tbuckley/cabot-search huggingface dataset:
A 37-Year-Old Mechanic with Multiple Chemical Sensitivities
Authors: Howard M. Kipen, Nancy Fiedler
Journal: Environmental Health Perspectives (2000)

A 37-year-old heating, ventilation, and air-conditioning mechanic developed respiratory, musculoskeletal, and central nervous system symptoms associated with a variety of odorous environmental chemicals. Organic disease was not evident, but the patient was distressed by these symptoms and was at risk for becoming disabled by them. His symptoms fit broadly into the condition recognized as multiple chemical sensitivity. Multiple chemical sensitivity is a diagnostic term for a group of symptoms without demonstrated organic basis. The symptoms are characteristic of dysfunction in multiple organ systems, they increase and decrease according to exposure to low levels of chemical agents in the patient's environment, and they sometimes occur after a distinct environmental change or insult such as an industrial accident or remodeling. Although traditional medical organizations have not agreed on a definition for this syndrome, it is being increasingly recognized and makes up an increasing percentage of the caseload at occupational and environmental medicine clinics. Although there is often dispute about whether the symptoms have a functional or organic basis, an informed approach to evaluation, diagnosis, and management and a careful assessment of impairment, disability, and work relatedness are necessary. Careful exclusion of organic causes is critical, and this should be followed by a judicious approach to coping with symptoms.
Chest pain not always what it seems; panic disorder may be cause in some
Authors: C. Raymond
Journal: JAMA (1989)

UP TO ONE THIRD of persons referred for coronary angiography have normal angiograms. Many of those persons may actually be suffering from panic disorder, according to a Seattle investigator. "With better training of primary care physicians, we may be able to screen out these persons" and avoid costly and potentially dangerous angiograms, says Wayne Katon, MD. Proper diagnosis would also facilitate more effective treatment, he says. <h3>Other Explanations Possible</h3> Others caution that there can be explanations for chest pain besides psychiatric problems. "As a group, patients with chest pain and normal angiograms are a heterogeneous population, and there is no one explanation," says Richard O. Cannon, MD, co-director of the Cardiovascular Diagnosis Section of the National Heart, Lung, and Blood Institute in Bethesda, Md. Cannon has been assessing a group of such patients with normal angiograms and is finding evidence for a still controversial disorder he calls "microvascular angina." Katon,
FRI0050 CYR61 induces IL-6 production by fibroblast-like synoviocytes promoting TH17 differentiation in rheumatoid arthritis
Authors: N.L. Li, J. Lin, Z. Zhou, R. Huo, L. Xiao, G. Ouyang, N. Li
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Cyr61/CCN1 is a product of an immediate early gene which functions in mediating cell adhesion and inducing cell migration. We previously showed that increased production of Cyr61 by fibroblast-like synoviocytes (FLS) in RA promotes FLS proliferation and participates in RA pathogenesis with IL-17 dependent pathway. However, whether Cyr61 in turn regulates Th17 cell differentiation and further enhances inflammation of RA remained unknown. <h3>Objectives</h3> To explored the potential role of Cyr61 as a pro-inflammatory factor to promote Th17 differentiation in RA pathogenesis. <h3>Methods</h3> Th17 differentiation was studied in a co-culture system of CD4<sup>+</sup> T and FLS cells. Collagen-induced arthritis (CIA) mice were used as the RA animal model to test the therapeutic effect of anti-Cyr61 antibody as well as its effect on IL-6 production by FLS and Th17 differentiation <i>in vivo</i>. Expression of cytokines was measured by ELISA, real-time PCR and flow cytometry, other factors by real-time PCR, western blotting or confocal microscopy. <h3>Results</h3> Cyr61 stimulated IL-6 production by FLS, via the Cyr61/αvβ5/Akt/NF-kB signaling pathway. Increased IL-6 in turn promoted Th17 differentiation. Blocking Cyr61 action with a monoclonal antibody (093G9) reduced IL-6 production by FLS, attenuated Th17 response, and ameliorated disease progression in CIA mice. <h3>Conclusions</h3> Cyr61 plays a critical role in stimulating IL-6 expression by FLS in RA and contributes to Th17 cell differentiation, and thus is likely a key molecule involved in the inflammation process of RA. Targeting Cyr61 may be a novel therapeutic strategy for RA. <h3>References</h3> Firestein GS. Evolving concepts of rheumatoid arthritis. Nature 2003;423(6937):356-61. Gaffen SL. The role of interleukin-17 in the pathogenesis of rheumatoid arthritis. Curr Rheumatol Rep 2009;11(5):365-70. Zhang Q, Wu J, Cao Q, Xiao L, Wang L, He D, et al. A critical role of Cyr61 in interleukin-17-dependent proliferation of fibroblast-like synoviocytes in rheumatoid arthritis. Arthritis Rheum 2009;60(12):3602-12. Chen CC, Lau LF. Functions and mechanisms of action of CCN matricellular proteins. Int J Biochem Cell Biol 2009;41(4):771-83. Jun JI, Lau LF. Taking aim at the extracellular matrix: CCN proteins as emerging therapeutic targets. Nat Rev Drug Discovery 2011;10, doi: 10.1038/nrd3599 Zhou, L., Ivanov, II, R. Spolski, R. Min, K. Shenderov, T. Egawa, D. E. Levy, W. J. Leonard, and D. R. Littman. 2007. IL-6 programs T(H)-17 cell differentiation by promoting sequential engagement of the IL-21 and IL-23 pathways. Nat Immunol 8:967-974. <h3>Disclosure of Interest</h3> None Declared
A Formula for Calculating the Dosages of Drugs in Emergencies
Authors: Arnold S. Kirshenbaum
Journal: JAMA (1987)

<h3>To the Editor.—</h3> I have developed a universal formula for readily calculating pediatric or adult dosages of cardiovascular drugs given by infusion in an emergency. The formula, its derivation, and specific examples of its use have been submitted to members of the American Heart Association responsible for overseeing advanced cardiac life support (ACLS) instruction and are currently under review. As an advanced life support instructor for two years and as a pediatrician, I find that the ACLS manual does not provide a simple, easy means of simultaneously calculating pediatric and adult dosages of drugs given by infusion. Lidocaine, for example, is being ordered as a milligrams per minute infusion for adults and as a micrograms per kilogram per minute infusion for pediatric patients, because of differences in weight.<sup>1(pp97-132)</sup>Furthermore, appendixes 2 through 4 in the chapter on infant and child resuscitation<sup>1(pp268-271)</sup>provide tables with different micrograms per milliliter
Academy Rash
Authors: Corstiaan Brass
Journal: JAMA (1982)

Over a few weeks, 69 children (13%) enrolled in a private school manifested an erythematous and migratory rash, most commonly on the extremities, along with fever or other systemic or respiratory symptoms. Fever lasted for a mean of four days, and rash, 11 days. Cases appeared in every grade from kindergarten through ninth, and the incidence peaked in the fifth through seventh grades. More boarding students were affected than day students. Secondary cases in households of affected children and among adults from the school were noted. Eighty-eight attempts at virus isolation were unsuccessful. The illnesses were consistent with erythema infectiosum, a disease of unknown etiology, which has occurred in epidemic form in schools and also in sporadic cases. (<i>JAMA</i>1982;248:568-572)
Ultrasound in the diagnosis of rectus sheath hematoma
Authors: G. M. Wyatt
Journal: JAMA (1979)

RECTUS sheath hematoma, an uncommon lesion, confronts the clinician with a diagnostic problem. Although it can sometimes be recognized in an appropriate clinical setting, the entity may be mistaken for an acute intra-abdominal condition and lead to an unnecessary emergency surgical procedure. Three recent cases are briefly presented, with a discussion of the cause, clinical signs and symptoms, and current methods of diagnosis. <h3>Report of Cases</h3><h3>Case 1.—</h3> This 67-year-old woman was admitted from a nursing home because of abdominal pain and distension. The surgeon felt a tender mass in the right midabdomen and made a clinical diagnosis of hydrops of the gallbladder; surgery was performed. A right rectus sheath hematoma was found and drained. Exploration of the abdominal cavity was normal. A sonogram performed the following day showed a left rectus sheath hematoma (Fig 1). The postoperative period was complicated by staphylococcal sepsis, congestive heart failure, and renal failure.
Oliver St John Gogarty, MD, FRCSI (1878-1957)
Authors: J. B. Lyons
Journal: JAMA (1979)

Writing to a Boston friend in 1934, Oliver St John Gogarty, MD, aviator, archer, and former cycling champion, said: I, for my poor part, have chosen the sock and not the Miltonian buskin. My spirit is God given? Very well: why does it prefer Aristophanes to Aeschylus?... Because the first does not usurp the metier of the Gods: and we are not thronged with destiny. In his youth (he was born on Aug 17, 1878, the eldest son of Henry Gogarty, FRCSI), when attending Trinity College, Dublin, his wit, levity, and irreverence made him an apt companion for James Joyce. He is Buck Mulligan in<i>Ulysses</i>—"Buck Mulligan, panamahelmeted, went step by step, iambing, trolling"—but when the novel was published, Gogarty was a member of the Irish Free State Senate and a leading ear, nose, and throat surgeon. Understandably, he resented the overstated characterization. He was more sensitive and less
Battles against many malignancies lie ahead as federal 'war on cancer' enters third decade
Authors: P. Gunby
Journal: JAMA (1992)

THE WAR on cancer—declared December 23, 1971, when then President Richard M. Nixon signed the National Cancer Act—now is in its third decade. Some of those involved say the United States is winning this so-called war. By some estimates, the federal government has spent as much as $22 billion on this effort in the past 20 years. <h3>Win, Lose, or Draw?</h3> However, some critics contend that this war is being lost. They argue that too little change is being seen in death rates from many major cancers (defined in terms of incidence and/or deaths attributable), although one of the candidates in this year's presidential race is a 9-year survivor of lymphoma. Still others take the view that there indeed has been progress against some cancers but less against others. Probably one of the few aspects that can be agreed upon is that it is difficult to make year-to-year comparisons because
Thérapeutique médicale. VI. Cœur et sang.
Journal: JAMA (1933)

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 Journals 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 2024 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
Hepatitis B prevalence in an unregistered prenatal population. Implications for neonatal therapy
Authors: N. S. Silverman
Journal: JAMA (1991)

<h3>Study Objective.</h3> —To evaluate the risk and associated cofactors for hepatitis B infection in inner-city pregnant women not registered for prenatal care. <h3>Design.</h3> —Fifteen-month survey of 208 patients not registered for prenatal care, compared with 1555 women registered for prenatal care during the same period. <h3>Setting.</h3> —An urban university hospital prenatal clinic and labor unit. <h3>Results.</h3> —Unregistered patients had a significantly higher rate of hepatitis B surface antigen positivity than patients who had registered with the clinic (6.7% vs 0.8%;<i>P</i>&lt;.0001). Unregistered patients with positive results of urine drug screening (46%) had a relative risk for seropositivity of 29.2%, compared with registered patients who did not have histories of illicit drug use (95% confidence interval, 25.9% to 32.4%), while registered patients with past histories of drug use had a relative risk of 6.7%, compared with the reference group that did not have histories of drug use (95% confidence interval, 1.8% to 24.0%). <h3>Conclusions.</h3> —Among inner-city pregnant women not registered for prenatal care, a positive result of urine drug screening is a rapidly available marker for increased risk of hepatitis B surface antigen positivity. Infants born to unregistered women with positive results of urine drug screening before maternal hepatitis B surface antigen results are available may warrant empiric initiation of hepatitis B virus—specific prophylaxis. (<i>JAMA</i>. 1991;266:2852-2855)
Toxicokinetics of Bone Lead
Authors: Michael B. Rabinowitz
Journal: Environmental Health Perspectives (1991)

This article discusses bone as a source of lead to the rest of the body and as a record of past lead exposure. Bone lead levels generally increase with age at rates dependent on the skeletal site and lead exposure. After occupational exposure, the slow decline in blood lead, a 5- to 19-year half-life, reflects the long skeletal half-life. Repeated measurements of bone lead demonstrate the slow elimination of lead from bone. Stable isotope ratios have revealed many details of skeletal uptake and subsequent release. The bulk turnover rates for compact bone are about 2% per year and 8% for spine. Turnover activity varies with age and health. Even though lead approximates calcium, radium, strontium, barium, fluorine, and other bone seekers, the rates for each are different. A simple, two-pool (bone and blood) kinetic model is presented with proposed numerical values for the changes in blood lead levels that occur with changes in turnover rates. Two approaches are offered to further quantify lead turnover. One involves a study of subjects with known past exposure. Changes in the ratio of blood lead to bone lead with time would reflect the course of bone lead availability. Also, stable isotopes and subjects who move from one geographical area to another offer opportunities. Sequential isotope measurements would indicate how much of the lead in blood is from current exposure or bone stores, distinct from changes in absorption or excretion.
Improvement in the quality of care for patients with locally advanced breast cancer through implementation of an integrated electronic care pathway.
Authors: S. Hogeveen, D. Han, R. L. George, M. Sweet-Goldstein, R. E. Dinniwell, D. Muradali, C. B. Brezden, R. Haq, C. E. Simmons
Journal: Journal of Clinical Oncology (2011)

e16580 Background: Locally advanced breast cancer (LABC) refers to the most advanced stage of non-metastatic tumours with an incidence of approximately 10% in newly diagnosed breast cancers. Currently, for optimal care, patients with LABC require a multidisciplinary approach including coordinated planning with medical, surgical and radiation oncologists. We created an interactive electronic care pathway and self populating quality assurance database at St. Michael’s Hospital (SMH) to facilitate multidisciplinary teams to track LABC patient histories and patient treatments in order to coordinate therapy effectively and expedite care (LABC E-PATH). Methods: This is an observational before-and-after cohort study of patients with LABC with a retrospective review pre-implementation and prospective collection of clinical data post-implementation. The completeness of workup and the timeliness of treatment pre- and post-implementation of the LABC E-PATH in May 2010 were assessed. Results: With the implementation of the LABC E-PATH in May 2010 at SMH, the delay between the identification of the patient as LABC and their referral to a medical oncologist for treatment for their LABC decreased from a median of 9 days pre-implementation, (range 0-780 days) to 1 day post-implementation, (range 0-52 days). The time between referral to medical oncologist and the start of their chemotherapy treatment decreased from a median of 12 days to 9 days (pre-implementation: range = 4 to 494, post-implementation: range = 0 to 39). All pre-treatment staging was completed faster post-implementation of the LABC e-path than pre-implementation, expediting time to initiation of chemotherapy. The number of referrals for LABC to the SMH program increased from < 1 patient per month to 5 patients per month post-implementation. Conclusions: The LABC E-PATH at SMH has achieved its goal of expediting care for this patient population. It has also ensured timely and appropriate resource allocation. This unique system may also be applied to other disease sites where coordination of a multi-disciplinary team is critical for appropriate patient management.
Renal Function Tests: What Do They Mean? A Review of Renal Anatomy, Biochemistry, and Physiology
Authors: W. O. Berndt
Journal: Environmental Health Perspectives (1976)

Renal physiology, biochemistry, and anatomy are reviewed. For the most part, those aspects of these disciplines will be discussed which relate directly to the question of the evaluation of nephrotoxicity. In addition, emphasis is placed on those procedures and techniques which are useful in the evaluation of nephrotoxicity. A detailed discussion of histological and anatomical considerations is not given, since this is probably the least useful criterion for evaluation of renal damage. This information is intended as background for the remainder of the symposium which will be directed toward an understanding of specific nephrotoxicity phenomena.
EXPERIMENTALLY PRODUCED CONVULSIONS AND EPILEPSY
Journal: JAMA (1931)

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
Facial Injuries
Authors: Erle E. Peacock
Journal: JAMA (1965)

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
Declining incidence of Haemophilus influenzae type b disease since introduction of vaccination
Authors: T. V. Murphy
Journal: JAMA (1993)

<h3>Objective.</h3> —To determine the incidence of invasive<i>Haemophilus influenzae</i>type b disease in children living in Minnesota and Dallas County, Texas, before and since introduction of plain polysaccharide vaccine in 1985, and conjugate vaccine in 1988. Initially, use of these vaccines was limited to infants 18 months of age and older. <h3>Design.</h3> —Identification of culture-proven cases of<i>H influenzae</i>type b disease was through systems of active, laboratory-based surveillance. The mean incidence of disease (cases observed/100 000 child-years) for 1983 and 1984 served as a baseline for comparison with subsequent years through 1991. <h3>Participants.</h3> —Children less than 5 years of age in Minnesota and Dallas County, Texas. Overall, there were 2557 confirmed age-eligible cases of invasive<i>H influenzae</i>type b disease from 1983 through 1991. <h3>Results.</h3> —Between the 1983-1984 baseline and 1991, the incidence of<i>H influenzae</i>type b disease decreased 85% in Minnesota and 92% in Dallas. Notably, declines in incidence were observed in children in the age group being vaccinated as well as in infants younger than 18 months of age prior to introduction of vaccination. <h3>Conclusion.</h3> —In two widely separated areas of the United States, a profound decrease in the incidence of<i>H influenzae</i>type b disease has occurred. The data suggest that vaccination may be protecting against disease, as well as decreasing the spread of infection to unvaccinated infants. (<i>JAMA</i>. 1993;269:246-248)
Editorial: Psychiatry and homicide.
Journal: BMJ (1976)

respiratory failure.Triage may be a helpful concept to the relatively inexperienced, alerting them to what to do first when there are a number of demands being made simultaneously.Triage can be taught to casualty officers, but it can also be taught to the front-line staff-the ambulance men6 and nurses.Already ambulance men are taking proficiency certificates in resuscitation and intubation.Contrary to what many doctors may believe, it may be on these men and women that the responsibility lies for action-before the patient reaches casualty at all.The concept of triage in civilian practice should mean that no considerations whatever-of administration, of hierarchy, or even of the doctors' personal feelings-may be allowed to stand in the way of prompt recognition and immediate treatment of the patient at high risk.