tbuckley/cabot-search huggingface dataset:
Role of the Nonuniversity Hospital in Surgical-Resident Training
Authors: Welles A. Standish
Journal: New England Journal of Medicine (1961)

IN discussing the role of the nonuniversity hospital A in surgical-resident training, I am touching upon a subject that concerns all surgeons. In compiling the material for this paper, I have come to the conclusion that all should be interested because university and nonuniversity teaching hospitals have one common problem: the diminishing number of service patients for surgical-resident training. This situation is becoming so acute that, unless it is corrected, it is conceivable that the whole concept of surgical training will have to be revised — even going back to the old preceptorship. Possibly, the title of this paper should . . .
Sensitization, asthma and allergic disease in young soccer players
Authors: M. T. Ventura, A. Cannone, D. Sinesi, R. Buquicchio, M. Carbonara, E. Di Leo, M. Bonini, M. Dagnello, S. Bonini
Journal: Allergy (2009)

The aim of this study was to identify the prevalence of allergic disease in young soccer players compared to age-matched students and to evaluate if this prevalence changes as the intensity of training increases.A modified ECRHS questionnaire was administered to 194 soccer players divided by age as Beginners (8-11 years), Juniors (12-16 years) and Under 21 (17-20 years) to evaluate the prevalence of allergic diseases and symptoms as well as drug consumption. Subjects with a positive personal history of allergic diseases underwent skin prick and/or patch tests. Age-matched students (n = 136) were used as a control group.The prevalence of allergic diseases was 34.5% in soccer players and 31.6% in control subjects (n.s.). Skin sensitization to inhalant allergens was detected in 14.4% of symptomatic soccer players and in 19.2% of control students (n.s.). Patch tests were positive in 35.7% of soccer players and 23.0% of controls with allergic dermatitis (n.s.). The prevalence of allergic diseases did not significantly change in relation to the intensity of training. Although the relative prevalence of sensitization to perennial allergens and asthma was less frequent in soccer players than in controls, and the occurrence of exercise-induced bronchoconstriction was similar in the two groups, soccer players used twice as many anti-allergic and anti-asthmatic drugs as control students.An increasingly intensive training programme is not associated with greater risk of allergic disease in soccer players. Therapy regimens of allergic athletes and exercisers should be monitored more closely to guarantee adequate treatment yet avoid inappropriate drug use and doping practices.
Fundamentals of Sleep Medicine
Authors: Marcel Hungs
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
Managing clinical risk
Authors: J Mant, A Gatherer
Journal: BMJ (1994)

The number of negligence claims made against health authorities rose dramatically during the 1980s.1 Since Crown Indemnity was introduced in 1990 the responsibility for meeting these claims has shifted from defence organisations to health authorities and NHS trusts. Settling these claims in England currently costs an estimated pounds sterling 75m a year2 - money that could otherwise be spent on patient care. What can NHS trusts do to minimise these costs?

The NHS Executive has recently issued Risk Management in the NHS, which recommends to chief executives that “risk management . . . is no longer an optional extra.”3 Four categories of risk management are identified: risks that relate to clinical care; non-clinical risks to patient safety, such as security and fire hazards; risks to the health of the workforce; and organisational risks, such as failure to safeguard confidential information and unlicensed use of computer software.

But how does risk management relate to clinical care? It aims at reducing adverse events (incidents that …
Primary effusion lymphoma in an elderly patient effectively treated by lenalidomide: case report and review of literature
Authors: A Antar, H El Hajj, M Jabbour, I Khalifeh, F EL-Merhi, R Mahfouz, A Bazarbachi
Journal: Blood Cancer Journal (2014)

Primary effusion lymphoma (PEL) is a rare aggressive subset of non-Hodgkin B-cell lymphoma. It is caused by Kaposi sarcoma-associated herpesvirus/human herpesvirus type 8 (KSHV/HHV8). It occurs mainly, but not exclusively, in HIV-positive patients. PEL predominantly develops in serous cavities and occasionally in extracavitary regions. PEL carries a very poor prognosis with a median survival time of <6 months. Indeed, currently used treatment modalities such as CHOP chemotherapy are far from achieving complete and sustainable remission. Therefore, there is no clear standard of care established in the treatment of PEL patients, stressing the need for novel-targeted approaches. Here, we have attempted a comprehensive assessment of the treatment of PEL, discussed avant-garde therapies and updated the state of preclinical research with promising clinical applications in the field. These include inhibitors of viral replication, modulators of cell signaling and inflammation, nuclear factor kappa B (NF-κB) and histone deacetylase inhibitors, and recently the combination of arsenic trioxide and interferon-alpha. Some of these targeted therapies have not yet reached clinical studies, although others were used in a few individual case reports with low numbers of patients. We also describe the first case of a 77-year-old, HIV-negative, HHV8-positive patient diagnosed with PEL limited to the pleural and peritoneal cavities. He received lenalidomide 25 mg/day for 21 days every 28 days. Treatment was well tolerated with no side effects. He rapidly improved after 1 month of treatment and progressively achieved complete remission persistent after 18 months of therapy. We believe that this review will bridge an important gap between classical chemotherapy and modern approaches of targeted therapy. Finally, our findings warrant further evaluation of lenalidomide in future prospective clinical studies.
VARIATIONS IN THE COMPLEMENT ACTIVITY AND FIXABILITY OF GUINEA PIG SERUM
Authors: Hideyo Noguchi, J. Bronfenbrenner
Journal: The Journal of Experimental Medicine (1911)

The following conclusions may be drawn from the foregoing series of experiments. The complementary activity varies within a definite limit in different specimens of guinea pig serum. With sera which stood in contact with the clot for twenty hours, the strongest and weakest were in the ratio of 0.015 cubic centimeter to 0.04 cubic centimeter. The former was 2.66 times stronger than the latter. The variation observed with the same series of sera after forty-six hours was still more striking. The strongest was 0.013 cubic centimeter, and the weakest, 0.06 cubic centimeter, that is, the former was 4.6 times stronger than the latter. These findings agree with those made by Massol and Grysez. The variations were not so marked with the majority of sera. It is noteworthy that a large number of the sera gained in the complementary activity when remaining in contact with the clot for forty-six hours, while some sera became weakened during the same length of time. The amount of serum fixed by given constant quantities of syphilitic serum and antigen varies much more markedly than the variations in their complementary activity. One serum failed altogether to be fixed. On the other hand, one sample of serum was so easily fixable that 0.24 cubic centimeter (corresponding to 9.6 complement units of this specimen) disappeared, while the average quantity fixed was only 0.098 cubic centimeter (corresponding to 4.64 complement units). The normal standard of fixability was shown in about 50 per cent. of the specimens examined. If the zone of normal fixability is enlarged in both directions by one unit, the percentage of normal fixability would become 65.8. There is no definite relationship between the complementary activity and the fixability of a given specimen of guinea pig serum. The facts derived from our present experiments, especially in regard to the exceptions in the fixative quality of this serum, demand the utmost precaution from those intending to employ it for diagnostic purposes, as, for example, in the Wassermann reaction. No quantitative work is possible with the complement fixation reaction unless the experimenter is capable of determining the fixability of the serum in use. One of us (Noguchi) has long realized this source of error, and in order to reduce it he has advised the employment of a mixture of sera from more than two guinea pigs.
Exocrine Pancreatic and β-cell Function in Malnutrition-Related Diabetes Among North Indians
Authors: Eesh Bhatia, Sanjay S Baijal, K Ramesh Kumar, Gourdas Choudhuri
Journal: Diabetes Care (1995)

OBJECTIVE To compare the pancreatic exocrine and β-cell function in the two variants of malnutrition-related diabetes mellitus (MRDM): fibrocalculous pancreatic diabetes (FCPD) and protein-deficient pancreatic diabetes (PDPD). RESEARCH DESIGN AND METHODS Fecal chymotrypsin (FCT) and fasting C-peptide levels were measured in 20 consecutive patients with FCPD and 19 with PDPD. FCPD was diagnosed by pancreatic calcification on ultrasonography, while the diagnosis of PDPD was made on the basis of low body mass index, severe diabetes requiring insulin therapy, and ketosis resistance on interruption of insulin. Twenty patients with type I diabetes and 32 healthy subjects served as control subjects. RESULTS Both FCPD and PDPD patients had diminished levels of FCT when compared with those of control subjects and patients with type I diabetes. However, FCT levels were significantly lower in subjects with FCPD (median 0.4 U/g, range 0–8.9 U/g), in comparison with those with PDPD (4.7 U/g, 0.6–40.5 U/g; P &amp;lt; 0.001). Of the FCPD patients, 13 of 20 (65%) had severe exocrine pancreatic deficiency (FCT &amp;lt; 1 U/g) vs. 3 of 19 (15.8%) PDPD subjects (P &amp;lt; 0.01). In comparison with control subjects, fasting serum C-peptide levels were significantly diminished in both MRDM groups. However, C-peptide levels in subjects with FCPD (mean ± SE, 0.22 ± 0.04 nmol/l) and PDPD (0.26 ± 0.04 nmol/l) were comparable. CONCLUSIONS Among the two variants of MRDM, subjects with FCPD have severe pancreatic exocrine deficiency in comparison with those with PDPD, even though their C-peptide levels are comparably diminished. This suggests that the pathogenesis of these two entities may differ or that the genetic and/or environmental factors leading to exocrine damage are different.
Role of adiponectin in the protective action of dietary saturated fat against alcoholic fatty liver in mice
Authors: Min You, Robert V. Considine, Teresa C. Leone, Daniel P. Kelly, David W. Crabb
Journal: Hepatology (2005)

Abstract The protective effect of dietary saturated fatty acids against the development of alcoholic liver disease has long been known, but the underlying mechanism is not completely understood. We examined the involvement of the adipocyte hormone adiponectin. Circulating adiponectin levels were significantly elevated by chronic ethanol administration to mice consuming a diet high in saturated fat. The increase in circulating adiponectin was associated with the activation a set of hepatic signaling pathways mediated through AMP-activated protein kinase, PPAR-α, and PPAR-γ coactivator α, which in turn led to markedly increased rates of fatty acid oxidation, prevention of hepatic steatosis, and alleviation of liver enzyme changes. Furthermore, treatment of rat 3T3-L1 adipocytes with saturated fatty acids (palmitic or stearic acids) in the presence of ethanol increased secretion of adiponectin and enhanced activity of a mouse adiponectin promoter. In conclusion , the protective action of saturated fat against the development of alcoholic fatty liver in mice is partially mediated through induction of adiponectin. The present findings suggest a novel paradigm for dietary fatty acids in the pathogenesis of alcoholic liver disease and provide a promising therapeutic strategy—nutritional modulation of adiponectin—in treating human alcoholic fatty liver disease. (Hepatology 2005.)
Contribution of Obesity to Defects of Intracellular Glucose Metabolism in NIDDM
Authors: Joyce W Chung, Kyo-Il Suh, Mary Joyce, Tim Ditzler, Robert R Henry
Journal: Diabetes Care (1995)

OBJECTIVE To examine the contribution of obesity to insulin resistance and abnormalities of intracellular glucose and fat metabolism in NIDDM. RESEARCH DESIGN AND METHODS Glucose turnover measurements and indirect calorimetry were performed in 10 obese non-insulin-dependent diabetes mellitus (NIDDM) and 10 lean NIDDM subjects (body mass index 35.3 ± 1.0 vs. 24.1 ± 0.5 kg/m2 P &amp;lt; 0.001) in the basal state and during hyperinsuhnemic (720 pmol · m-2 · min-1) euglycemic (5.0-5.5 mmol/1) clamps. RESULTS Obese and lean NIDDM subjects demonstrated similar basal rates of glucose uptake (GU) (1.15 ± 0.08 vs. 1.26 ± 0.08 mmol/min, NS) as well as oxidative (0.49 ± 0.07 vs. 0.53 ± 0.05 mmol/min, NS) and nonoxidative (0.67 ± 0.10 vs. 0.73 ± 0.12 mmol/min, NS) glucose metabolism. During hyperinsuhnemic glucose clamp studies, rates of GU were lower in obese NIDDM subjects (34.1 ± 2.3 vs. 55.2 ± 3.8 μmol · kg fat-free mass [FFM]-1 · min-1, P ≥ 0.001) as were rates of oxidative (14.1 ± 1.3 vs. 22.1 ± 2.1 μmol · kg FFM-1 · min-1 P &amp;lt; 0.005) and nonoxidative (20.0 ± 2.3 vs. 33.1 ± 3.6 μmol · kg FFM-1 · min-1 P &amp;lt; 0.01) glucose metabolism. Although absolute rates of insulin-stimulated GU were decreased in the obese group, the relative distribution into glucose oxidation (Gox) and nonoxidative glucose metabolism (Nox) was comparable in both groups (Gox 42% in obese and 41% in lean subjects; Nox 58% in obese and 59% in lean subjects). The NIDDM groups had similar basal free fatty acid levels that were suppressed equally during hyperinsulinemic clamps. However, basal fat oxidation (Fox) was greater in the obese NIDDM group (103 ± 11 vs. 73 ± 8 μmol/min, P ≥ 0.05) and was less suppressed to insulin (74 ± 13 vs. 16 ± 3 μmol/ min, P &amp;lt; 0.001). CONCLUSIONS These results indicate that when obesity is present in NIDDM subjects with this degree of hyperglycemia, insulin-stimulated GU is lower by 35-40%. Reduced GU in obese NIDDM subjects leads to decreased intracellular substrate availability and lower rates of oxidative and nonoxidative glucose metabolism. Insulin suppression of Fox is also impaired when obesity is present and may contribute to decreased insulin-mediated GU in NIDDM. We conclude that obesity increases insulin resistance in NIDDM primarily by effects on GU rather than the intracellular pathways of glucose metabolism.
Geriatric Rheumatology: A Comprehensive Approach
Authors: Robert J. Quinet
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
Redox control of resistance to cis-diamminedichloroplatinum (II) (CDDP): protective effect of human thioredoxin against CDDP-induced cytotoxicity.
Authors: T Sasada, S Iwata, N Sato, Y Kitaoka, K Hirota, K Nakamura, A Nishiyama, Y Taniguchi, A Takabayashi, J Yodoi
Journal: Journal of Clinical Investigation (1996)

Thioredoxin is a small ubiquitous protein with multiple biological functions, including cellular defense mechanisms against oxidative stress. In the present study, we investigated the role of human thioredoxin (hTRX) in the acquisition of cellular resistance to cis-diamminedichloroplatinum (II) (CDDP). The expression and activity of hTRX in Jurkat T cells was dose-dependently enhanced by exposure to CDDP, as determined by immunoblot analysis and insulin reducing assay. Furthermore, chloramphenicol acetyltransferase analysis using the hTRX promoter-reporter gene construct revealed that treatment of Jurkat cells with CDDP caused transcriptional activation of the hTRX gene, which might be mediated through increased generation of intracellular reactive oxygen intermediates. To examine the biological significance of hTRX induction, we established hTRX-overexpressing derivatives of L929 fibrosarcoma cells by stable transfection with the hTRX cDNA. The clones, which constitutively expressed the exogenous hTRX, displayed increased resistance to CDDP-induced cytotoxicity, compared with the control clones. After exposure to CDDP, the control cells showed a significant increase in the intracellular accumulation of peroxides, whereas the hTRX-transfected cells did not. Taken together, these results suggest that overexpressed hTRX is responsible for the development of cellular resistance to CDDP, possibly by scavenging intracellular toxic oxidants generated by this anticancer agent.
Characterization of GLP-1 Effects on β-Cell Function After Meal Ingestion in Humans
Authors: Bo Ahrén, Jens J. Holst, Andrea Mari
Journal: Diabetes Care (2003)

OBJECTIVE—Glucagon-like peptide 1 (GLP-1) is an incretin that augments insulin secretion after meal intake and is developed for treatment of type 2 diabetes. As a novel therapeutic agent, characteristics of its β-cell effects are important to establish. Previously, β-cell effects of GLP-1 have been characterized in humans during graded intravenous infusions of glucose, whereas its effects after more physiological stimuli, like meal intake, are not known. RESEARCH DESIGN AND METHODS—Eight women (aged 69 years, fasting glucose 3.7–10.3 mmol/l, BMI 22.4–43.9 kg/m2) who had fasted overnight were served a breakfast (450 kcal) with intravenous infusion of saline or synthetic GLP-1 (0.75 pmol · kg–1 · min–1), and β-cell function was evaluated by estimating the relationship between glucose concentration and insulin secretion (calculated by deconvolution of C-peptide data). RESULTS—GLP-1 markedly augmented insulin secretion, despite lower glucose. Total insulin secretion was 29.7 ± 4.2 nmol/m2 with GLP-1 versus 21.0 ± 1.6 nmol/m2 with saline (P = 0.048). GLP-1 increased the dose-response relationship between glucose concentration and insulin secretion (70 ± 26 with GLP-1 versus 38 ± 16 pmol insulin · min−1 · m2 · mmol−1 glucose · l without, P = 0.037) and augmented the potentiation factor that modulates the dose response (2.71 ± 0.42 with GLP-1 versus 0.97 ± 0.17 without, P = 0.005). The potentiation factor correlated to GLP-1 concentration (r = 0.53, P &amp;lt; 0.001); a 10-fold increase in GLP-1 levels produced a twofold increase in the potentiation factor. These effects of GLP-1 did not correlate with fasting glucose levels or BMI. CONCLUSIONS—Administration of GLP-1 along with ingestion of a meal augments insulin secretion in humans by a dose-dependent potentiation of the dose-response relationship between plasma glucose and insulin secretion.
ABC of arterial and vascular disease: Secondary prevention of peripheral vascular disease
Authors: S. Tierney
Journal: BMJ (2000)

<h3>Background</h3> Injuries are a leading cause of death and disability in children. The majority of these deaths occur in low- and middle-income countries and disproportionately on children from the most disadvantaged groups. <h3>Methods</h3> During April – May 2014, the Health Behaviour in School Aged Children (HBSC) study was conducted in Albania, including a representative sample of 4898 school children (2507 girls and 2391 boys) aged 11, 13 and 15 years. The data were collected through self-completion questionnaires administered in the classroom. <h3>Results</h3> 35% of the children 11, 13, 15 years reported that during the past year they have been injured at least once, in such a manner that they needed medical intervention. Of these, 11% have required serious medical interventions up to hospitalisation. Home surroundings (11%), sport facilities (8%), school (6%) and streets (4%) are the most frequent environments for the occurrence of injuries among children. About 14% of the children have been injured during sport exercises, whereas 7% of the them have been injured while walking in the street. In all cases, boys have been substantially more injured compared with the girls. <h3>Conclusions</h3> Our findings indicate the urgent need for improving the environment where children are involved, for being safe and free from injury. Informing interventions to prevent and reduce injuries among children should be a priority of public health as well as, programmes for child health should give priority to preventing and controlling child injuries in Albania.
Primary care emergency centres Will result in chaos
Authors: L C Luke, K Kumar, D B Olney
Journal: BMJ (1994)

EDITOR, - Before general practitioners proceed in their experimentation with out of hours services, I wish to plead for less muddled nomenclature. Tom O'Dowd and Hamish Sinclair report the collapse of general practitioners' enthusiasm for 24 hour availability under a tidal wave of patient “consumerism” and the plans for primary care emergency centres, to which existing accident and emergency departments could reroute some of their patients who attend inappropriately.1

But do the authors really believe that fewer patients will attend inappropriately or, more importantly, that the public (or even paramedical staff) will be able to distinguish between a “primary care emergency” and an “accident and emergency department emergency”? Plainly they are unaware that accident and emergency medicine (the fastest growing discipline in Britain2) originated in the chaotic conditions of the 800 casualty …