal: Thorax (1961)

Dionosil aqueous," 10-15 ml., was introduced by catheter into the left bronchus for bronchography, as described by Smith, Davies, Rothwell, Lodwig, and Mahoney (1960).The immediate film showed good bronchial filling confined to the left lung and most complete in the upper lobe.There was no obvious bronchial block except possibly in a subdivision of the left apico-posterior bronchus.The posterior division of the left upper lobe was updrawn." Alveolar" filling did not occur, but the appearance of " peripheral pooling " was seen at the terminations of all the outlined twigs of the upper part of the on July 19, 2023 by guest.
LAW AND MEDICINE
Authors: Richard P. Bergen
Journal: JAMA (1970)

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
Comparison of Inhaled Fluticasone with Intravenous Hydrocortisone in the Treatment of Adult Acute Asthma
Authors: Gustavo J. Rodrigo
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Several studies published in the second half of the 1990s have shown a therapeutic early effect of inhaled corticosteroids in acute asthma. However, systemic corticosteroids are considered the standard of care.To compare the effect of repeated doses of inhaled fluticasone with the standard treatment of systemic corticosteroids in adult patients with severe acute asthma.One hundred six patients (mean age, 33.5 +/- 8.8 years) were randomly assigned to receive fluticasone (3,000 microg/hour) administered through a metered-dose inhaler and spacer at 10-minute intervals for 3 hours, or 500 mg of intravenous hydrocortisone. In addition, all patients received inhaled albuterol and ipratropium bromide.Subjects treated with fluticasone showed 30.5 and 46.4% greater improvements in PEF and FEV1, respectively, compared with the hydrocortisone group. The fluticasone group had better PEF and FEV1 at 120, 150, and 180 minutes (p < 0.05). Also, the fluticasone group showed higher rates of patients who obtained the discharge threshold at 90, 120, and 150 minutes. This therapeutic benefit was particularly evident in those patients with the most severe obstruction. Subjects with a baseline FEV1 of less than 1 L treated with fluticasone showed a significant increase in pulmonary function (p = 0.001) and a significant decrease in hospitalization rate (p = 0.05).The use of repeated doses of inhaled fluticasone was more effective than intravenous hydrocortisone and was associated with an early improvement. This therapeutic benefit was particularly evident in those patients with the most severe obstruction.
Molecular Pathways: The Complex Roles of Inflammation Pathways in the Development and Treatment of Liver Cancer
Authors: Kostas Nikolaou, Michalis Sarris, Iannis Talianidis
Journal: Clinical Cancer Research (2013)

Inflammatory signals from the surrounding microenvironment play important roles in tumor promotion. Key inflammatory mediators and pathways that induce and sustain tumorigenesis have recently been identified in many different cancers. Hepatocellular carcinoma is a paradigm for inflammation-induced cancer, as it most frequently develops in the setting of chronic hepatitis, consecutive cellular damage, and compensatory regeneration. Recent studies revealed that liver damage-mediated inflammation and carcinogenesis are triggered by a complex cross-talk between NF-κB, c-jun-NH2-kinase, and STAT3 signaling pathways. Molecular dissection of the mechanisms involved in the interplay between these pathways identified promising new targets for therapeutic intervention. Targeting different components of the signaling cascades may provide efficient means for blocking the apparently irreversible sequence of events initiated by chronic liver inflammation and culminating in liver cancer.
Phosphorylated Tau as a Candidate Biomarker for Amyotrophic Lateral Sclerosis
Authors: Murray Grossman, Lauren Elman, Leo McCluskey, Corey T. McMillan, Ashley Boller, John Powers, Katya Rascovsky, William Hu, Les Shaw, David J. Irwin, Virginia M.-Y. Lee, John Q. Trojanowski
Journal: JAMA Neurology (2014)

<h3>Importance</h3> An increasingly varied clinical spectrum of cases with amyotrophic lateral sclerosis (ALS) has been identified, and objective criteria for clinical trial eligibility are necessary. <h3>Objective</h3> To develop a cerebrospinal fluid (CSF) biomarker sensitive and specific for the diagnosis of ALS. <h3>Design, Setting, and Participants</h3> A case-control study including 51 individuals with ALS and 23 individuals with a disorder associated with a 4-repeat tauopathy was conducted at an academic medical center. <h3>Main Outcomes and Measures</h3> The CSF level of tau phosphorylated at threonine 181 (ptau) and ratio of ptau to total tau (ttau). <h3>Results</h3> Using a cross-validation prediction procedure, we found significantly reduced CSF levels of ptau and the ptau:ttau ratio in ALS relative to 4-repeat tauopathy and to controls. In the validation cohort, the receiver operating characteristic area under the curve for the ptau:ttau ratio was 0.916, and the comparison of ALS with 4-repeat tauopathy showed 92.0% sensitivity and 91.7% specificity. Correct classification based on a low CSF ptau:ttau ratio was confirmed in 18 of 21 cases (86%) with autopsy-proved or genetically determined disease. In patients with available measures, ptau:ttau in ALS correlated with clinical measures of disease severity, such as the Mini-Mental State Examination (n = 51) and ALS Functional Rating Scale–Revised (n = 42), and regression analyses related the ptau:ttau ratio to magnetic resonance imaging (n = 10) evidence of disease in the corticospinal tract and white matter projections involving the prefrontal cortex. <h3>Conclusions and Relevance</h3> The CSF ptau:ttau ratio may be a candidate biomarker to provide objective support for the diagnosis of ALS.
Probing the Intracellular Redox Status of Tumors with Magnetic Resonance Imaging and Redox-Sensitive Contrast Agents
Authors: Fuminori Hyodo, Ken-ichiro Matsumoto, Atsuko Matsumoto, James B. Mitchell, Murali C. Krishna
Journal: Cancer Research (2006)

Nitroxide radicals are paramagnetic contrast agents, used in magnetic resonance imaging (MRI), that also exert antioxidant effects. Participating in cellular redox reactions, they lose their ability to provide contrast as a function of time after administration. In this study, the rate of contrast loss was correlated to the reducing power of the tissue or the "redox status." The preferential reduction of nitroxides in tumors compared with normal tissue was observed by MRI. The influence of the structure of the nitroxide on the reduction rate was investigated by MRI using two cell-permeable nitroxides, 4-hydroxy-2,2,6,6,-tetramethyl-1-piperidynyloxyl (Tempol) and 3-carbamoyl-2,2,5,5-tetramethylpyrrolidine-1-oxyl (3CP), and one cell-impermeable nitroxide, 3-carboxy-2,2,5,5,5-tetramethylpyrrolidine-1-oxyl (3CxP). Pharmacokinetic images of these nitroxides in normal tissue, tumor, kidney, and artery regions in mice were simultaneously obtained using MRI. The decay of Tempol and 3CP in tumor tissue was significantly faster than in normal tissue. No significant change in the total nitroxide (oxidized + reduced forms) was noted from tissue extracts, suggesting that the loss in contrast as a function of time is a result of intracellular bioreduction. However, in the case of 3CxP (membrane impermeable), there was no difference in the reduction rates between normal and tumor tissue. The time course of T(1) enhancement by 3CxP and the total amount of 3CxP (oxidized + reduced) in the femoral region showed similar pharmacokinetics. These results show that the differential bioreduction of cell-permeable nitroxides in tumor and normal tissue is supported by intracellular processes and the reduction rates are a means by which the intracellular redox status can be assessed noninvasively.
Multicenter Independent Assessment of Outcomes in Chronic Myeloid Leukemia Patients Treated With Imatinib
Authors: Carlo Gambacorti-Passerini, Laura Antolini, François-Xavier Mahon, Francois Guilhot, Michael Deininger, Carmen Fava, Arnon Nagler, Chiara Maria Della Casa, Enrica Morra, Elisabetta Abruzzese, Anna D’Emilio, Fabio Stagno, Philipp le Coutre, Rafael Hurtado-Monroy, Valeria Santini, Bruno Martino, Fabrizio Pane, Andrea Piccin, Pilar Giraldo, Sarit Assouline, Muheez A. Durosinmi, Onno Leeksma, Enrico Maria Pogliani, Miriam Puttini, Eunjung Jang, Josy Reiffers, Maria Grazia Valsecchi, Dong-Wook Kim
Journal: JNCI Journal of the National Cancer Institute (2011)

Imatinib slows development of chronic myeloid leukemia (CML). However, available information on morbidity and mortality is largely based on sponsored trials, whereas independent long-term field studies are lacking. Consecutive CML patients who started imatinib treatment before 2005 and who were in complete cytogenetic remission (CCyR) after 2 years (±3 months) were eligible for enrollment in the independent multicenter Imatinib Long-Term (Side) Effects (ILTE) study. Incidence of the first serious and nonserious adverse events and loss of CCyR were estimated according to the Kaplan–Meier method and compared with the standard log-rank test. Attainment of negative Philadelphia chromosome hematopoiesis was assessed with cytogenetics and quantitative polymerase chain reaction. Cumulative incidence of death related or unrelated to CML progression was estimated, accounting for competing risks, according to the Kalbleisch–Prentice method. Standardized incidence ratios were calculated based on population rates specific for sex and age classes. Confidence intervals were calculated by the exact method based on the χ 2 distribution. All statistical tests were two-sided. A total of 832 patients who were treated for a median of 5.8 years were enrolled. There were 139 recorded serious adverse events, of which 19.4% were imatinib-related. A total of 830 nonserious adverse events were observed in 53% of patients; 560 (68%) were imatinib-related. The most frequent were muscle cramps, asthenia, edema, skin fragility, diarrhea, tendon, or ligament lesions. Nineteen patients (2.3%) discontinued imatinib because of drug-related toxic effects. Forty-five patients lost CCyR, at a rate of 1.4 per 100 person-years. Durable (>1 year) negative Philadelphia chromosome hematopoiesis was attained by 179 patients. Twenty deaths were observed, with a 4.8% mortality incidence rate (standardized incidence ratio = 0.7; 95% confidence interval = 0.40 to 1.10, P = .08), with only six (30%) associated with CML progression. In this study, CML-related deaths were uncommon in CML patients who were in CCyR 2 years after starting imatinib, and survival was not statistically significantly different from that of the general population.
On the Antiseptic Principle in the Practice of Surgery
Authors: Joseph Lister
Journal: BMJ (1867)

<h3>Objective:</h3> To test whether level of perceived stress and reductions in levels of perceived stress (i.e., “let-down”) are associated with the onset of migraine attacks in persons with migraine. <h3>Methods:</h3> Patients with migraine from a tertiary headache center were invited to participate in a 3-month electronic diary study. Participants entered data daily regarding migraine attack experience, subjective stress ratings, and other data. Stress was assessed using 2 measures: the Perceived Stress Scale and the Self-Reported Stress Scale. Logit-normal, random-effects models were used to estimate the odds ratio for migraine occurrence as a function of level of stress over several time frames. <h3>Results:</h3> Of 22 enrolled participants, 17 (median age 43.8 years) completed &gt;30 days of diaries, yielding 2,011 diary entries including 110 eligible migraine attacks (median 5 attacks per person). Level of stress was not generally associated with migraine occurrence. However, decline in stress from one evening diary to the next was associated with increased migraine onset over the subsequent 6, 12, and 18 hours, with odds ratios ranging from 1.5 to 1.9 (all <i>p</i> values &lt; 0.05) for the Perceived Stress Scale. Decline in stress was associated with migraine onset after controlling for level of stress for all time points. Findings were similar using the Self-Reported Stress Scale. <h3>Conclusions:</h3> Reduction in stress from one day to the next is associated with migraine onset the next day. Decline in stress may be a marker for an impending migraine attack and may create opportunities for preemptive pharmacologic or behavioral interventions.
Application of New Cholesterol Guidelines to a Population-Based Sample
Authors: Michael J. Pencina, Ann Marie Navar-Boggan, Ralph B. D'Agostino, Ken Williams, Benjamin Neely, Allan D. Sniderman, Eric D. Peterson
Journal: New England Journal of Medicine (2014)

The 2013 guidelines of the American College of Cardiology and the American Heart Association (ACC-AHA) for the treatment of cholesterol expand the indications for statin therapy for the prevention of cardiovascular disease.Using data from the National Health and Nutrition Examination Surveys of 2005 to 2010, we estimated the number, and summarized the risk-factor profile, of persons for whom statin therapy would be recommended (i.e., eligible persons) under the new ACC-AHA guidelines, as compared with the guidelines of the Third Adult Treatment Panel (ATP III) of the National Cholesterol Education Program, and extrapolated the results to a population of 115.4 million U.S. adults between the ages of 40 and 75 years.As compared with the ATP-III guidelines, the new guidelines would increase the number of U.S. adults receiving or eligible for statin therapy from 43.2 million (37.5%) to 56.0 million (48.6%). Most of this increase in numbers (10.4 million of 12.8 million) would occur among adults without cardiovascular disease. Among adults between the ages of 60 and 75 years without cardiovascular disease who are not receiving statin therapy, the percentage who would be eligible for such therapy would increase from 30.4% to 87.4% among men and from 21.2% to 53.6% among women. This effect would be driven largely by an increased number of adults who would be classified solely on the basis of their 10-year risk of a cardiovascular event. Those who would be newly eligible for statin therapy include more men than women and persons with a higher blood pressure but a markedly lower level of low-density lipoprotein cholesterol. As compared with the ATP-III guidelines, the new guidelines would recommend statin therapy for more adults who would be expected to have future cardiovascular events (higher sensitivity) but would also include many adults who would not have future events (lower specificity).The new ACC-AHA guidelines for the management of cholesterol would increase the number of adults who would be eligible for statin therapy by 12.8 million, with the increase seen mostly among older adults without cardiovascular disease. (Funded by the Duke Clinical Research Institute and others.).
Reversal of bronchoconstriction by inhaled nitric oxide. Histamine versus methacholine.
Authors: R H Brown, E A Zerhouni, C A Hirshman
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Using high-resolution CT (HRCT), which measures changes in innervated airways greater than 1 mm in diameter, we compared the ability of nitric oxide (NO) to dilate airways preconstricted with histamine and methacholine in five anesthetized dogs. After the airways were preconstricted, NO was inhaled in concentrations of 100, 200, and 400 ppm. Additionally, histamine was given with and without atropine and methylene blue. Data were analyzed by one-way analysis of variance. Histamine and methacholine decreased airway area to a similar extent: 60 +/- 3% (mean +/- SEM) and 63 +/- 3% of control, respectively (p = 0.85). Atropine completely reversed the histamine-induced constriction (255 +/- 19%). NO also completely reversed histamine-induced airway constriction in a dose-related fashion. The airway area went from 60 +/- 3% during histamine infusion to 85 +/- 5, 102 +/- 5, and 111 +/- 10% of control, respectively (p < 0.01), after doses of 100, 200, and 400 ppm NO. Methylene blue partially inhibited the reversal by 200 ppm NO of histamine-induced constriction. In contrast, NO only partially reversed methacholine-induced constriction. NO at 100, 200, and 400 ppm partially attenuated the methacholine-induced airway constriction. Airway area went from 63 +/- 3 to 67 +/- 3, 75 +/- 3, and 75 +/- 2% of control, respectively (p < 0.01). We conclude that NO relaxes canine conducting airways by indirect mechanisms as well as by directly relaxing the airway smooth muscle.
Pharmacotherapy of Mood Disorders
Authors: Michael E. Thase, Timothey Denko
Journal: Annual Review of Clinical Psychology (2008)

The mood disorders-primarily major depressive disorder and bipolar affective disorder-constitute one of the world's greatest public health problems and are associated with significant reductions in productivity, health, and longevity. In addition, people who suffer from these common illnesses, along with their families and loved ones, experience an incalculable toll on quality of life. Dating to the introduction of the first effective therapies for mood disorders in the late 1950s and 1960s, various types of pharmacotherapy have become a mainstay for the management of mood disorders, particularly more severe, chronic, and recurrent forms of depression and most forms of bipolar disorder. This review examines recent developments in the pharmacotherapy of both forms of mood disorder, comparing the newer antidepressants such as the selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors with their predecessors (the monoamine oxidase inhibitors and tricyclic antidepressants) and likewise comparing the older standard for management of bipolar disorder, lithium, with newer classes of medications, such as a selected group of anticonvulsants and the atypical antipsychotics. Although these newer classes of medications have generally improved upon the earlier treatments in terms of better tolerability and safety, there are no universally effective pharmacologic treatments for mood disorders, and careful medical management of these medications is still warranted.