tbuckley/cabot-search huggingface dataset:
HUMAN BRAIN METABOLISM
Authors: JOSEPH WORTIS, KARL M. BOWMAN, WALTER GOLDFARB
Journal: American Journal of Psychiatry (1940)

The metabolism of the brain was studied in normal, schizophrenic, paretic and senile subjects, and the effect of alcohol, paraldehyde and morphine was studied. Arterio-venous differences for oxygen, carbon dioxide, glucose and lactic acid were determined by means of internal jugular puncture. The observations support the following conclusions: 1. The O2 arterio-venous difference of the brain in schizophrenics, both before and after insulin therapy, is normal. 2. In general paresis the O2 arterio-venous difference of the brain shows a slight diminution of questionable significance. 3. The O2 arterio-venous difference of the brain in patients with cerebral arteriosclerosis is normal, but their systemic circulation is somewhat slow. This would indicate a reduced brain metabolism. 4. The O2 arterio-venous difference in chronic alcoholism tends to be higher than normal and is associated with an elevated arterial glucose level. 5. Alcohol and morphine diminish the O2 arterio-venous difference of the brain. 6. In therapeutic doses paraldehyde did not diminish the O2 arterio-venous difference of the brain of chronic alcoholic patients.
A randomised controlled trial of self-help interventions in patients with a primary care diagnosis of irritable bowel syndrome
Authors: A Robinson
Journal: Gut (2005)

<b>Introduction:</b> Functional abdominal symptoms are very common and account for nearly two million primary care consultations in Britain every year and produce significant morbidity. The aims of this study were to evaluate the impact of two self-help interventions on consultation rates and symptom severity in patients with a primary care diagnosis of irritable bowel syndrome. <b>Methods:</b> A total of 420 patients from 54 primary care centres were randomised either to receive self-help information in the form of a guidebook or the guidebook plus a “self-help” group meeting or to be in a control group receiving neither intervention. Data were collected using questionnaires and primary care records. <b>Results:</b> At one year, patients in the guidebook group had a 60% reduction in primary care consultations (p&lt;0.001) and a reduction in perceived symptom severity (p&lt;0.001) compared with controls. Allocation to the self-help group conferred no additional benefit. Actual symptom scores did not change significantly in any group. Costs per patient were reduced by £73 (confidence interval £43, £103) or 40% per year. <b>Conclusion:</b> Introduction of a self-help guidebook results in a reduction in primary care consultations, a perceived reduction in symptoms, and significant health service savings. This suggests that patients attending their primary care physician with functional abdominal symptoms should be offered self-help information as part of their management.
Role of Ion Channels and Exchangers in Mechanical Stretch–Induced Cardiomyocyte Hypertrophy
Authors: Tsutomu Yamazaki, Issei Komuro, Sumiyo Kudoh, Yunzeng Zou, Ryozo Nagai, Ryuichi Aikawa, Hiroki Uozumi, Yoshio Yazaki
Journal: Circulation Research (1998)

Abstract —We have previously reported that stretching of cardiomyocytes activates the phosphorylation cascade of protein kinases, including Raf-1 kinase and mitogen-activated protein (MAP) kinases, followed by an increase in protein synthesis partly through enhanced secretion of angiotensin II and endothelin-1. Membrane proteins, such as ion channels and exchangers, have been postulated to first receive extracellular stimuli and evoke intracellular signals. The present study was performed to determine whether mechanosensitive ion channels and exchangers are involved in stretch-induced hypertrophic responses. Neonatal rat cardiomyocytes cultured on expandable silicone dishes were stretched after pretreatment with a specific inhibitor of stretch-sensitive cation channels (gadolinium and streptomycin), of ATP-sensitive K + channels (glibenclamide), of hyperpolarization-activated inward channels (CsCl), or of the Na + -H + exchanger (HOE 694). Pretreatment with gadolinium, streptomycin, glibenclamide, and CsCl did not show any inhibitory effects on MAP kinase activation by mechanical stretch. HOE 694, however, markedly attenuated stretch-induced activation of Raf-1 kinase and MAP kinases by ≈50% and 60%, respectively, and attenuated stretch-induced increase in phenylalanine incorporation into proteins. In contrast, HOE 694 did not inhibit angiotensin II–and endothelin-1–induced Raf-1 kinase and MAP kinase activation. These results suggest that among many mechanosensitive ion channels and exchangers, the Na + -H + exchanger plays a critical role in mechanical stress–induced cardiomyocyte hypertrophy.
Treatment of nine cases of pemphigus vulgaris with cyclosporine
Authors: H. Barthelemy, A. Frappaz, F. Cambazard, G. Mauduit, B. Rouchouse, J. Kanitakis, P. Souteyrand, A.L. Claudy, J. Thivolet
Journal: Journal of the American Academy of Dermatology (1988)
Problematic Use of Multiple Subgroup Analyses in Assessing the Impact of Aspirin in Prostate Cancer
Authors: Margaret Lee, Hui-Li Wong, Peter Gibbs
Journal: Journal of Clinical Oncology (2015)

TO THE EDITOR: We are concerned that the conclusions made by Jacobs et al, after their extensive analysis of the impact of aspirin on prostate cancer–specific mortality using data from a large clinical database, are not justified. Specifically, due to the large number of subgroups assessed, without adjustment for multiple testing, there is considerable potential for false discovery. Furthermore, it is not appropriate to highlight any desired results seen from subgroup analyses, while ignoring any undesirable results. A review of the data presented in Tables 2 and 3 along with the conclusions made by Jacobs et al unfortunately illustrates the potential risks of multiple testing. The authors make much of the subgroup that benefit from aspirin, namely men with high-risk prostate cancer that received postdiagnosis aspirin (hazard ratio [HR] 0.60; 95% CI, 0.37 to 0.97), a difference that remained significant only in the lowerdose aspirin group (HR 0.50; 95% CI, 0.27 to 0.92). However, review of these tables also indicate two additional subgroups that are harmed to a similar or greater extent by aspirin usage; shorter duration of daily prediagnosis aspirin use in low-risk prostate cancer (HR 2.47; 95% CI, 1.25 to 4.88) and daily postdiagnosis higher-dose aspirin in low-risk prostate cancer (HR 1.62; 95% CI, 1.02 to 2.58). No mention of this is made in the article. We would suggest that it is not possible to conclude that the apparent benefits are real and that the apparent harms are spurious and can be ignored. The analysis performed by Jacobs et al would have been enhanced by the use of an appropriate statistical method to minimize the risk of false discovery due to multiple testing. Given the marginal statistical significance of the observed impact of aspirin in the analysis performed, where the limits of the 95% CIs already approach 1, it would seem likely that in an adjusted analysis no significant impact of aspirin (beneficial or harmful) would be evident. Unfortunately the current analysis could lead clinicians to recommend daily lower-dose aspirin to men with high-risk prostate cancer, and/or to prospective studies using only lower-dose aspirin, both of which are not justified based on the data presented.
Radiological Evaluation of Lymph Node Metastases in Patients With Cervical Cancer
Authors: Juergen Scheidler
Journal: JAMA (1997)

To apply meta-analysis to compare the utility of lymphangiography (LAG), computed tomography (CT), and magnetic resonance (MR) imaging for the diagnosis of lymph node metastasis in patients with cervical cancer.MEDLINE literature search and manual reviews of article bibliographies.Studies selected included at least 20 patients with imaging-histologic correlation, described diagnostic criteria for lymph node metastasis, and presented data to allow calculation of contingency tables.Independently by 2 investigators, stratified for stage of disease (early vs late) and for lymph node location (pelvic vs para-aortic).Seventeen studies met the inclusion criteria for LAG, 17 for CT, and 10 for MR imaging. Summary receiver operator characteristic analysis showed no significant differences in the overall performance of LAG, CT, and MR imaging. There was, however, a trend toward better performance for MR imaging than for LAG or CT, both globally and when stratified for stage of disease or for lymph node location. Bayesian analysis of clinical utility showed only moderate increases in positive posttest probability of lymph node metastasis for all methods. Negative test results had a greater impact and, depending on the clinical setting, decreased the probability of lymph node metastasis from 15% to 44% (pretest) to 3% to 18% (posttest).The LAG, CT, and MR imaging perform similarly in the detection of lymph node metastasis from cervical cancer. As CT and MR imaging are less invasive than LAG and also assess local tumor extent, they should be considered the preferred adjuncts to clinical evaluation of invasive cervical cancer.
Endobronchial ultrasound-guided transbronchial lung biopsy in solitary pulmonary nodules and peripheral lesions
Authors: F.J.F. Herth, A. Ernst, H.D. Becker
Journal: European Respiratory Journal (2002)

Transbronchial biopsy (TBBX) for peripheral lung lesions is usually performed with the help of fluoroscopy, but the yield varies widely. This feasibility study aimed to assess the ability of endobronchial ultrasound (EBUS) to provide imaging guidance for TBBX. In a prospective study, 50 consecutive patients referred for TBBX for peripheral lesions underwent fluoroscopy-guided and EBUS-guided TBBX in random order. Diagnostic yields were compared for both modalities and feasibility was assessed for EBUS. Diagnostic material was obtained in 80% of patients with EBUS and 76% of patients with fluoroscopy. There was a nonsignificant trend for EBUS to be better than fluoroscopy for lesions &lt;3 cm in diameter. Four lesions could not be visualised with EBUS. There were no significant complications associated with the use of EBUS. Endobronchial ultrasound-guided transbronchial biopsy is feasible. It appears to be at least equivalent to fluoroscopy without the accompanying radiation exposure. Further large-scale studies are indicated to assess the possible role of endobronchial ultrasound as a potential imaging method of choice for the biopsy of peripheral lung lesions.
Interferon γ Eliminates Responding Cd4 T Cells during Mycobacterial Infection by Inducing Apoptosis of Activated Cd4 T Cells
Authors: Dyana K. Dalton, Laura Haynes, Cong-Qiu Chu, Susan L. Swain, Susan Wittmer
Journal: The Journal of Experimental Medicine (2000)

In Mycobacterium bovis Bacille Calmette-Guérin (BCG)-infected wild-type mice, there was a large expansion of an activated (CD44(hi)) splenic CD4 T cell population followed by a rapid contraction of this population to normal numbers. Contraction of the activated CD4 T cell population in wild-type mice was associated with increased apoptosis of activated CD4 T cells. In BCG-infected interferon (IFN)-gamma knockout (KO) mice, the activated CD4 T cell population did not undergo apoptosis. These mice accumulated large numbers of CD4(+)CD44(hi) T cells that were responsive to mycobacterial antigens. Addition of IFN-gamma to cultured splenocytes from BCG-infected IFN-gamma KO mice induced apoptosis of activated CD4 T cells. IFN-gamma-mediated apoptosis was abolished by depleting adherent cells or Mac-1(+) spleen cells or by inhibiting nitric oxide synthase. Thus, IFN-gamma is essential to a regulatory mechanism that eliminates activated CD4 T cells and maintains CD4 T cell homeostasis during an immune response.
Alveolar Fluid Clearance Is Impaired in the Majority of Patients with Acute Lung Injury and the Acute Respiratory Distress Syndrome
Authors: LORRAINE B. WARE, MICHAEL A. MATTHAY
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Because experimental studies have shown that intact alveolar epithelial fluid transport function is critical for resolution of pulmonary edema and acute lung injury, we measured net alveolar fluid clearance in 79 patients with acute lung injury or the acute respiratory distress syndrome. Pulmonary edema fluid and plasma were sampled serially in the first 4 hours after intubation. Net alveolar fluid clearance was calculated from sequential edema fluid protein measurements. Mean alveolar fluid clearance was 6%/h. Of the patients, 56% had impaired alveolar fluid clearance (< 3%/h), 32% had submaximal clearance (> or = 3%/h, < 14%/h), and 13% had maximal clearance (> or = 14%/h). These findings are contrasted to our recent report of 65 patients with hydrostatic pulmonary edema, in whom mean alveolar fluid clearance was 13%/h; only 25% had impaired clearance whereas 75% had submaximal or maximal clearance (J Appl Physiol 1999;87:1301-1312). Acute lung injury with maximal alveolar fluid clearance were more likely to be female (p = 0.03), and less likely to have sepsis (p = 0.01). Endogenous and exogenous catecholamines did not correlate with alveolar fluid clearance. Patients with maximal alveolar fluid clearance had significantly lower mortality and a shorter duration of mechanical ventilation. In summary, in contrast to hydrostatic pulmonary edema, alveolar fluid clearance in patients with acute lung injury and the acute respiratory distress syndrome is impaired in the majority of patients, and maximal alveolar fluid clearance is associated with better clinical outcomes.
Likelihood ratios for a sleep apnea clinical prediction rule.
Authors: W W Flemons, W A Whitelaw, R Brant, J E Remmers
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Nocturnal polysomnography, the standard diagnostic test for sleep apnea, is an expensive and limited resource. In order to help identify the urgency of need for treatment, we determined which clinical features were most useful for establishing an accurate estimate of the probability that a patient had sleep apnea. Of 263 physician-referred patients, 200 were eligible for the study and 180 (90%) completed it. All patients had their histories recorded with a standard questionnaire, and underwent anthropomorphic measurements and nocturnal polysomnography. Sleep apnea was defined as more than 10 episodes of apnea or hypopnea per hour of sleep. Multiple linear and logistic regression models predictive of sleep apnea were compared with physicians' subjective impressions and previously reported models. Likelihood ratios were calculated for several levels of a sleep apnea clinical score produced by one of the linear models. Predictors of sleep apnea in the final model (R2 = 0.34) included neck circumference, hypertension, habitual snoring, and bed partner reports of nocturnal gasping/choking respirations. This model was superior to physician impression, slightly inferior to more detailed linear and logistic models, and comparable to previously reported models. A sleep apnea clinical score of less than 5 had a likelihood ratio of 0.25 (95% CI: 0.15 to 0.42) and a corresponding posttest probability of 17%, while a score of greater than 15 had a likelihood ratio of 5.17 (95% CI: 2.54 to 10.51) and posttest probability of 81%. These likelihood ratios can simply and accurately determined the probability of whether a patient has sleep apnea.
Do non-steroidal anti-inflammatory drugs increase colonic permeability?
Authors: A P Jenkins, D R Trew, B J Crump, W S Nukajam, J A Foley, I S Menzies, B Creamer
Journal: Gut (1991)

Urinary excretion of orally administered lactulose and 51 chromium labelled ethylenediamine tetra-acetate (51Cr-EDTA) was measured in 12 healthy adult subjects and in six patients with ileostomies to assess intestinal permeability. In normal subjects, 24 hour urinary recovery of 51Cr-EDTA was significantly greater than that of lactulose (mean (SEM) 2.27 (0.15) v 0.50 (0.08)% oral dose; p less than 0.001), but in ileostomy patients recovery of the two markers was the same. In normal subjects, therefore, the difference between the two markers may arise from bacterial break-down of lactulose but not of 51Cr-EDTA in the distal bowel, urinary excretion of lactulose representing small intestinal permeation and that of 51Cr-EDTA representing both small and large intestinal permeation. The markers were then given simultaneously to nine patients receiving non-steroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis and osteoarthritis. The 24 hour urinary recovery of 51Cr-EDTA in the patients was significantly greater than normal (4.64 (1.20) v 2.27 (0.15)% oral dose; p less than 0.01), but that of lactulose was not significantly affected. Moreover, the increase in 51Cr-EDTA recovery was most noticeable in the later urine collections. Both of these findings suggest that NSAIDs may increase colonic permeability.
Groups Propose Plan to Accredit Controversial Stem Cell Therapy Clinics
Authors: Bridget M. Kuehn
Journal: JAMA (2012)

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
Contribution of dendritic cells to stimulation of the murine syngeneic mixed leukocyte reaction.
Authors: M C Nussenzweig, R M Steinman
Journal: The Journal of Experimental Medicine (1980)

We have studied the proliferative response of unprimed T cells to syngeneic dendritic cells (DC) (syngeneic mixed leukocyte reaction [SMLR]) in cultures of mouse spleen and lymph node. T cells purified by passage over nylon wool contain few DC and exhibits little proliferative activity during several days of culture. Addition of small numbers of purified syngeneic DC induces substantial, dose-dependent, T cell-proliferative responses that peak at day 4-5. B cells purified on anti-Ig-coated plates do not respond to DC at all doses tested. DC culture medium does not induce proliferation, and coculture of DC and T cells is required. Purified mouse B and T lymphocytes stimulate SMLR weakly if at all. Likewise, peritoneal and spleen macrophages are weak or inactive. Therefore, DC are potent and possibly unique primary cells for stimulating the SMLR in mice. sIg- spleen and lymph node cells show extensive background proliferative responses in vitro, and fail to respond to small numbers of purified DC. If the sIg- cells are treated with anti-Ia and complement, or passed over nylon wool, DC are removed and proliferative activity falls. Proliferative activity is restored by adding back DC at levels similar to those present in sIg- cells (1-2%). Thus, DC-dependent, T cell proliferation probably occurs in all spleen and lymph node cultures. As expected from previous work (6), DC are also potent inducers of allogeneic MLR. On a per DC basis, the syngeneic response is 10 times weaker than the allogeneic MLR, and it is not accompanied by the development of cytotoxic lymphocytes. The magnitude of the SMLR was not altered by antigen priming, and DC maintained in isologous rather than fetal calf serum were active stimulators. Therefore, syngeneic stimulation appears to be an intrinsic property of DC, and modification by exogenous agents does not seem to be required. Coculture of DC and T cells results in the development of cell clusters that can be isolated and characterized directly. The clusters account for 10-20% of the viable cells in the culture, but contain greater than 80% of the responding T cells and stimulating DC by morphologic and surface-marker criteria. The efficient physical association of DC and responding T cells implies specific cell-cell recognition. We conclude that the SMLR reflects the ability of T cells, or some subpopulation of T cells, to interact with and proliferate in response to small numbers of DC.
Primary anaerobic peritonitis.
Authors: P Matthews
Journal: BMJ (1979)

903which were nitrazepam 30-40 mg (patient 3), digoxin, paracetamol, and aspirin.Eight patients were unconscious (grade 2, 3, or 41) on arrival, and on another five occasions consciousness was lost after admission.Patients 1, 2, and 3 had severe respiratory depression and required endotracheal intubation and artificial ventilation for 3, 4, and 18 hours respectively.Patient 4 breathed satisfactorily after intubation.In a further six an oropharyngeal airway was used.Bronchoscopy was performed in two patients (1, 6a) who had apparently aspirated vomit before admission.Three patients (1, 2, 3) were hypothermic and hypotensive (rectal temperatures 31 5-33-5-C, systolic blood pressures 50-70 mm Hg).Another three had systolic blood pressures of only 85- 90 mm Hg.The pulse rates on admission ranged from 68-150/min (mean 99).Electrocardiograms in eight unconscious patients showed no unexpected features.The muscle tone and limb reflexes were reduced or absent in deeply unconscious patients.The pupils showed no consistent changes.Bowel sounds were present in all patients.Increased salivation was observed during seven admissions in six patients.Bronchial secretions were increased in patients with chronic bronchitis but appeared normal in the others.Intensive supportive treatment was given, as for barbiturate poisoning.'All patients recovered, although five were unconscious for more than 20 hours and one was in grade 4 coma for 41 hours and unconscious for 92 hours after reaching hospital.Of the six patients who developed pneumonia, four had chronic bronchitis and two had aspirated vomit before admission.Plasma was assayed for alcohol and chlormethiazole by gas- liquid chromatography2 and screened for other drugs.The highest plasma chlormethiazole concentration recorded in a conscious patient was 11 5 mg/l.Concentrations in unconscious patients ranged from 7 to 36 mg/l.In 10 cases in which serial concentrations were measured the plasma half-lives ranged from 4 to 15 hours, but in one elderly patient (1) the plasma con- centration was about 18 mg/l for 36 hours before falling with a half-life of 17 hours.