tbuckley/cabot-search huggingface dataset:
Future Therapy of the Insulin-dependent Diabetic Patient—The Implantable Insulin Delivery System
Authors: David S Schade, R Philip Eaton, Gary A Carlson, Raymond E Bair, John I Gaona, Jerry T Love, Ruben S Urenda, William J Spencer
Journal: Diabetes Care (1981)

An implantable insulin delivery system has several advantages not shared by currently available, portable external delivery devices. First, since the implantable system does not come in contact with the external environment, insulin delivery routes other than the subcutaneous tissue may be utilized without the danger of infection. These alternative routes may provide more rapid insulin absorption, enhanced hepatic insulinization, and improved diabetic control for “C”-peptide-negative brittle diabetic patients. Second, the implantable system is protected from external trauma, permitting a wider range of daily activities and sporting events. Third, the implantable system is easily concealed by clothing, thereby increasing patient acceptance of it. However, an implantable system also has disadvantages. First, surgery will be required to implant or explant the pump module and reservoir, and second, the implanted system must be highly reliable and include failsafe mechanisms to insure the safety of the recipient. These advantages and disadvantages have resulted in delineation of general specifications for an inv plantable insulin delivery system. Desirable features of an implantable insulin delivery system include (1) reliability and failsafe operation, (2) being implantable and explantable under local anesthesia, (3) long battery life, (4) multiple insulin delivery rates, (5) small size and weight, (6) biocompatible materials, (7) remote programmability based upon recipient blood glucose monitoring, and (8) ability to deliver concentrated insulin with infrequent reservoir refilling. Using available technology, each of these specifications has been incorporated into the functioning of our current implant system, which is being tested in diabetic dogs. Future experiments in man will undoubtedly alter and add to the current specifications.
Doppler Echocardiography
Authors: STEVE L. JOHNSON, DONALD W. BAKER, ROBERT A. LUTE, HAROLD T. DODGE
Journal: Circulation (1973)

A range-gated pulsed Doppler flowmeter has recently been developed that measures the average velocity of blood flow within a small tear-drop shaped (4 mm by 2 mm) sample volume. Unlike the continuous wave Doppler, the distance from the transducer face to the sampling site can be continuously varied by a range adjustment knob. Twenty patients with cardiac murmurs were evaluated in a noninvasive laboratory by brief cardiac physical examination, abbreviated phonocardiogram, complete echocardiogram, and localization of the murmurs by Doppler echocardiography. The localization depends on the detection of turbulent flow or jets at the sampling site. The murmurs included the diastolic rumble of mitral stenosis, mitral regurgitation, the murmur of left ventricular outflow tract obstruction, aortic stenosis, aortic insufficiency, diastolic rumble of tricuspid stenosis, augmented right ventricular filling sound in atrial septal defects, pulmonic stenosis, pulmonic insufficiency, and high velocity flow through the obstruction in ccarctation of the aorta.
Reversible toxicity in poisoning with colloidal bismuth subcitrate.
Authors: M. Hudson, N. A. Mowat
Journal: BMJ (1989)

particularly in a mobile service in which flexibility is limited.Furthermore, its use may affect acceptability.In conclusion, higher compliance is achievable with preallocated appointments, though the method described requires further evaluation especially for use in mobile screening.We thank the staff of the Aylesbury Vale breast screening service for their help and Drs E Rose and M Orton for allowing us to study patients under their care.1 Working Party on Breast Cancer Screening.Report to the health ministers of England, Wales, Scotland and Northern Ireland.London:
Changes in atrial electrical properties following cardioversion of chronic atrial fibrillation: relation with recurrence
Authors: E Manios
Journal: Cardiovascular Research (2000)

To study the reversibility of atrial electrical remodeling and its relation with recurrence in post-conversion chronic atrial fibrillation (CAF) patients.In 28 drug-free CAF patients (mean AF duration 41+/-39 months) electrically converted to sinus rhythm effective refractory period (ERP) at 500 ms, monophasic action potential at 90% of repolarization (MAPd90) at five cycle lengths (CL, 350, 400, 450, 500, 600 ms), and P wave duration were measured three times: within the interval 5-20 min post-conversion, 24 h and 1 month later. Fifteen subjects with no history of AF and normal atrial structure served as a control group. Patients were followed up for recurrence for 1 month; 12 relapsed.ERP changed from 205+/-20 to 243+/-31 to 241+/-24 ms (P<0. 001), attaining a level comparable to that of the controls (238+/-21 ms) within 24 h. MAPd90 significantly (P<0.001) increased (from 175+/-11 to 190+/-19 to 191+/-10 ms at CL 350 ms and 201+/-12 to 234+/-20 and 233+/-23 ms at CL 600 ms) also reaching control levels within 24 h. MAPd90 exhibited an abnormal adaptation to rate only in the first evaluation. P wave duration was prolonged (137+/-33 ms) and exhibited a slower course of shortening (130+/-32 to 123+/-27 ms, P<0.001), reaching control levels within 1 month. Patients with higher values of MAPd90 at CL 350 in the immediate post-conversion period were more likely to relapse (P<0.005).ERP and repolarization shortening as a result of CAF are reversed within 24 h after conversion, while P wave duration reduces more slowly. Post-conversion MAPd90 values contain prognostic information for recurrence.
The Pattern of Discharge and Readmission in Norwegian Mental Hospitals, 1936-1963
Authors: ØRNULV ØDEGÅRD
Journal: American Journal of Psychiatry (1968)

This analysis of over 17,000 first admissions to psychiatric hospitals in Norway during the period 1936 to 1958 is based upon three separate four-year cohorts of patients admitted for psychoses. The data do not support the theory that the current rising rates of discharge and readmission reflect a "revolving door" pattern of multiple readmissions which can be traced to the introduction of psychoactive drug therapy.
Interferon-γ induces progressive nigrostriatal degeneration and basal ganglia calcification
Authors: Paramita Chakrabarty, Carolina Ceballos-Diaz, Wen-Lang Lin, Amanda Beccard, Karen Jansen-West, Nikolaus R McFarland, Christopher Janus, Dennis Dickson, Pritam Das, Todd E Golde
Journal: Nature Neuroscience (2011)
Differential Activation of the Phosphatidylinositol 3′-Kinase/Akt Survival Pathway by Ionizing Radiation in Tumor and Primary Endothelial Cells
Authors: Daniel Zingg, Oliver Riesterer, Doriano Fabbro, Christoph Glanzmann, Stephan Bodis, Martin Pruschy
Journal: Cancer Research (2004)

Abstract Ionizing radiation induces an intracellular stress response via activation of the phosphatidylinositol 3′-kinase (PI3K)/Akt survival pathway. In tumor cells, the PI3K/Akt pathway is induced through activation of members of ErbB receptor tyrosine kinases. Here, we investigated the receptor dependence of radiation-induced PI3K/Akt activation in tumor cells and in endothelial cells. The integrity of both the ErbB and the vascular endothelial growth factor (VEGF) ligand-activated PI3K/Akt pathway in endothelial cells was demonstrated using specific ErbB and VEGF receptor tyrosine kinase inhibitors. Irradiation of endothelial cells resulted in protein kinase B (PKB)/Akt activation in a similar time course as observed in response to VEGF. More importantly, radiation-induced PKB/Akt phosphorylation in endothelial cells was strongly down-regulated by the VEGF receptor tyrosine kinase inhibitor, whereas the ErbB receptor tyrosine kinase inhibitor did not affect PKB/Akt stimulation in response to irradiation. An opposite receptor dependence for radiation-induced PKB/Akt phosphorylation was observed in ErbB receptor-overexpressing A431 tumor cells. Furthermore, direct VEGF receptor phosphorylation was detected after irradiation in endothelial cells in absence of VEGF, which was almost completely inhibited after irradiation in presence of the VEGF receptor tyrosine kinase inhibitor. These data demonstrate that ionizing radiation induces VEGF ligand-independent but VEGF receptor-dependent PKB/Akt activation in endothelial cells and that PI3K/Akt pathway activation by radiation occurs in a differential cell type and receptor-dependent pattern.
Abstract B3: Angiotensin IV-Related Hepatocyte Growth Factor Antagonists act as Anti-Angiogenic Anti-Cancer Agents
Authors: Leen H. Kawas, Brandi C. Ward, Chromewell Mojica, John W. Wright, Joseph W. Harding
Journal: Clinical Cancer Research (2012)

Abstract Hepatocyte growth factor (HGF) promotes tumor angiogenesis by both vascular endothelial growth factor (VEGF)-dependent and VEGF-independent mechanisms. The VEGF-dependent action of HGF relies on its ability to induce VEGF expression while the VEGF-independent mechanism appears to involve the direct activation of Akt and ERK. This later mechanism may also be an important contributor to development of tumor resistance to anti-VGEF (anti-angiogenic) drugs. As such, the rational design of newer therapeutics that target and inhibit HGF may provide a more complete and long-lasting therapeutic effect. Angiogenesis, the development of new blood vessels, is essential for tumorigenesis. Tumor cells often up-regulate the production of pro-angiogenic growth factors such as the HGF. The angiotensin IV analog Norleual has been shown recently to act as an HGF/Met antagonist, inhibiting HGF dimerization and activation, blocking the binding of HGF to its Met receptor, impeding HGF-dependent activation of Met, and attenuating HGF-dependent cellular activities. Here we show for the first time that Norleual can inhibit the proliferation and migration of human endothelial cells. Further Norleual treatment results in a dramatic loss of deposited extracellular matrix proteins from both human endothelial and murine breast cancer cells. As anticipated from the abovementioned studies, Norleual markedly attenuated both ex vivo and in vivo angiogenesis. These results were extended to a murine breast cancer model where Norleual dramatically suppressed both tumor growth and vascularization. The major implication of this study is that molecules targeting the HGF/Met system like Norleual are powerful antiangiogenics and may be useful in combination with anti-VGEF drugs (multitargeted approach) to inhibit pathophysiological angiogenesis. Rational combination therapies may help in decreasing the possibility for drug resistance development and resolving issues related to toxicity.
Unconscious Race and Social Class Bias Among Acute Care Surgical Clinicians and Clinical Treatment Decisions
Authors: Adil H. Haider, Eric B. Schneider, N. Sriram, Deborah S. Dossick, Valerie K. Scott, Sandra M. Swoboda, Lia Losonczy, Elliott R. Haut, David T. Efron, Peter J. Pronovost, Pamela A. Lipsett, Edward E. Cornwell, Ellen J. MacKenzie, Lisa A. Cooper, Julie A. Freischlag
Journal: JAMA Surgery (2015)

Significant health inequities persist among minority and socially disadvantaged patients. Better understanding of how unconscious biases affect clinical decision making may help to illuminate clinicians' roles in propagating disparities.To determine whether clinicians' unconscious race and/or social class biases correlate with patient management decisions.We conducted a web-based survey among 230 physicians from surgery and related specialties at an academic, level I trauma center from December 1, 2011, through January 31, 2012.We administered clinical vignettes, each with 3 management questions. Eight vignettes assessed the relationship between unconscious bias and clinical decision making. We performed ordered logistic regression analysis on the Implicit Association Test (IAT) scores and used multivariable analysis to determine whether implicit bias was associated with the vignette responses.Differential response times (D scores) on the IAT as a surrogate for unconscious bias. Patient management vignettes varied by patient race or social class. Resulting D scores were calculated for each management decision.In total, 215 clinicians were included and consisted of 74 attending surgeons, 32 fellows, 86 residents, 19 interns, and 4 physicians with an undetermined level of education. Specialties included surgery (32.1%), anesthesia (18.1%), emergency medicine (18.1%), orthopedics (7.9%), otolaryngology (7.0%), neurosurgery (7.0%), critical care (6.0%), and urology (2.8%); 1.9% did not report a departmental affiliation. Implicit race and social class biases were present in most respondents. Among all clinicians, mean IAT D scores for race and social class were 0.42 (95% CI, 0.37-0.48) and 0.71 (95% CI, 0.65-0.78), respectively. Race and class scores were similar across departments (general surgery, orthopedics, urology, etc), race, or age. Women demonstrated less bias concerning race (mean IAT D score, 0.39 [95% CI, 0.29-0.49]) and social class (mean IAT D score, 0.66 [95% CI, 0.57-0.75]) relative to men (mean IAT D scores, 0.44 [95% CI, 0.37-0.52] and 0.82 [95% CI, 0.75-0.89], respectively). In univariate analyses, we found an association between race/social class bias and 3 of 27 possible patient-care decisions. Multivariable analyses revealed no association between the IAT D scores and vignette-based clinical assessments.Unconscious social class and race biases were not significantly associated with clinical decision making among acute care surgical clinicians. Further studies involving real physician-patient interactions may be warranted.
Genome-wide analysis of transcriptional regulators in human HSPCs reveals a densely interconnected network of coding and noncoding genes
Authors: Dominik Beck, Julie A. I. Thoms, Dilmi Perera, Judith Schütte, Ashwin Unnikrishnan, Kathy Knezevic, Sarah J. Kinston, Nicola K. Wilson, Tracey A. O’Brien, Berthold Göttgens, Jason W. H. Wong, John E. Pimanda
Journal: Blood (2013)
Physician by Number
Authors: Rachel A Winer
Journal: JAMA (2009)

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
Barbiturate and anticonvulsant treatment in relation to osteomalacia with haemodialysis and renal transplantation.
Authors: A M Pierides, H A Ellis, M Ward, W Simpson, K M Peart, F Alvarez-ude, P R Uldall, D N Kerr
Journal: BMJ (1976)

To elucidate mechanisms underlying mitochondrial dysfunctions induced by glutamate, we have examined the effects of <i>in vivo</i> treatment with the ionotropic glutamate receptor agonist kainate on localization of the transcription factor activator protein-1 (AP-1) in mitochondria as well as nuclei of murine brain. A systemic administration of kainate dramatically enhanced AP-1 DNA binding in both mitochondrial and nuclear extracts of mouse cerebral cortex and hippocampus 1 hr to 3 d later. Unlabeled AP-1 probe selectively competed for AP-1 DNA binding in mitochondrial extracts of cortex and hippocampus obtained from mice injected with kainate. Supershift and immunoblotting analyses revealed participation of c-Fos, Fos-B, and Jun-B proteins in potentiation by kainate of mitochondrial AP-1 DNA binding in cortex and hippocampus. An immunohistochemical study demonstrated marked expression by kainate of c-Fos protein in the pyramidal and dentate granular layers, whereas an immunoelectron microscopic analysis showed localization of c-Fos protein within mitochondria, as well as nuclei, of the CA1 pyramidal and dentate granular cells in hippocampus obtained 2 hr after the administration of kainate. Mitochondrial AP-1 DNA binding was inhibited by particular unlabeled oligonucleotides containing sequences similar to the AP-1 site found in the noncoding region of mitochondrial DNA. Kainate markedly potentiated binding of radiolabeled oligonucleotide probes containing sequences effective in competing for AP-1 DNA binding in hippocampal mitochondrial extracts. These results suggest that kainate may facilitate expression of the AP-1 complex and subsequent translocation into mitochondria to participate in mechanisms associated with transcriptional regulation of mitochondrial DNA in murine hippocampus.
Half of US patients with advanced dementia are prescribed drugs of questionable benefit, study finds
Authors: M. McCarthy
Journal: BMJ (2014)

More than half of patients with advanced dementia in US nursing homes are prescribed medicines of questionable benefit even though they have reached the end stage of the disease and have just a short time to live, a new study has found. 

The article was published online on 8 September in JAMA Internal Medicine .1 Jennifer Tjia, of the University of Massachusetts Medical School in Worcester, Massachusetts, was the paper’s lead author.

In the study, Tjia and her colleagues used data from a prescriptions database maintained by a pharmacy that serves about half of the 1.3 million residents of long term care facilities in the United States and from another database, the Minimum Data Set (MDS), which contains clinical assessments of nursing home residents in all federally funded US nursing homes. The assessments included information …
Randomized Comparison of Everolimus-Eluting and Paclitaxel-Eluting Stents
Authors: Gregg W. Stone, Mark Midei, William Newman, Mark Sanz, James B. Hermiller, Jerome Williams, Naim Farhat, Ronald Caputo, Nicholas Xenopoulos, Robert Applegate, Paul Gordon, Roseann M. White, Krishnankutty Sudhir, Donald E. Cutlip, John L. Petersen
Journal: Circulation (2009)

Background— In the prospective randomized Clinical Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients with de novo Native Coronary Artery Lesions (SPIRIT) III trial, an everolimus-eluting stent (EES) compared with a widely used paclitaxel-eluting stent (PES) resulted in a statistically significant reduction in angiographic in-segment late loss at 8 months and noninferior rates of target vessel failure (cardiac death, myocardial infarction, or target vessel revascularization) at 1 year. The safety and efficacy of EES after 1 year have not been reported. Methods and Results— A total of 1002 patients with up to 2 de novo native coronary artery lesions (reference vessel diameter, 2.5 to 3.75 mm; lesion length ≤28 mm) were randomized 2:1 to EES versus PES. Antiplatelet therapy consisted of aspirin indefinitely and a thienopyridine for ≥6 months. Between 1 and 2 years, patients treated with EES compared with PES tended to have fewer episodes of protocol-defined stent thrombosis (0.2% versus 1.0%; P =0.10) and myocardial infarctions (0.5% versus 1.7%; P =0.12), with similar rates of cardiac death (0.3% versus 0.3%; P =1.0) and target vessel revascularization (2.9% versus 3.0%; P =1.0). As a result, at the completion of the 2-year follow-up, treatment with EES compared with PES resulted in a significant 32% reduction in target vessel failure (10.7% versus 15.4%; hazard ratio, 0.68; 95% confidence interval, 0.48 to 0.98; P =0.04) and a 45% reduction in major adverse cardiac events (cardiac death, myocardial infarction, or target lesion revascularization; 7.3% versus 12.8%; hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.83; P =0.004). Among the 360 patients who discontinued clopidogrel or ticlopidine after 6 months, stent thrombosis subsequently developed in 0.4% of EES patients versus 2.6% of PES patients ( P =0.10). Conclusions— Patients treated with EES rather than PES experienced significantly improved event-free survival at a 2-year follow-up in the SPIRIT III trial, with continued divergence of the hazard curves for target vessel failure and major adverse cardiac events between 1 and 2 years evident. The encouraging trends toward fewer stent thrombosis episodes after 6 months in EES-treated patients who discontinued a thienopyridine and after 1 year in all patients treated with EES rather than PES deserve further study.
Quantifying the Impact of a Short-Interval Interruption of Insulin-Pump Infusion Sets on Glycemic Excursions
Authors: Howard Zisser
Journal: Diabetes Care (2008)

This prospective, open-label study was designed to measure the impact of short-term infusion-set disconnects on glucose levels. Continuous subcutaneous insulin infusion therapy allows for uninterrupted delivery of insulin. Patients disconnect their insulin pumps from their infusion sets when showering, swimming, exercising, or during intimate moments. Interrupting insulin infusion results in cessation of basal insulin delivery. Nineteen subjects with type 1 diabetes were studied on two separate in-clinic days. One hour after arriving at the clinic in a fasting state, subjects either temporarily disconnected their infusion sets from their pumps, interrupting basal insulin infusion for 30 min, or, on a separate day, changed their infusion sets. Glucose levels were monitored for an additional 4 h on both occasions. Changing infusion sets did not affect short-term glucose control. However, the 30-min interruption of basal insulin infusion resulted in significant glucose elevation; approximately 1 mg/dl for each minute basal insulin infusion was interrupted.