tbuckley/cabot-search huggingface dataset:
Radical or Expectant Therapy of Acute Cholecystitis
Authors: E E VUORI
Journal: JAMA (1963)

Abstract   A series of 400 consecutive cases of cholelithiasis and/or cholecystitis is presented. Operation was performed using ideal cholecystectomy and beginning the dissection from the fundus. Thirty-eight per cent of the cases were acutely inflamed (14 per cent to the stage of necrosis). Of the patients with necrosis, two (1.3 per cent of the acute cases) died of myocardial infarction. With regard to mortality, incidence of postoperative complications, postoperative elevation of body temperature, and duration of postoperative hospitalization there were no statistically significant differences between the groups. Therefore, it is concluded that in this series, operation at the acute stage was no more unfavorable than at the other stages. Having compared series treated expectantly or by elective operation in the literature, the author considers the operation advisable as early as possible with regard to the duration of the disease and the age of the patient, providing, however, that adequate shock, electrolyte, fluid balance and other necessary treatment is given preoperatively, and that there are no strong contraindications.
SAT0009 Role of the Protein Tyrosine Phosphatase LYP in Neutrophil Activation
Authors: A. Gardette, V. Marzaioli, M. Hurtado-Nedelec, Z.-Y. Zhang, P. Dieudé, J. El-Benna
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Rheumatoid arthritis (RA) is a multifactorial disease, which is likely associated with the effects of environmental and genetic factors. The <i>PTPN22</i> rs2476601 variant has been unambiguously identified as a RA risk genetic factor. <i>PTPN22</i> encodes the lymphoid specific phosphatase Lyp that affects the responsiveness of T and B cell receptors. However, to date, its role in the activation of neutrophils NADPH oxidase remains undetermined. <h3>Objectives</h3> To study the role of Lyp in neutrophils, particularly the activation and the priming, of NADPH oxidase in healthy donors. <h3>Methods</h3> Neutrophils will be isolated from the blood of healthy donors using the Dextran-Ficoll gradient techniques. Lyp mRNA will be analyzed by quantitative real time PCR. Expression and localization of Lyp will be detected by SDS-PAGE, Western Blot techniques and confocal microscopy. The effects of the TNFα will be investigated. The signaling pathways implicated in activation of the NADPH oxidase will be analyzed by SDS-PAGE and Western Blots techniques. The protein targets of LYP will be analyzed by co-immunoprecipitation. The role of Lyp in reactive oxygen species (ROS) production by neutrophils will be determined by using two Lyp inhibitors. ROS production will be measured by luminol-amplified chemo-luminescence, NADPH activation will be measured by the cytochrome c reduction assay. <h3>Results</h3> Lyp is expressed in resting human neutrophils. With TNFα, Lyp expression increase and Lyp translocates to the membrane. Two Lyp inhibitors inhibit the production of ROS and anion superoxyde (O2°-) in human neutrophils stimulated with fMLF alone and when they are primed by TNFα. They have no effect on degranulation. Lyp inhibitors also inhibit the phosphorylation of ERK1/2 after stimulation with TNFα, and the phosphorylation of p47phox induced by fMLF. <h3>Conclusions</h3> The tyrosine phosphatase Lyp could have a NADPH oxidase activator role in human neutrophils. Lyp is involved in the activation of ERK1/2 and p47phox phosphorylation. Lyp inhibitors could have anti-inflammatory effects in RA. <h3>Disclosure of Interest</h3> None declared
Coronary artery disease: a sociocultural perspective.
Authors: Syme Sl
Journal: Circulation (1987)

A sociocultural perspective on biobehavioral factors is important both for studies of the cause of coronary heart disease and for efforts to prevent the disease. One-to-one programs are limited because coronary heart disease is so prevalent and because people have great difficulty in changing their behavior to lower their risk. Data are now available regarding several psychosocial risk factors that shed light on possible environmental influences. These factors include social mobility, stressful life events, type A behavior, and social support. These factors are now being studied in bus drivers to illustrate the ways in which sociocultural interventions can be developed to prevent disease.
Predicting the response of multiple myeloma to the proteasome inhibitor Bortezomib by evaluation of the unfolded protein response
Authors: N Nikesitch, C Tao, K Lai, M Killingsworth, S Bae, M Wang, S Harrison, T L Roberts, S C W Ling
Journal: Blood Cancer Journal (2016)

Predicting the response of multiple myeloma to the proteasome inhibitor Bortezomib by evaluation of the unfolded protein response
OCCUPATIONAL HEALTH NURSING
Authors: R Parent
Journal: JAMA (1963)

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
Spasticity
Authors: Jan Koch-Weser, Robert R. Young, Paul J. Delwaide
Journal: New England Journal of Medicine (1981)

DiazepamBenzodiazepines such as diazepam enhance presynaptic inhibition in the spinal cord of the cat by facilitating or potentiating the postsynaptic effects of gamma-aminobutyric acid (GABA)20 (Fig. 2, Part I). To do this, benzodiazepines interact with an allosteric protein modulator of GABA-recognition sites to increase these receptors' affinity for GABA, thereby rendering them more efficient in increasing chloride conductance across nerve membrane — a mechanism by which presynaptic and postsynaptic inhibition is mediated. Benzodiazepines may also act presynaptically to enhance the endogenous release of GABA or may depress postsynaptic excitatory responses mediated by glutamate.Benzodiazepines have no direct GABA-mimetic effect, . . .
Case 55-1964
Authors: Edwin O. Wheeler, Benjamin Castleman
Journal: New England Journal of Medicine (1964)

Presentation of CaseA sixty-five-year-old woman entered the hospital because of fatigue.The history was of doubtful reliability. Several weeks before admission she began to experience fatigue, which progressed markedly during the week before entry. A diagnosis of diabetes had been made five years previously, and she had taken 6 tablets of tolbutamide daily but had not tested the urine or followed a diet. For several months she had been taking an oral diuretic agent because of ankle edema. She had had occasional dysuria and a non-productive cough. She had never taken insulin and denied the occurrence of diabetic ketosis, . . .
Multimedia: Too Much Medicine?
Authors: Peter Richards
Journal: BMJ (1999)

Ray Moynihan


ABC Books, $A19.95, pp 308 




ISBN 0 7333 0652 7

———————

Rating: ★★★

This is a meticulous and thoughtful critique of the amount of investigation and treatment experienced by patients in modern medicine. Take, for example, the worldwide explosion of diagnostic endoscopy for indigestion. Firstly, there is no evidence that it has resulted in a major improvement in health outcome. Secondly, an army of endoscopists has been created, who see this as all or most of their life’s work. Thirdly, armouries of ingenious but expensive endoscopes have been manufactured by a major new industry. Lastly, physicians have, as endoscopists, joined the league of big surgical earners for the first time (except for invasive cardiologists, who arrived there some time ago). So even if there were, as there may be, good reasons for restraint, what chance is there of achieving it? Might a careful history together with the minimum of investigation (a red cell count, for example) and the simplest of treatment be the first and, in many young adults, the safest and most cost effective approach?

Moynihan is young and a journalist, but he is not an angry young man, not even a latter-day Illich. He is talented: you will enjoy his clear and critical examination of complicated issues, and the trustees of the Harkness Foundation have this year awarded him a scholarship to Harvard. He has already won prizes for both medical and science journalism.

He is concerned at the inability of doctors to stand back from the treadmill of professional practice to examine and re-examine what we do and why. He sees us as driven by technological and pharmacological advance, by uncritical press and public opinion (regarding therapeutic and diagnostic fashion), and more than a little driven by financial interests—our own and those of industry. His purpose is to encourage public scrutiny and healthy scepticism of doctors, to weigh the risks, benefits, and fundamental uncertainties of medical practice, and to consider what is sensible, safe, and necessary.

We may have heard most of this before, but the issues have probably never been put more clearly, coherently, and sympathetically. The public has not yet taken these issues to heart, but the medical profession is starting to take seriously damage from “friendly fire.” That we still have a long way to go is neither surprising nor necessarily a criticism, but it makes a spur to greater effort welcome.
Anorexia nervosa and bulimia among 300 suburban women shoppers
Authors: H G Pope, J I Hudson, D Yurgelun-Todd
Journal: American Journal of Psychiatry (1984)

Of 300 female shoppers who responded to a questionnaire on anorexia nervosa and bulimia, 0.7% reported a history of anorexia nervosa and 10.3% reported a history of bulimia. The data support the belief that these disorders may be increasing in prevalence.
Association of AR-V7 on Circulating Tumor Cells as a Treatment-Specific Biomarker With Outcomes and Survival in Castration-Resistant Prostate Cancer
Authors: Howard I. Scher, David Lu, Nicole A. Schreiber, Jessica Louw, Ryon P. Graf, Hebert A. Vargas, Ann Johnson, Adam Jendrisak, Richard Bambury, Daniel Danila, Brigit McLaughlin, Justin Wahl, Stephanie B. Greene, Glenn Heller, Dena Marrinucci, Martin Fleisher, Ryan Dittamore
Journal: JAMA Oncology (2016)

A critical decision in the management of metastatic castration-resistant prostate cancer (mCRPC) is when to administer an androgen receptor signaling (ARS) inhibitor or a taxane.To determine if pretherapy nuclear androgen-receptor splice variant 7 (AR-V7) protein expression and localization on circulating tumor cells (CTCs) is a treatment-specific marker for response and outcomes between ARS inhibitors and taxanes.For this cross-sectional cohort study at Memorial Sloan Kettering Cancer Center, 265 men with progressive mCRPC undergoing a change in treatment were considered; 86 were excluded because they were not initiating ARS or taxane therapy; and 18 were excluded for processing time constraints, leaving 161 patients for analysis. Between December 2012 and March 2015, blood was collected and processed from patients with progressive mCRPC immediately prior to new line of systemic therapy. Patients were followed up to 3 years.Prostate-specific antigen (PSA) response, time receiving therapy, radiographic progression-free survival (rPFS), and overall survival (OS).Overall, of 193 prospectively collected blood samples from 161 men with mCRPC, 191 were evaluable (128 pre-ARS inhibitor and 63 pretaxane). AR-V7-positive CTCs were found in 34 samples (18%), including 3% of first-line, 18% of second-line, and 31% of third- or greater line samples. Patients whose samples had AR-V7-positive CTCs before ARS inhibition had resistant posttherapy PSA changes (PTPC), shorter rPFS, shorter time on therapy, and shorter OS than those without AR-V7-positive CTCs. Overall, resistant PTPC were seen in 65 of 112 samples (58%) without detectable AR-V7-positive CTCs prior to ARS inhibition. There were statistically significant differences in OS but not in PTPC, time on therapy, or rPFS for patients with or without pretherapy AR-V7-positive CTCs treated with a taxane. A multivariable model adjusting for baseline factors associated with survival showed superior OS with taxanes relative to ARS inhibitors when AR-V7-positive CTCs were detected pretherapy (hazard ratio, 0.24; 95% CI, 0.10-0.57; P = .035).The results validate CTC nuclear expression of AR-V7 protein in men with mCRPC as a treatment-specific biomarker that is associated with superior survival on taxane therapy over ARS-directed therapy in a clinical practice setting. Continued examination of this biomarker in prospective studies will further aid clinical utility.
The hibernator heart -- Nature's model of resistance to ventricular fibrillation
Authors: B.W. Johansson
Journal: Cardiovascular Research (1996)

During hibernation the animals decrease their body temperature down to a few degrees above 0 degree C. This means that when entering into and arousing from hibernation their body temperature passes the critical level of 20 degrees C, a temperature region where nonhibernating mammals develop circulatory arrest, usually ventricular fibrillation (VF). We found in other experiments that the hibernator heart is resistant to VF, not only induced by hypothermia, but also when induced by local application of aconitine on the epicardium, addition of 0.55 molar CaCl2 to isolated hearts perfused with a potassium free Tyrode solution, addition of procaine to isolated hearts perfused with Tyrode solution after previous administration of adrenaline, ligation of the proximal part of the left anterior descending coronary artery, and electrical stimulation in the vulnerable phase of the heart cycle. Several mechanisms are at work to explain this resistance to VF of the hibernator heart when compared to the nonhibernator heart. The factors of greatest importance seem to be the different adrenergic innervation pattern, different physico-chemical properties with a lower melting point of the lipids in the hibernator, different enzyme temperature activity curves in the hibernator and a different handling of intracellular calcium resulting in a protection against calcium overload in the hibernator heart, when compared with the nonhibernator heart.
AB0607 Oxygen Uptake, Fatigue and Quality of Life in Patients with Primary Sjögren's Syndrome: Table 1.
Authors: S.T. Miyamoto, R. Altoé, L. Carletti, A.J. Perez, D. Sauer, L.H. Diaz, E.V. Serrano, W.-F. Ng, M. Trenell, J. Natour, V. Valim
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Aerobic capacity is a key biomarker of health and wellbeing, from risk of secondary disease to quality of life (QOL). Although anecdotally reported to be reduced in primary Sjögren9s syndrome (pSS)<sup>1</sup>, aerobic capacity has not been objectively assessed. The lack of data limits the ability to target aerobic capacity as a therapy for QOL and secondary disease. <h3>Objectives</h3> This pilot study defines the relationship between aerobic capacity with fatigue, disease activity, depression and QOL in pSS. <h3>Methods</h3> In a preliminary cross-sectional study, 20 pSS (AECG) sedentary women with a mean age of 53 (±7) performed a maximal progressive treadmill exercise test. Expired gas analysis was performed with a computerized metabolic system. They were evaluated through the questionnaires FACIT-Fatigue, ESSPRI, ESSDAI, BDI and SF-36. Pearson9s tests were used to correlate the variables. Multiple linear regressions were used to examine the effect of the variables on VO<sub>2max</sub> and VO<sub>2AT</sub>. <h3>Results</h3> ESSDAI, ESSPRI and FACIT-Fatigue scores mean were 1.55 (±1.43), 6.13 (±2.75) and 32 (±8.49), respectively. Mean of VO<sub>2max</sub> was 19 (±4) ml/kg<sup>-1</sup>/min<sup>-1</sup> and VO<sub>2AT</sub> was 15 (±3) ml/kg<sup>-1</sup>/min<sup>-1</sup>. VO<sub>2max</sub> correlated with ESSPRI dryness (r=-0.53; p&lt;0.05), ESSPRI fatigue (r=-0.59; p&lt;0.01) and ESSPRI total (r=-0.53; p&lt;0.05). VO<sub>2AT</sub> correlated with ESSPRI fatigue (r=-0.47; p&lt;0.05), ESSPRI total (r=-0.44; p&lt;0.05), SF-36 General Health (GH) domain (r=0.49; p&lt;0.05) and SF-36 Social Functioning (SF) domain (r=0.59; p&lt;0.01). Patients reporting higher levels of fatigue, pain and dryness have worse QOL and depression (table 1). Multiple linear regression analysis showed that creatine kinase (CK) was independently associated with VO<sub>2max</sub> (β=0,02; p&lt;0.05), as well SF-36 GH and SF domains with VO<sub>2AT</sub> (β=0.07; p&lt;0.05 and β=0.06; p&lt;0.01, respectively). <h3>Conclusions</h3> In pSS, low aerobic capacity is associated with worse symptoms, higher levels of CK and lower QOL. The optimization of aerobic capacity should be explored as a way to modify clinical presentations and increase QOL in pSS. <h3>References</h3> Strömbeck B et al. Physical capacity in women with primary Sjögren9s syndrome: a controlled study. Arthritis Rheum. 2003; 49:681–8. <h3>Acknowledgements</h3> CAPES Foundation <h3>Disclosure of Interest</h3> None declared
NEW MEDICAL PRACTICE ACT.
Authors: B UNDERWOOD
Journal: JAMA (1895)

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
Profiling cytochrome P450 CYP1 enzyme expression in primary melanoma and disseminated disease utilizing spectral imaging microscopy (SIM)
Authors: S. A. Everett, V. M. McErlane, K. F. McLeod, F. M. Daley, P. R. Barber, B. Vojnovic, P. D. Nathan, P. I. Richman, R. A. Pearl, C. Linge, R. Grover
Journal: Journal of Clinical Oncology (2007)

8556 Background: The aim of this study was to profile cytochrome CYP1 family (CYP1A1/1A2, and CYP1B1) mono-oxygenase enzymes during the malignant progression of primary melanoma and metastatic disease. Methods: Tissue microarrays of primary (n = 75), and metastatic (n = 104) melanoma were constructed with the patient demographics: (1) primary melanoma; age 22 to 93 (median 59); sex M/F 36/44; Breslow thickness 0.4 to 15 mm (median 2.5 mm); ulceration 25/80, and (2) metastatic melanoma; age 26 to 92 (median 60 mm); sex M/F 54/49; ulceration 30/104; number of nodes 1 to 15 (median 2); extra-capsular spread 20/95. CYP1 protein was detected by IHC using validated selective poly- and monoclonal antibodies. Vector SG (grey) stain for CYP1 was used with nuclear fast red counterstain to aid spectral resolution from background melanin. Staining intensity was scored visually (negative 0, weak 1, moderate 2, strong 3) and using SIM at every pixel of a captured image of each melanoma core. Reference spectra of individual chromophores were used to spectrally ‘un-mix’ CYP1 staining before the mean normalised absorbance intensity was determined. Grading was by the 2002 AJCC classification system: primary stage I n = 27 (1A 8, 1B 19), and stage II n = 48 (2A 22, 2B 16, 2C 10), lymph node metastasis stage III n = 98 (3B 53, 3C 45), visceral metastasis stage IV n = 6. Normal skin (n = 27), benign naevi (n = 14), and dysplastic naevi (n = 21) were also included. Results: CYP1B1 was not in normal skin but was over-expressed in both primary and metastatic melanoma (visual: 71% &amp; 65%, SIM: 91% &amp; 83%). Primary melanoma (stage I &amp; II) was significantly greater (p = 0.004) than metastasis (stage III &amp; IV). CYP1B1 did not correlate with ulceration or Breslow thickness but did correlate with N stage lymph node metastasis (p = 0.005). CYP1B1 expression in dysplastic naevi indicated up-regulation at an early stage of melanoma progression. CYP1A1/1A2 was not expressed in normal skin nor primary/metastatic melanoma. Conclusions: CYP1B1 protein expression is maintained with advancing AJCC stage from primary through to visceral metastasis. Future work will seek to correlate protein expression with functionality with a view to exploiting CYP1B1 in the enzyme/prodrug therapy of malignant melanoma. No significant financial relationships to disclose.
FRI0012 IL-10-Producing Regulatory B Cell Deficiency is a Feature of Psoriatic Arthritis
Authors: A. Mavropoulos, A. Varna, I. Alexiou, N. Kolokotsa, E. Zafeiriou, M. Vlychou, D. Bogdanos, L. Sakkas
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> In mice, IL-10-producing regulatory B cells (Bregs) suppress inflammatory immune responses and adoptive transfer of Bregs reduced imiquimod-induced psoriatic skin lesions in CD19(-/-) mice (1). Inflammatory Tcells and cytokines (Th1,Th17, TNFa) play a significant role in the pathogenesis of psoriasis and psoriatic arthritis (PsA). <h3>Objectives</h3> To assess the phenotypic and functional characteristics of Breg subsets, CD19(pos)CD27(pos)CD24(high) memory and CD19(pos)CD24(high)CD38(high) transitional Bregs in patients with PsA. <h3>Methods</h3> Peripheral blood mononuclear cells were isolated from 25 patients with PsA and 15 normal controls (NCs). The expression of surface CD19, CD24, CD27 and CD38 and cytoplasmic IL-10 by Bregs was examined by flow cytometry following bacterial CpG (ODN2006) stimulation using fluorochrome-conjugated monoclonal antibodies. <h3>Results</h3> Memory and transitional B regs were significantly decreased in PsA patients compared to NCs, respectively (2.2±0.42 <i>vs</i> 6.1±0.5, <i>p</i>=0.01 and 0.8±0.31 <i>vs</i> 1.5±0.21, <i>p</i>=0.03, respectively). The ratio of CD24(high) to CD24(low) B cells was also significantly decreased in PsA patients compared to NCs (p&lt;0.001). IL-10 expressing Bregs after Toll-like receptor (TLR)-9 stimulation were primarily detected within memory than transitional B cell subsets in NCs; both subsets were significantly decreased in PsA compared to NCs (p&lt;0.05). After ODN2006 stimulation for 24hrs, CD24(low) B cells from NCs are capable to produce IL10, in sharp contrast to CD24(low) from PsA which are unable to express IL10 (p=0.037). <h3>Conclusions</h3> This is the first study to demonstrate that Bregs are reduced and functionally impaired after innate stimulus in PsA. This suggests that Bregs may be implicated in the development of PsA. <h3>References</h3> Yanaba K et al. J leuk Biol 2013;94:563 <h3>Disclosure of Interest</h3> None declared