tbuckley/cabot-search huggingface dataset:
Combining insulin with metformin or an insulin secretagogue in non-obese patients with type 2 diabetes: 12 month, randomised, double blind trial
Authors: Søren S. Lund, Lise Tarnow, Merete Frandsen, Bente B. Nielsen, Birgitte V. Hansen, Oluf Pedersen, Hans Henrik Parving, Allan A. Vaag
Journal: BMJ (2009)

<b>Objectives</b> To study the effect of insulin treatment in combination with metformin or an insulin secretagogue, repaglinide, on glycaemic regulation in non-obese patients with type 2 diabetes. <b>Design</b> Randomised, double blind, double dummy, parallel trial. <b>Setting</b> Secondary care in Denmark between 2003 and 2006. <b>Participants</b> Non-obese patients (BMI ≤27) with preserved beta cell function. <b>Interventions</b> After a four month run-in period with repaglinide plus metformin combination therapy, patients with a glycated haemoglobin (HbA<sub>1c</sub>) concentration of 6.5% or more were randomised to repaglinide 6 mg or metformin 2000 mg. All patients also received biphasic insulin aspart 70/30 (30% soluble insulin aspart and 70% intermediate acting insulin aspart) 6 units once a day before dinner for 12 months. Insulin dose was adjusted aiming for a fasting plasma glucose concentration of 4.0-6.0 mmol/l. The target of HbA<sub>1c</sub> concentration was less than 6.5%. Treatment was intensified to two or three insulin injections a day if glycaemic targets were not reached. <b>Main outcome measure</b> HbA<sub>1c</sub> concentration. <b>Results</b> Of the 459 patients who were eligible, 102 were randomised, and 97 completed the trial. Patients had had type 2 diabetes for approximately 10 years. At the end of treatment, HbA<sub>1c</sub> concentration was reduced by a similar amount in the two treatment groups (insulin plus metformin: mean (standard deviation) HbA<sub>1c</sub> 8.15% (1.32) <i>v</i> 6.72% (0.66); insulin plus repaglinide: 8.07% (1.49) <i>v</i> 6.90% (0.68); P=0.177). Total daily insulin dose and risk of hypoglycaemia were also similar in the two treatment groups. Weight gain was less with metformin plus biphasic insulin aspart 70/30 than with repaglinide plus biphasic insulin aspart 70/30 (difference in mean body weight between treatments −2.51 kg, 95% confidence interval −4.07 to −0.95). <b>Conclusions</b> In non-obese patients with type 2 diabetes and poor glycaemic regulation on oral hypoglycaemic agents, overall glycaemic regulation with insulin in combination with metformin was equivalent to that with insulin plus repaglinide. Weight gain seemed less with insulin plus metformin than with insulin plus repaglinide. <b>Trial registration</b>NCT00118963
Elevated Serum 1,25-Dihydroxyvitamin D Concentrations in Siblings with Primary Fanconi's Syndrome
Authors: Martin Tieder, Raphael Arie, David Modai, Ruth Samuel, Joshua Weissgarten, Uri A. Liberman
Journal: New England Journal of Medicine (1988)

THE de Toni–Debré–Fanconi syndrome,1 2 3 or Fanconi's syndrome, is characterized by multiple abnormalities in renal tubular function. Defective handling of phosphate, glucose, and amino acids is the cardinal feature of the syndrome.1 , 2 Increased renal clearance of bicarbonate, sodium, potassium, calcium, and uric acid, as well as hyposthenuria, may be present.2 , 3 Rickets, osteomalacia, or both are important clinical manifestations. It has been reported that serum concentrations of 1,25-dihydroxyvitamin D (1,25-(OH)2D) in Fanconi's syndrome are either decreased4 5 6 7 or normal, but inappropriately low relative to the degree of hypophosphatemia.6 7 8 9 10 11 We describe two siblings with primary hereditary Fanconi's syndrome, severe bone disease, and . . .
Foodhandler-Associated Outbreak of Hepatitis Type A
Authors: Jules L. Dienstag, John A. Routenberg, Robert H. Purcell, Richard R. Hooper, William O. Harrison
Journal: Annals of Internal Medicine (1975)

Immune electron microscopy, which can detect hepatitis A antigen and antibody (anti-HA), was used to study a foodhandler-associated outbreak of hepatitis among 136 naval recruits. In stool specimens collected during the acute phase of illness, 27-nm viruslike hepatitis A antigen particles were shown, but only in patients with icteric hepatitis. Detection was possible in stools collected as early as 10 days before peak serum aminotransferase activity and up to the time of peak enzyme activity, but not thereafter. The immunologic similarity of these viruslike particles to those found in acute phase stools of volunteers inoculated with the MS-1 strain of hepatitis A virus was determined, and an increase in anti-HA was shown between acute and convalescent serums from 25 of the recruits. These data support the view that the MS-1 strain of hepatitis A virus is serologically related to naturally acquired type A hepatitis.
REPORT OF A CASE OF PEMPHIGUS CHRONICUS.
Authors: WILLIAM FRICK
Journal: JAMA (1903)

The word pemphigus is derived from a Greek word, which means a blister. Hence the earlier writers used the term, with some qualifying adjective, for all bullous eruptions. This gave a large number of varieties. More recently the term is more restricted in its use, and instead of some of these varieties we hear of the bullous eruptions of syphilis, impetigo bullosa, epidermolysis bullosa, etc. This seems to indicate that the work of elimination is going on and the term will in the near future be restricted in its use to some definitely described disease or perhaps several varieties of the same disease. The disease known as pemphigus vulgaris by Hebra, Kaposi and others, or as pemphigus chronicus by Unna, Crocker and others, is the one to which no other name is given, and seems entitled to be distinctly known as pemphigus. It would seem that pemphigus foliaceous is but
CARDIAC-TARGETED AAV-S100A1 HEART FAILURE GENE THERAPY: TRANSLATION OF A NOVEL MOLECULAR TARGET TOWARDS CLINICAL CARE
Authors: Sven T. Pleger, Jan Kszienyk, Raffi Bekeredjian, Gang Qiu, Christophe Weber, Hugo Katus, Walter J. Koch, Oliver Müller, Patrick Most
Journal: Journal of the American College of Cardiology (2011)
The Action of Muscles Including Muscle Rest and Muscle Re-education.
Authors: MacKenzie William Colin Sir
Journal: JAMA (1930)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Treatment Options for Carpal Tunnel Syndrome
Authors: E. F. Shaw Wilgis
Journal: JAMA (2002)

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
SHALL FRACTURE AT THE LOWER END OF THE HUMERUS BE TREATED IN THE FLEXED OR EXTENDED POSITION.
Authors: OSCAR H. ALLIS
Journal: JAMA (1894)

As only ten minutes are allotted to this paper the author can not enter into any defense of the principles herein advocated. For a fuller discussion, the reader is referred to the annals of the Anatomical and Surgical Society, Brooklyn. Vol. II. No. 8, 1880. Reprints of the artiele therein contained will be cheerfully sent to any one interested in the subject, by addressing the author, 1604 Spruce Street. For alleged malpractice, with verdict for the defendant, see paper by Dr. C. E. Kurtz, Trans. College of Physicians of Philadelphia, Pa. The advantages claimed for the rectangular position are: 1. That it is convenient, the patient can be up and about, enjoying his freedom. 2. That if ankylosis supervenes, the rectangular position furnishes the most useful stiff elbow. In regard to the first point, viz., "that it is convenient," I have simply to say that the argument has far more consideration
Endothelial integrins and angiogenesis: not so simple anymore
Authors: Dean Sheppard
Journal: Journal of Clinical Investigation (2002)

The rapid growth and precise spatial organization of new blood vessels are central features of organ development, tissue repair, and neoplasia. Like many other processes that require tight spatial regulation, blood vessel formation is critically dependent on extracellular signals that are spatially restricted by their association with components of the ECM. Once regarded as simply a structural scaffold for the maintenance of tissue integrity, the ECM has emerged over the past decade as a highly dynamic repository of positional signals. These signals include matrix-associated growth factors, cytokines, and proteases as well as the ECM proteins, such as collagens, laminins, and fibronectin, which contribute to structural integrity.

Integrins are heterodimeric transmembrane proteins that function principally as receptors for spatially restricted extracellular ligands, including most of the structural components of the ECM and several matrix-associated growth factors and proteases (1). It is therefore not surprising that several integrins have been implicated in vascular development and angiogenesis (2–5). However, there is controversy about the principal integrins involved in this regulation in vivo as well as the mechanisms by which these integrins regulate normal and pathological blood vessel development.

New data from Kim et al. (6) in this issue of the JCI suggest that a resolution of this controversy may now be emerging. The authors convincingly show that in endothelial cells activated by the growth factor bFGF, inhibitors of the integrins α5β1 or αvβ3 induce apoptosis without causing cell detachment. This response, associated with the activation of protein kinase A (PKA), can be mimicked by increases in cAMP and by heterologous expression of constitutively active PKA and can be prevented by PKA inhibition. Apoptosis appears to be mediated by activation of the inducer caspase, caspase 8, both in vitro in endothelial cells and in vivo in the chick chorioallantoic membrane. Together, these results strongly suggest that a pathway that links at least two different integrins to inhibition of PKA and protection from apoptosis plays an important role in blood vessel growth or maintenance. They also identify PKA as a potential new target for antiangiogenic therapies.
How much does relapse after one year erode effectiveness of smoking cessation treatments? Long term follow up of randomised trial of nicotine nasal spray
Authors: J. A Stapleton, G. Sutherland, M. A H Russell
Journal: BMJ (1998)

inhibitor-1 and increasing severity of disease according to Dukes's stage, which is an established predictor of poor prognosis in patients with colorectal cancer.We thank the RANX05 Colorectal Cancer Study Group for the collection of the plasma samples.Contributors: HJN and NB had the original idea for and planned the study.HJN was also responsible for collecting the samples and patient data.FM established the database and participated in planning the clinical trial.JG-H developed the enzyme linked immunosorbent assay and analysed all the samples.IJC and HP were responsible for the statistical analyses of the data.The paper
Gifts to Physicians From Industry-Reply
Authors: Teri Randall
Journal: JAMA (1991)

<h3>In Reply.</h3> —The days are long gone when the only gifts that pharmaceutical companies gave physicians were pens, notepads, and free lunches. During the last decade, it has become common, and sometimes even expected, for pharmaceutical companies to offer frequent-flier miles, trips to exotic locations, and other gifts that have nothing to do with patient care. Some companies skip the formalities and just offer cold, hard cash to physicians who prescribe their products. These promotional activities are now considered unethical under the AMA's guidelines. Patients unknowingly pay for these gifts, at no benefit to themselves. In 1989, the 100-plus member Pharmaceutical Manufacturers Association spent $5 billion of its $32.4 billion total sales revenues on marketing—more than $8000 per allopathic and osteopathic physician in the United States. Over the last several years, the percentage of revenues spent on marketing and promotion has nearly equaled the percentage invested in research and development.
Reduced microvascular thrombosis and improved outcome in acute murine stroke by inhibiting GP IIb/IIIa receptor-mediated platelet aggregation.
Authors: T F Choudhri, B L Hoh, H G Zerwes, C J Prestigiacomo, S C Kim, E S Connolly, G Kottirsch, D J Pinsky
Journal: Journal of Clinical Investigation (1998)

Treatment options in acute stroke are limited by a dearth of safe and effective regimens for recanalization of an occluded cerebrovascular tributary, as well as by the fact that patients present only after the occlusive event is established. We hypothesized that even if the site of major arterial occlusion is recanalized after stroke, microvascular thrombosis continues to occur at distal sites, reducing postischemic flow and contributing to ongoing neuronal death. To test this hypothesis, and to show that microvascular thrombosis occurs as an ongoing, dynamic process after the onset of stroke, we tested the effects of a potent antiplatelet agent given both before and after the onset of middle cerebral arterial (MCA) occlusion in a murine model of stroke. After 45 min of MCA occlusion and 23 h of reperfusion, fibrin accumulates in the ipsilateral cerebral hemisphere, based upon immunoblotting, and localizes to microvascular lumena, based upon immunostaining. In concordance with these data, there is a nearly threefold increase in the ipsilateral accumulation of 111In-labeled platelets in mice subjected to stroke compared with mice not subjected to stroke. When a novel inhibitor of the glycoprotein IIb/IIIa receptor (SDZ GPI 562) was administered immediately before MCA occlusion, platelet accumulation was reduced 48%, and fibrin accumulation was reduced by 47% by immunoblot densitometry. GPI 562 exhibited a dose-dependent reduction of cerebral infarct volumes measured by triphenyltetrazolium chloride staining, as well as improvement in postischemic cerebral blood flow, measured by laser doppler. GPI 562 caused a dose-dependent increase in tail vein bleeding time, but intracerebral hemorrhage (ICH) was not significantly increased at therapeutic doses; however, there was an increase in ICH at the highest doses tested. When given immediately after withdrawal of the MCA occluding suture, GPI 562 was shown to reduce cerebral infarct volumes by 70%. These data support the hypothesis that in ischemic regions of brain, microvascular thrombi continue to accumulate even after recanalization of the MCA, contributing to postischemic hypoperfusion and ongoing neuronal damage.
Making Monsters: False Memory, Psychotherapy and Sexual Hysteria
Authors: Burton C. Einspruch
Journal: JAMA (1995)

Recovered memories of early sexual trauma, satanic ritual reconstructions, and the development of multiple personalities satisfy the wish of both patient and therapist to understand a bewildering array of symptoms that plead cautious study. Until the 1970s, multiple personalities were considered extremely rare. Although almost entirely absent from the European and Japanese literature, more cases of multiple personality have been described in the past five years than collectively in the past hundreds of years. The Federal Bureau of Investigation has not found one single case of satanic cult ritual burial remains, although tens of thousands of individuals every year are purported to have been victims. <i>Making Monsters</i>is an overdue book in which Richard Ofshe, a Pulitzer Prize— winning social psychologist, and writer Ethan Watters sensitively and scientifically dissect an epidemic. They acknowledge that there is no excusing of incest and that sexual abuse is a practice condemned by essentially
Ischaemic Heart Disease in Young Women
Authors: M. F. Oliver
Journal: BMJ (1974)

The mortality rate from ischaemic heart disease (I.H.D.) has increased in young women by about 50% in 12 years, and it is now possible to report the findings in 150 women who developed symptoms and signs of I.H.D. under the age of 45. Data obtained from 145 of these women form the basis of this report: 81 presented with myocardial infarction and 64 with angina. In the remaining five there was a definite nonatherosclerotic cause for the premature onset of I.H.D.Hypercholesterolaemia, hypertension, or excessive cigarette smoking each occurred in a large minority, and more than one of these major risk factors was present in most patients. Hypercholesterolaemia was the commonest factor. In women in whom lipoprotein typing was undertaken the type II pattern was more frequent than type IV. The prevalence of hypercholesterolaemia and hypertension was the same in those with myocardial infarction and in those with angina.Excessive cigarette smoking was more common in women with myocardial infarction than in those with angina. The latter did not differ in their cigarette smoking habits from the normal population.A premature menopause had occurred in 20% of these women, but there was no relation between the early onset of I.H.D. with age at menarche, parity, or the incidence of abortion. Oral contraceptives did not increase the risk of myocardial infarction unless one of the major risk factors was also present.Altogether 75% of patients with angina or myocardial infarction survived 12 years. Coexisting hypertension worsened the prognosis. The prognosis after myocardial infarction was similar in these women to that previously described for men under the age of 40.
Commentary: Swedish initiative on person centred care
Authors: Inger Ekman, Håkan Hedman, Karl Swedberg, Catarina Wallengren
Journal: BMJ (2015)

The Swedish approach to implementing person centred care is being led and evaluated by a dedicated unit established in 2010 at the University of Gothenburg. The unit focuses primarily on people living with long term conditions. It is funded by the Swedish government (€10m; £8m; $12m) as part of a broad initiative to stimulate research at Swedish universities. The centre conducts research, develops and distributes educational resources such as courses for health professionals and students , and facilitates implementation of person centred care programmes in local hospitals and primary care centres by providing guidance on reshaping services and ongoing support. Feedback from managerial and clinical staff suggests that reinforcing shared decision making between patients and clinicians increases professional satisfaction.1 From the outset patient representatives have …
CHEMICAL VERSUS SERUM TREATMENT OF EPIDEMIC MENINGITIS
Authors: Simon Flexner, Harold L. Amoss
Journal: The Journal of Experimental Medicine (1916)

Claims of efficiency have been made at two widely separated periods for the chemical treatment of epidemic meningitis, in the first instance for lysol and in the second for protargol. The use of lysol was long since abandoned; the recommendation for protargol is based on a single series of cases, small in number. Because of the variable severity of epidemics of meningitis, small reliance can be placed on results of treatment limited in extent to small numbers of cases and to one locality. A more uniform and accurate measure of the value of a method of treatment is provided by animals infected experimentally with pathogenic cultures of meningococci. Young guinea pigs respond in a definite manner to intraperitoneal inoculation of virulent meningococci. Neither protargol nor lysol proved to have any curative action on the experimental infection thus produced in these animals. Monkeys respond in a characteristic manner to the inoculation of virulent cultures into the subarachnoid space. Protargol displayed no curative action on the experimental infection thus produced in these animals. On the contrary, both lysol and protargol exert antileukotactic and antiphagocytic effects, and are also potent protoplasmic poisons, and the leukocytes with which they come in contact are injured and made to degenerate. According to the extent to which these harmful properties are exerted, the chemicals promote the advance rather than restrain the progress of meningococcic infection. Recovery from meningococcic infection in man and animals is accomplished chiefly through the process of phagocytosis. The specific antiserum acts curatively by increasing the emigration of leukocytes, by promoting phagocytosis directly, and by agglutinating the meningococci, and also by neutralizing endotoxin. Any means which interfere with and reduce these essential processes retard or prevent recovery. Both lysol and protargol interfere with and diminish the emigration of leukocytes and the phagocytosis of meningococci, and neither possesses antitoxic power. The mixture of antiserum with lysol and with protargol reduces to a certain extent the antileukotactic and antiphagocytic effect of the chemicals; but this action is insufficient to set aside wholly the injurious effects which they produce. It follows, therefore, that whatever theoretical advantages might accrue from a bactericidal activity exerted by these chemicals independently of the type of meningococcus causing epidemic meningitis, is more than offset by the harmful effects which they cause. Hence specific antiserum seems to provide the logical therapeutic agent with which to combat epidemic meningitis, since it is itself innocuous and promotes those processes essential to recovery from the disease. The problem up to the present has been that of producing an antiserum which represents the several types of the meningococcus, and this problem is now in a fair way to being solved.